Deep Vein Thrombosis

Deep Vein Thrombosis

Case study:

Sandra is a 27-year-old female admitted with a possible Deep Vein Thrombosis (DVT). She smokes one pack per day and is on birth control. She has a history of hypertension and obesity. She is admitted to the hospital and placed on bedrest. Heparin drip is started per protocol. The Provider is anticipating on sending her home with Coumadin.

  1. Can Sandra be placed on Coumadin and Heparin at the same time? What is the reason she is on both medications at the same time? Use critical thinking skills and rationale along with data from your resource to support the reason.
  2. Develop 3 teaching points important for Sandra to know about her medications regimen.
  3. What 3 questions would you ask Sandra to verify that she understand the 3 teaching points?
  4. Please include at least 1 reference and provide appropriate citation of your reference(s), only time frame of 2019-2021 is to be used for your references

 PTSD illness

 PTSD illness

  • Briefly explain the neurobiological basis for PTSD illness.
  • Discuss the DSM-5 diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?
  • Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard treatment” from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.

Need 3 sources and must attach the 3 sources.

https://www.youtube.com/watch?v=RkSv_zPH-M4. – Give an example from this video.

reproductive morbidity

Response

discuss the condition encompassing clinical experiences and critique the post.

  • Length: A minimum of 180 words per post, not including references
  • Citations: At least one high-level scholarly reference in APA per post from within the last 5 years.

Number 1 Post: RW

Trichomonas is the most common non-viral sexually transmitted infection in the world.  It is an important source of reproductive morbidity and thus is a public health problem.  However, it is not a reportable disease and surveillance is not generally done.  Most person infected with trichomonas are asymptomatic.  The treatment of choice for women has been metronidazole, for decades, and a single dose has been the first line of defense. (Kissinger, 2015).

Pathogen and Proliferation

Trichomonas vaginalis, a parasitic protozoan, is a etiologic agent of trichomoniasis.  It is a flagellated protozoan possessing five flagella.  Although cell division has been extensively described through the use of microscopy, the life cycle of trichomonas is poorly understood.  Like many other protozoan parasites, it is known to exit only as a trophozoite and lacks a cystic stage.  Trichomonas is a primitive eukaryotic organism.  Although similar to many other eukaryotes it differs in its energy metabolism and shows remarkable similarity to primitive anerobic bacteria. (Petrin et al., 2018).  Trichomonas is a protozoan parasite that tends to destroy epithelial cells and induce pathogenesis. (Lin et al., 2015).

Male partner treatment

The CDC recommends male partners be treated with a single dose of 2g of metronidazole orally.  Concurrent treatment of all sex partners is vital for preventing reinfections.  Current partners should be referred for presumptive therapy.  Partners also should be advised to abstain from intercourse until they and their sex partners have been treated and any symptoms have resolved. (2021).

Metronidazole is a small molecule the enters trichomonas via passive diffusion.  The drug itself is inactive, but anaerobic reduction results in the formation of a cytotoxic nitro radical anion.  The nitro radial is then hypothesized to bind transiently to DNA, disrupting or breaking the strands and leading to cell death.  The action is a short-lived reaction rather than irreversible binding of the drug to DNA. (Cudmore et al., 2004).

Chlamydia

Chlamydia is a sexually transmitted infectious disease caused by the bacterium Chlamydia trachomatis.  It is the most commonly reported bacterial infection, Globally, it is the most common sexually transmitted infection.  It causes an ocular infection called “trachoma”, which is the leading infections cause of blindness worldwide.  In females, the cervix is the site that is most commonly infected. Chlamydial infections in women, especially if untreated, increase the risk of infertility and ectopic pregnancy.  In men, infection with chlamydia can lead to urethritis, epididymitis, prostatitis, proctitis, or reactive arthritis. (Mohseni et al., 2021).

 

 

Number 2 post: PG

A 16-year-old male presents with delayed pubertal signs and social immaturity. His lab values show low testosterone. He was administered GnRH, and no LH was produced. HCG was administered, which restored testosterone to normal levels.

  1. Discuss male hypogonadism
  2. Explain hormone administration
  3. Is there a problem with the hypothalamus? Why or why not?

 

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Male hypogonadism is a testosterone deficiency in men (Dlugasch & Story, 2021). According to Butanis et al. (2017), male hypogonadism results from testosterone or sperm levels in the testes not reaching the proper levels due to disruption of the hypothalamic-pituitary-testicular (HPT) axis. Male hypogonadism causes include congenital, tumors, disease, drug-related, acquired cases, or chronic illness (Salonia et al., 2019). Furthermore, a research study found metabolic syndrome as a causative factor to hypogonadism (Lawrence et al., 2017). In this document, male hypogonadism explored; primary plus secondary are explained; hormone administration explored, and is there a problem with the hypothalamus? Why or why not?

