Nursing

Familial Health Traditions
Familial Health Traditions
Instructions:
Read and follow the directions on pages 160 and 161.
Conduct an interview with an older family member.
Summarize your findings regarding familial and social changes, and your ethnocultural and religiousheritage. (Include one example)
Your paper should be:
One (1) page
Typed according to APA style for margins, formating and spacing standards
See NUR3045 – Library (located on left-side on menu) for tutorial Using APA Style
Typed into a Microsoft Word document, save the file, and then upload the file.
I ATTACHED THE PDF OF THE BOOK SO YOU CAN LOOK AT PAGE 160 AND 161 WHCIH IS PART OF CHAPTER 7
Encyclopedias almanacs transcripts and maps
Traditional Health Beliefs, Practices
Traditional Health Beliefs, Practices
Updated Sep 05 2019 Print Article Share Article
Traditional Health Beliefs, Practices
views 2,612,688 updated Sep 05 2019
TRADITIONAL HEALTH BELIEFS, PRACTICES
The beliefs and traditions of community members have a profound effect on the health of the community. Traditional beliefs regarding specific health behaviors such as smoking can influence policy, for example, on whether or not funds will be spent on antismoking legislation or on some other matter such as highway infrastructure. These beliefs also influence the types of food, recreational activities, and health services available in a community. Traditional health-related beliefs and practices among different ethnic groups fall into three groups: (1) beliefs that result in no harmful health effects, (2) beliefs that may produce beneficial health outcomes, and (3) beliefs and traditions which have serious, harmful health outcomes.
HARMLESS BELIEFS
Societies and cultures throughout the world are replete with traditional health beliefs and practices surrounding fertility. For example, pregnant women in many Asian cultures are advised that if they eat blackberries their baby will have black spots, or that if they eat a twin banana they will give birth to twins. Such ethnocentric beliefs have their foundation in folklore and traditional practices. The Vietnamese traditionally believe that disease is caused by an imbalance of the humoral forces of yin and yang. When ill, Vietnamese commonly use herbal medicines and a set of indigenous folk practices referred to as “southern medicine” in an effort to restore the yin/yang balance. These practices, from the Western viewpoint, were once thought to pose barriers to health. Recent investigations, however, revealed that certain beliefs and practices predicted neither lack of access to, nor underutilization of, health services. In fact, individuals should not be discouraged from placing faith in such beliefs, as they may result in positive health outcomes.
POSITIVE HEALTH OUTCOMES
The popular Western belief, “an ounce of prevention is worth a pound of cure,” aptly illustrates the value of prevention—the planning for and taking action to prevent or forestall the occurrence of an undesirable event. Prevention is more desirable than intervention, which is the taking of action during an event. Preventive activities include immunization for childhood diseases, the use of protective clothing or sunscreen to prevent , health-education and health-promotion programs, the use of automotive passenger restraints and bicycle helmets, chlorination of a community’s , and safe-housing projects.
Cigarette smoking, the largest preventable cause of death and disability in developed countries (and a rapidly growing health problem in developing countries), is a classic example of a behavior for which an ounce of prevention is truly worth a pound of cure. Despite thousands of conclusive studies establishing cigarette smoking as a cause of cancer, and despite the resulting coughing, odor, facial wrinkles, skin discoloration, ostracism, and increasingly socially unacceptable nature of this behavior, smoking rates remain high in certain population groups. Between 1993 and 1995, 47 percent of both black males and white males with less than twelve years of education were smokers. Among U.S. youths, in the late 1990s, more than one-third of high school seniors reported having smoked during the preceding two weeks. Unfortunately, because the debilitating effects of smoking are not visibly present for many years following initiation of the behavior, most individuals are not willing to do the “ounce of prevention” part of the adage. A different story emerges for those who do quit smoking. Smokers who have quit for up to five years soon regain positive health benefits, such as less coughing, better breathing, and life expectancies equivalent to individuals of the same age who have never smoked. An additional benefit to society is purely economic: for every dollar invested in a smoking cessation program, society gets back ten dollars in terms of decreased rates of tobacco-related morbidity and mortality (or a cost savings of over $50 billion per year at current rates of investment).
NEGATIVE OUTCOMES
On the other side of the scale are health beliefs and practices that result in physical harm or negative health outcomes. Female circumcision, or female genital mutilation (FMG), is a graphic illustration of a traditional practice with a negative health outcome. The traditional belief is that the practice of FMG ensures virginity and family honor, secures fertility, promotes the economic and social future of daughters, and perpetuates a “religious tradition.” FMG is also believed to preserve group identity, help maintain cleanliness and health, and further marriage goals, including enhancement of sexual pleasure for men. As of 2001, the practice was outlawed in the , , , the , , , , , and in some African nations, such as , , and . The practice of FMG is justified by proponents who assert it “attenuates sexual desires in girls and protects their morals.” Complications occurring immediately after the practice, and in ensuing years, range from disability to premature death. The practice is also believed to play a significant role in facilitating the transmission of human immunodeficiency virus () infection through numerous mechanisms.

Assignment: Sexual Abuse and Trauma
Assignment: Sexual Abuse and Trauma
Permalink:
Rita is a 22-year-old, heterosexual, Latina female working in the hospitality industry at a resort. She is the youngest of five children and lives at home with her parents. Rita has dated in the past but never developed a serious relationship. She is close to her immediate and extended family as well as to her female friends in the Latino community. Although her parents and three of her siblings were born in the Dominican Republic, Rita was born in the United States.
A year ago, Rita was sexually assaulted by an acquaintance of a male coworker. Rita and a female coworker met Juan and Bob after work at a local bar for a light meal and a few drinks. Because Rita had to get up early to work her shift the next day, Bob offered to drive her home. Instead of taking Rita directly home, however, he drove to a desolate spot nearby and assaulted her. Afterward, Bob threatened to harm her family if she did not remain silent and proceeded to drive her home. Although Rita did not tell her family what happened, she did call our agency hotline the next day to discuss her options. Because Rita’s assault occurred within the 5-day window for forensic evidence collection of this kind, Rita consented to activation of the county’s sexual assault response team (SART). Although she agreed to have an advocate and the sexual assault nurse examiner (SANE) meet her at the hospital, Rita tearfully stated that she did not want to file a police report at that time because she did not want to upset her family. The nurse examiner interviewed Rita, collected evidence, recorded any injuries, administered antibiotics for possible sexually transmitted infections, and gave Rita emergency contraception in case of pregnancy. The advocate stayed with Rita during the procedure, supporting her and validating her experience, and gave her a referral for individual crisis counseling at our agency.
My treatment goals for Rita included alleviation of rape trauma syndrome symptoms that included shame and self-blame, validation of self-worth and empowerment, and processing how it would feel to disclose to others when the time felt right. In addition, Rita would receive important information regarding state policy and procedure for victims of sexual assault that would assist her in deciding when and how to report the crime if she chose to do so.
My treatment involved crisis intervention and stabilization along with emotional support and validation surrounding her experience. Managing her trauma and acute stress symptoms were key to her recovery. Those symptoms included guilt, shame, emotional shock, powerlessness, anxiety, fear, anger, and doubting her judgment. We processed Rita’s emotional dysregulation and sense of outrage over what happened. Over the weeks that followed, we also explored Rita’s relationship to her immediate and extended family and how they had high expectations for her and her future. Rita’s shame over the assault prevented her from telling her family for fear they would also be shamed and judge her for accepting a ride from someone she did not know well. We discussed the policy for reporting a sexual assault to the police in our state and how Rita only had a 90-day window to report the crime after her forensic evidence was obtained. After 90 days, the forensic kit would be destroyed.
The problem with the current 90-day hold policy in our state for victims like Rita is that a person in crisis experiences strong and conflicting emotions and is faced with an acute sense of disequilibrium and disorientation. This, in turn, affects her or his ability to retain information and make decisions. The person, therefore, has barely enough time to make sense of what happened to her or him, let alone decide what to do about it. The 90-day hold policy may not afford a traumatized victim of sexual assault enough time to make a decision to report to law enforcement.