The hypothalamus releases Gonadotropin-releasing hormone (GnRH) in normal physiology (Salonia et al., 2019). Also, in response to GnRH, the anterior pituitary secretes follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Additionally, Sertoli and Leydig cells in the testis are stimulated to produce sperm and testosterone by FSH and LH. Typically, the above occurs in normal physiology. However, problems could arise due to factors that can contribute to hypogonadism. As mentioned earlier, there are two types of hypogonadism: primary and secondary. Primary hypogonadism stems from an inherent defect within the testes (Salonia et al., 2019). Therefore, low or absent testosterone levels are accompanied by high gonadotropin levels in the condition (Salonia et al., 2019).

Additionally, spermatogenesis is often severely impaired and may not respond to hormonal treatment (Salonia et al., 2019). Secondary hypogonadism (also known as central hypogonadism or hypogonadotropic hypogonadism) results from hypothalamic or pituitary dysfunction (Salonia et al., 2019). The biochemical characteristics of this condition are low or inappropriately normal gonadotropin levels and low total testosterone levels (Salonia et, 2019). Moreover, spermatogenesis is impaired, but treatment usually improves it (Salonia et ., 2019).

Clinicians should perform tests to determine if the condition is primary or secondary and treat accordingly (Lawrence et al., 2017). Also, patient education and management guidelines are vital during treatment. For example, Salonia et al. (2019) informed testosterone therapy for congenital cases of hypogonadism is lifelong, and management of acquired care depends on whether the condition can be managed or if the state is permanent. Treatment may consist of replacing testosterone to raise the level in the blood and assist in countering the symptoms of male hypogonadism (Salonia et al., 2019). Treatment, for instance of testosterone, comes in various forms, such as injectables, esters, gels, nasal gels, or oral (Salonia et al. 2019). Also, Salonia et al. (2019) mentioned treatment of males less than ten should be treated with caution due to bone age and that high doses could cause premature epiphyseal closure.

According to Mayo Clinic (2022), in male hypogonadism, one could be born with a congenital condition or develop later in life. As mentioned above, the primary problem is with the testes (Mayo clinic, 2022). However, this type of hypogonadism in secondary could indicate a problem in the hypothalamus or the pituitary gland (Mayo clinic, 2022). Moreover, The hypothalamus produces gonadotropin-releasing hormones, which cause the pituitary to produce follicle-stimulating hormones and luteinizing hormones (Mayo clinic, 2022). In addition, luteinizing hormones stimulate testosterone production in the testes (Mayo clinic, 2022).

In closing, hypogonadism is a testosterone deficiency in males, and supplemental steroids may aid in relieving symptoms of this disorder and raise the blood level of the hormone. The problem of hypogonadism may lie with the testes or central (in the brain) like the hypothalamus or pituitary gland. As professionals in health care, monitoring steroid use, client education, and client, plus steroid guidelines are vital in managing the disorder.

 

reproductive disorder

 

Sexually Transmitted Disease

 

Select ONE sexually transmitted infection (STI) or reproductive disorder (male or female) and conduct research on it. Create a concept map (not a paper) about the condition/issue. In the concept map, be sure to discuss the concepts below:

 

Four References using APA format 7 edition

      Write from nursing prospective

       No consideration for plagiarism

       DUE 2/5 @ 1400

growth and development

      

MATERNALCHILD06–Child Observation Worksheet

TOPIC: Child Observation Worksheet

 

Purpose of Assignment

This assignment will help to identify the normal growth and development by topic for each age group. In the final column of the assignment, you need to observe a child and apply the information you gathered and document your findings in comparison by the particular age of that child.

 

Competency

Compare principles of growth and development when caring for pediatric clients.

Explain the topics in the worksheet by age. Identify one milestone and one expected norm for each category by age group.

 

After you fill out the milestones and expected norms for each category by age group, imagine observe a child of any age for 30 minutes to an hour, and apply the knowledge that you learned to the child you are observing and record this information in the purple Observation Data column.

 

 

NO CONSIDERATION FOR PLAGIARISM

APA FORMAT AND INDEX CITATION, REFERENCES THREE

PLEASE WRITE FROM NURSING PERSPECTIVE

 

DUE 2/7/22 AT 11AM

 

 

 

 

FOLLOW ALL Rubric Details CORRECTLY TO AGAIN FULL POINTS

 

  • Content and Mechanics

50% of total grade

Mastery: Advanced or exceeds achievement

Contains thorough details by age group to represent the topic identified. Information is current.