I utilized a strengths-based model in my treatment with Rita to help her address the decision to report the crime. A strengths-based framework is client-led with a focus on future outcomes and strengths that the client brings to a problem or crisis. It is an effective helping strategy that builds on a person’s resiliency and ego strength. An integrative strengths-based intervention can contribute to the development of a positive outcome for clients in crisis.
I counseled Rita for 6 months. After 5 months, Rita felt strong enough to disclose to her family and file a report with the police. However, because the 90-day window had closed by the time she was stabilized and emotionally ready to file, her forensic evidence was unavailable.

Assignment: Ethical Dilemmas
Assignment: Ethical Dilemmas
Permalink:
In this assignment you will analyze the implications of an ethical issue according to your worldview.
Write a 1,000-1,500-word essay in which you analyze ethical thinking and use values-based decision making to address a case study from the perspective of the Christian worldview as compared to your own worldview assumptions. Choose one case study from the five options listed on “Ethical Dilemmas.”
After an appropriate introductory paragraph with thesis statement, in which you name the scenario you are choosing, address each of the following six sections with at least one paragraph each. Use the underlined titles for each of your heading.
Ethical Dilemma: Briefly describe the ethical dilemma in your own words, including (a) What in the scenario makes it difficult to make an ethical decision? and (b) Name at least two options for resolving the scenario, providing a brief overview of what sort of ethical decisions each option might make.
Core Beliefs: What beliefs about God and humanity from the Christian worldview are relevant to the scenario? How might these core worldview commitments of Christians influence one’s decision making with regard to this scenario?
Resolution: Describe the Christian worldview’s proposal for resolving the ethical dilemma. How should the person in the scenario act, according to the Christian worldview? What is the best course of action for a Christian? (Note: The resolution should be consistent with Christian worldview commitments.)
Evaluation: What might be the unintended consequences and perceived benefits of the resolution proposed by the Christian worldview?
Comparison: How does the Christian worldview’s resolution compare to another option?
Conclusion: Synthesize the main points, pulling the ideas of the paper together.
References
Use and cite two course resources (textbook, lectures, and the Bible), and at least two scholarly sources that address the issue from opposing sides. You may want to make use of the Opposing Viewpoints in Context database found in the GCU Library.
Prepare this assignment according to the guidelines found in the GCU Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Assignment: skills of professional nurse
Assignment: skills of professional nurse
Permalink:
Purpose
The purpose of this assignment is to demonstrate the skills of the professional nurse as an educator. You are to prepare a guide that will serve as a handout to assist a specific patient that you identify. Your guide or handout should help this patient find and evaluate a reliable mobile health, or mHealth application (app) that is already developed. This may be related to his or her disease process or diagnosis, or may be an app that can help a patient maintain or improve good health, and prevent illness.
You will develop the guide using Microsoft PowerPoint. PowerPoint is a versatile application that lets you design slideshows and handouts. For this assignment, you will be using PowerPoint to create a guide or handout that you may print and give to patients and families. You will be submitting this PowerPoint file to the Dropbox.
Course Outcomes
This assignment enables the student to meet the following Course Outcome.
CO#1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO#1)
CO#5: Identify patient care technologies, information systems, and communication devices that support safe nursing practice. (PO#5)
Points
This assignment is worth a total of 175 points.
Due Date
The Patient Education Technology Guide to a Mobile Health Application PowerPoint assignment is due at the end of Week 2. Submit your completed assignment to the Dropbox by Sunday; 11:59 p.m. MT. You may consult the Policies, under the Course Home tab, for details regarding late assignments. Late assignments will result in loss of points. Post questions about this assignment in the Q & A discussion.
Directions
Use Microsoft PowerPoint to create slides, which will be the basis of the guide or handout. You are required to cite your source(s) as it relates to your application slide. Other citations are permitted, but this is not a requirement for the assignment.
· Title slide (first slide): Include a title slide with your name and title of the presentation.