30

Proficiency: Clear/effective achievement

Contains sufficient details by age group to represent the topic identified. Information is current.

27.9

Competence: Adequate/basic achievement

Contains some details by age group to represent the topic identified. Information is mostly current.

25.2

Emerging: Limited or growing achievement

Details are minimal or non-existent.

19.5

  • Client Data

40% of total grade

Mastery: Advanced or exceeds achievement

Observation data is documented with extensive details.

24

Proficiency: Clear/effective achievement

Observation data is documented with sufficient details.

22.32

Competence: Adequate/basic achievement

Observation data is documented with some details.

20.16

Emerging: Limited or growing achievement

Observation data is incomplete.

15.6

  • Spelling and Grammar

5% of total grade

Mastery: Advanced or exceeds achievement

Demonstrates an exemplary application of spelling and grammar.

3

Proficiency: Clear/effective achievement

Displays proper grammar application and writing contains minimal to no spelling errors. May contain rare improper uses of words (ex., their vs. there), a misplaced modifier, or a run-on sentence, but does not detract from the overall understanding of the sentence and/or paragraph.

2.79

Competence: Adequate/basic achievement

Spelling and grammar errors occur but are inconsistent. Paragraphs and sentences are coherent but may exhibit spelling errors, run-on’s or fragments, and/or improper verb tense usage.

2.52

Emerging: Limited or growing achievement

Spelling and grammar contain substantial errors that makes sentences and/or paragraphs incoherent.

1.95

  • APA Style

5% of total grade

Mastery: Advanced or exceeds achievement

APA citations are free of style and formatting errors.

3

Proficiency: Clear/effective achievement

Errors in APA citations are less noticeable and do not detract from the ability to locate the original source (for example, a missing or misused comma or period, missing parentheses, author name not properly abbreviated, indentation is misaligned).

2.79

Competence: Adequate/basic achievement

Errors in APA citations are noticeable and may detract from the ability to locate the original source (for example, no title provided, year of publication is missing, no punctuation).

2.52

Emerging: Limited or growing achievement

Citations do not follow APA Style. Quotations, paraphrases, and summaries are not cited, or there is no attempt to cite them using APA style.

1.95

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Module 06 Worksheet- Development Assignment

Infancy Toddler Pre School School Age Adolescent Observation Data for [insert age, gender, and any other relevent information]. Example: Female, Age 4, Autistic.

*only fill out this column for the age group you observed.

Erikson’s Theory  

 

 

 

 

 

Cognitive Development

 

 

 

 

Language Development

 

 

 

 

Psych-Social Development  

 

 

 

 

 

 

Moral Development  

 

 

 

 

 

Discipline

 

 

 

 

 

 

 

 

Physical Development  

 

 

 

 

 

Injury Prevention  

 

 

 

 

 

 

Nutritional needs  

 

 

 

 

 

 

Dental Care  

 

 

 

 

 

Sleep  

 

 

 

Activity and Play types  

 

 

 

 

 

 

Vital Signs

Including type of Pain assessment

 

 

 

bronchiolitis

MATERNALCHILD_MODULE7

TOPIC: Module 07 Assignment – Pediatric Assessment: PDA with RSV

Purpose of Assignment
The goal of creating a nursing concept map and create a plan of care for a child with bronchiolitis. The nursing interventions would reflect the underlying respiratory syncytial virus with patent ductus arteriosus (PDA) history.

Competency
Apply the foundations of pediatric nursing when caring for clients with health alterations.

Scenario
You are working in a large urban pediatric clinic after-hours.
A mother brings her 6-month-old daughter, Vivi Mitchell, to the clinic for rhinorrhea, congestion, fever, and cough. Upon assessment, you identify the child has wheezing upon auscultation and on inspection, you identify retractions.
• The child is in less than 10th percentile of weight and has a cardiac history of Patent Ductus Arteriosus (PDA).
• Born at 36 weeks gestation.
• Mother states this child doesn’t go to day care but her two other children ages 2 and 3 do attend daycare.
• T- 102.1 HR 140 RR 40 BP 83/58 Pulse ox 96%
• A swab for respiratory syncytial virus (RSV) is positive.

Doctor orders – Nasal bulb suction and saline drops PRN, Tylenol 15mg/kg Q4 PRN for fever, Albuterol nebulizer in office and push po fluids as tolerated.
After the albuterol neb treatment, respirations are 36 and oxygen saturation is 100%. Wheezing has diminished. Mom is an ER nurse and the doctor feels comfortable that she has a nebulizer at home and can return to pediatric afterhours or ER if needed.
Client is discharged with these orders:
• methylprednisolone 0.4 mg/kg oral BID for 3
• Albuterol Q4 hours for 24 hours, then Q 6 hours for 24 hours, and Q6 as needed.
• Call if needed prior to the Q4 dose.
•e Manage fever with Tylenol and continue hydration and nasal bulb suction Q6 while awak.

• Return for re-evaluation in 3 days

Instructions
In a two to three-page APA formatted paper, provide reponses for these questions and requests for information: pathophysiology of bronchiolitis and identify the most common organism causing this infecti
Criteria:
1. Describe theon. What laboratory testing can confirm your suspicion?
2. Describe the pathophysiology of PDA and why the history of PDA is significant in this scenario.
3. What risk factors place Vivi Mitchell at a greater risk for the development of bronchiolitis?
4. What are the characteristic signs/symptoms of bronchiolitis?
5. Vivi Mitchell been prescribed the following medications; acetaminophen, albuterol nebulizer, corticosteroids. Provide the rationale for why each medication has been included as part of her medical management and explain any potential contraindications related to these medications.
6. You are designing Vivi Mitchell’s plan of care. Identify two priority nursing diagnoses to include in your plan. For each nursing diagnosis, identify two SMART goals, and two interventions for each goal.
7. What short and long-term possible complications should the nurse anticipate?
8. What client education is appropriate for Vivi Mitchell as she is discharged from the after-care clinic?
* Include a minimum of four scholarly sources

Format
• Standard American English (correct grammar, punctuation, etc.)
• Logical, original and insightful
• Professional organization, style, and mechanics in APA format

NO CONSIDERATION FOR PLAGIARISM
APA FORMAT AND INDEX CITATION
PLEASE WRITE FROM NURSING PROSPECTIVE

DUE 2/10/22

• FOLLOW ALL Rubric Details CORRECTLY TO AGAIN FULL POINTS

• Criteria 1, 2, 3
23% of total grade
Mastery: Advanced or exceeds achievement
Addresses criteria correctly with thorough development of the topic. Gives clinical examples. Includes research in the answer.
14.72
Proficiency: Clear/effective achievement
Addresses criteria correctly. Demonstrates solid understanding of the topic. Gives examples without research.
13.69
Competence: Adequate/basic achievement
Addresses criteria correctly. Demonstrates basic understanding of the topic.
12.36
Emerging: Limited or growing achievement
Addresses criteria incorrectly.
9.57
• Criteria 4, 5, 6
15% of total grade
Mastery: Advanced or exceeds achievement
Addresses criteria correctly with thorough development of the topic. Gives clinical examples. Includes research in the answer.
9.6
Proficiency: Clear/effective achievement
Addresses criteria correctly. Demonstrates solid understanding of the topic. Gives examples without research.
8.93
Competence: Adequate/basic achievement
Addresses criteria correctly. Demonstrates basic understanding of the topic.
8.06
Emerging: Limited or growing achievement
Addresses criteria incorrectly.
6.24
• Criteria 7, 8, 9
31% of total grade
Mastery: Advanced or exceeds achievement
Addresses criteria correctly with thorough development of the topic. Gives clinical examples. Includes research in the answer.
19.84
Proficiency: Clear/effective achievement
Addresses criteria correctly. Demonstrates solid understanding of the topic. Gives examples without research.
18.45
Competence: Adequate/basic achievement
Addresses criteria correctly. Demonstrates basic understanding of the topic.
16.67
Emerging: Limited or growing achievement
Addresses criteria incorrectly.
12.9
• Tone
15% of total grade
Mastery: Advanced or exceeds achievement
Uses consistent professional tone with excellent use of medical terminology.
9.6
Proficiency: Clear/effective achievement
Tone is professional. Good use of medical terminology.
8.93
Competence: Adequate/basic achievement
Tone is professional. Inconsistent use of medical terminology.
8.06
Emerging: Limited or growing achievement
Tone is consistently unprofessional with poor use of medical terminology.
6.24
• Spelling and Grammar
9% of total grade
Mastery: Advanced or exceeds achievement
Demonstrates an exemplary application of spelling and grammar.
5.76
Proficiency: Clear/effective achievement
Displays proper grammar application and writing contains minimal to no spelling errors. May contain rare improper uses of words (ex., their vs. there), a misplaced modifier, or a run-on sentence, but does not detract from the overall understanding of the sentence and/or paragraph.
5.36
Competence: Adequate/basic achievement
Spelling and grammar errors occur but are inconsistent. Paragraphs and sentences are coherent but may exhibit spelling errors, run-on’s or fragments, and/or improper verb tense usage.
4.84
Emerging: Limited or growing achievement
Spelling and grammar contain substantial errors that makes sentences and/or paragraphs incoherent.
3.74
• APA Style
7% of total grade
Mastery: Advanced or exceeds achievement
APA citations are free of style and formatting errors.
4.48
Proficiency: Clear/effective achievement
Errors in APA citations are less noticeable and do not detract from the ability to locate the original source (for example, a missing or misused comma or period, missing parentheses, author name not properly abbreviated, indentation is misaligned).
4.17
Competence: Adequate/basic achievement
Errors in APA citations are noticeable and may detract from the ability to locate the original source (for example, no title provided, year of publication is missing, no punctuation).
3.76
Emerging: Limited or growing achievement
Citations do not follow APA Style. Quotations, paraphrases, and summaries are not cited, or there is no attempt to cite them using APA style.
2.91

pediatric health alterations

MATERNALCHILD_Module 09 Discussion – Pediatric Safety

TOPIC: – Pediatric Safety

 

Purpose of Assignment

Part 2

This assignment will address the current issues in pediatric healthcare related to safety. Growth and development is an important factor that should be considered along with safety in many areas of pediatric health alterations. Many times, the health alterations experienced by children can be prevented if safety education is provided.

Competency

Prioritize nursing interventions when caring for pediatric clients with health disorders.

Instructions

This assignment will focus on the importance of teaching a chosen safety concern in the pediatric population. You will present your response in this assignment addressing the following questions: (assignment should be 300 words).

Initial Post:

  1. Determine the age and developmental stage and how that impacts the child related to the safety concern.
  2. Describe why you believe the safety education you chose will benefit the pediatric population. Who do you believe is the target age range for this specific educational teaching?
  3. Describe at least three nursing diagnoses related to the incident you are providing teaching to prevent. Support your choices with rationales citing three scholarly sources.

Part 2 400 words

Discuss two different safety education than you chose in part 1 and add additional rationale for why this type of education is beneficial. Cite four scholarly sources to support each.

 

NO CONSIDERATION FOR PLAGIARISM

APA FORMAT AND INDEX CITATION

PLEASE WRITE FROM NURSING PROSPECTIVE

 

DUE 2/15/22

 

 

ED RN

ED RN

A patient is receiving tissue plasminogen activator (tPA). You noticed the patient has become more drowsy and their mental status is deteriorating. Their Glasgow Coma Scale (GCS) is 10. What do you anticipate the provider to order NEXT?

Shadow Health Focused Exams

Shadow Health Focused Exams

  • Complete the ShadowHealth© Focused Exams – Special Populations: Chest Pain, Cough and Abdominal Pain assignments

After you have achieved at least 80% on the assignment(s) download, save and upload your LabPass document to the dropbox.

Professional Development

  • Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
    • What went well in your assessment?
    • What did not go so well? What will you change for your next assessment?
    • What findings did you uncover?
    • What questions yielded the most information? Why do you think these were effective?
    • What diagnostic tests would you order based on your findings?
    • What differential diagnoses are you currently considering?
    • What patient teaching were you able to complete? What additional patient teaching is needed?
    • Would you prescribe any medications at this point? Why or why not? If so, what?
    • How did your assessment demonstrate sound critical thinking and clinical decision making?

Gynecologic Health

Gynecologic Health

Select a patient that you examined as a nurse practitioner student during the last three weeks of clinical on OB/GYN Issue. With this patient in mind, address the following in a SOAP Note 1 OR 2 PAGES :

Subjective: What details did the patient provide regarding her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters for this patient , as well as a rationale for this treatment and management plan.

Very Important:  Reflection notes: What would you do differently in a similar patient evaluation?

Reference

Gagan, M. J. (2009). The SOAP format enhances communication. Kai Tiaki Nursing New Zealand, 15(5), 15.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

Chapter 6, “Care of the Well Woman Across the Life Span” ,“Care of the Woman Interested in Barrier Methods of Birth Control” (pp. 275–278)

Chapter 7, “Care of the Woman with Reproductive Health Problems”

“Care of the Woman with Dysmenorrhea” (pp. 366–368)

“Care of the Woman with Premenstrual Symptoms, Syndrome (PMS), or Dysphoric Disorder (PMDD)” (pp. 414–418)