· Scenario Slide (one slide): This slide should include a brief scenario, then identify a patient who is experiencing a specific disease process or diagnosis who would benefit from an already developed and reliable mHealth app. Or, identify a person is currently healthy and would like to maintain or improve health and prevent illness. Be sure to include the nurse’s assessment of the patient’s learning needs and readiness to learn. Be specific.
Example:
Scenario for Ms. Ellis
Jane Doe (your name here)
· Jennifer Ellis, a 62-year-old African American who has been recently diagnosed with chronic kidney disease (CKD). She has been prescribed several medications she must take every day.
· The nephrologist has stressed the importance of leading a healthy life style to slow or stop the progression of CKD.
· She is interested in ways in which she can better track her health and make healthier choices.
· She is a high school graduate and iPhone user, mostly to send text messages to family and friends.
· She is eager to learn how to use an app that can help her manager her CKD.
Prepare the following slides as if you are presenting them to the patient.
· mHealth Application Slide (one to three slides): Identify a developed and reliable mHealth app that could benefit the patient. Describe the app including its:
· Name
· Purpose
· Intended audience
· Mobile device(s) upon which it will operate
· Where to download or obtain it. Include a working link if it is to be downloaded from a website.
· And any other information you believe would be pertinent to this situation.
· Sources that are used are cited.
· Teaching Slides (one to three slides): Prepare slides that contain important points about the app that you want to teach to the patient such as: how to use the app safely and effectively including how to interpret and act on the information that is provided.
· Evaluation Slide (one to three slides): Describe how you would determine the success of the patient’s use of this app. For example, include ways to evaluate the effectiveness of the teaching plan that are a good fit for the type of app or focus on specific ways that this app benefits the patient’s health and wellness.
· References (last slide): List any references for sources that were used or cited in the presentation.
Writing and Design: There should be no spelling or grammatical errors. Writing is concise and clear. Avoid words that the patient may not understand. Slides are visually appealing incorporating graphics, photographs, colors, and themes.
Review the section on Academic Integrity Policy found in the RNBSN Policies. All work must be original (in your own words) unless properly cited.
Best Practices in Preparing PowerPoint Slideshows
· Be creative, but realistic.
· Incorporate graphics, color, themes, or photographs to increase interest.
· Make easy to read with short bullet points and large font.
· Review directions thoroughly.
· Cite all sources within the slides with (author, year) as well as on the Reference slide.
· Proofread prior to final submission.
· Spell check for spelling and grammar errors prior to final submission.
· Abide by the Chamberlain academic integrity policy.
· Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found under the Special Courses list in Canvas.
Grading Criteria
Category Points % Description
Scenario Slide 40 23% Scenario is clear and concise, including a disease process or diagnosis, or identify a patient with a desire to maintain good health and prevent illness. Include the nurse’s assessment of learning needs and readiness to learn.
mHealth Application Slide 50 28% Identify a mHealth app that could benefit the patient. Describe the app including its:
· Name
· Purpose
· Intended audience
· Mobile device(s) upon which it will operate
· Where to download or obtain it. Include a working link if it is to be downloaded from a website.
· And any other information you believe would be pertinent to this situation.
· Citation
Teaching Slides 40 23% Information on slides to be taught to patient about the mHealth app including any safety guidelines, and how to interpret and act on the information that is provided.
Evaluation Slide 20 12% Describe how you would determine the success of the patient’s use of the mHealth app.
Writing and Design 25 14% Writing contains no spelling or grammatical errors. Bullets should be used instead of long sentences or paragraphs. Reading level is appropriate for patient described. Slides are visually appealing incorporating graphics, photographs, colors and themes. Sources that are used are cited.
Total 175 points 100% A quality assignment will meet or exceed all of the above requirements.

Assignment: Diversity and Health Assessments
Assignment: Diversity and Health Assessments
Permalink:
In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.
Case 1
JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”
Case 2
TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.
Case 3
MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.
To prepare:
· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
· Select one of the three case studies. Reflect on the provided patient information.
· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
Post
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
This work should have Introduction and conclusion
– This work should have at 3 to 5current references (Year 2013 and up)
– Use at least 2 references from class Learning Resources

Discussion: Cognitive Behavior therapy
Discussion: Cognitive Behavior therapy
Permalink:
Required Assignments (RAs) are substantive assignments intended to measure student performance against selected course objectives and/or program outcomes within a course. RAs are completed by all students across all Argosy University campuses and delivery formats without exception. Discussion: Cognitive Behavior therapy
Each RA contributes to a significant portion of the overall course grade and is assessed by faculty using the grading criteria designed for that assignment. These are individual assignments and students earn individual grades. Required Assignment: Theoretical Orientation Development Plan Paper 300 pts
Description of RA: From what you have learned in this course, select a theoretical perspective that interests you the most. In this assignment, you will conduct a literature search on that theoretical approach and develop a personalized plan for your continued development.
Theoretical Orientation Development Plan Paper Review the literature and construct a paper presenting and supporting your personal counseling theoretical preference (choosing from the major theories studied in this course). You should conduct a computerized literature search on the particular theoretical approach that feels like the best fit. Remember to select a theory that aligns with your worldview and your perspective of the best therapeutic relationship. References should be from empirical/scholarly works that support and further define the position. You should include the following in your paper:
• Summarize the fundamental elements of your theory of choice, including definitions of important terms, personality development, and major historical figures associated with the theory.
• Explain how your personal worldview (e.g. core beliefs about others and the world) connects to the theory of choice. • Explain how the therapeutic relationship aligns with your interpersonal style.
• Discuss how your theory of choice addresses the multicultural nature of our diverse society.
• Present support for the effectiveness of your chosen theoretical approach by examining and analyzing the existing efficacy-based research. Include findings across age groups, gender, and/or multicultural groups.
• Discuss limitations of your chosen therapeutic approach, including any clients or presenting problems for which it may not be appropriate. Support your ideas with findings from existing research on the approach.
• Identify the ethical standards from the American Counseling Association’s Code of Ethics (2014) that apply to the use of an approach determined to be unsuitable for a particular group or presenting problem. Discuss the potential harm that could be caused by applying an unsuitable approach. Spring 1 – 2018
• Provide an example of how you would apply a minimum of two specific theoretical techniques to a fictitious client’s need.
• Provide a plan for how you will continue to develop your knowledge and skills related to that theory.
Your final deliverable will be a Word document, approximately 8-10 pages in length, utilizing a minimum of 7 scholarly references. Your paper should be written in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, punctuation, and APA format.
CACREP Standards: 2.F.5.a, 5.C.1.a, 5.C.1.b, 2.F.5.g, 2.F.5.h, 2.F.5.j, 5.C.3.b, 2.F.5.n, 2.F.2.c,
5.C.2.c, 2.F.1.i, 5.C.2.l
Theoretical Summary: Summarize the fundamental elements of your theory of choice, including definitions of important terms, personality development, and major historical figures associated with the theory.
Summary clearly states all critical elements of the theory of choice. All relevant technical terms are defined, theoretical understanding of personality development is described, and the importance of each historical figure is clearly and accurately stated. /40 pts.
Personal Worldview: Explain how your personal worldview connects to the theory of choice.
Correlation between the student’s worldview and the theory of choice is clearly stated. The effect of the worldview towards the use of the theory is appropriate. /20 pts.
Interpersonal Style: Explain how the therapeutic relationship described in your theory of choice aligns with your interpersonal style.
Correlation between important aspects of the therapeutic relationship and the student’s interpersonal style is clearly stated. How the student’s interpersonal style would be appropriate or be a challenge is clearly stated. /20 pts.
Cultural and
Developmental Considerations: Discuss how your theory of choice addresses the multicultural nature of our diverse society and individual developmental needs.
The effect of the theory towards a variety of clients is accurate and clearly stated. /38 pts.
Theoretical Strengths: Present research findings in support of the effectiveness of your chosen theoretical approach.
Findings are presented of at least one peer-reviewed, efficacy study on the chosen theoretical approach. /30 pts.
Theoretical Limitations: Present research findings related to the limitations of your chosen theoretical approach.
Findings are presented of at least one peer-reviewed study examining the limitations of the chosen approach. /30 pts.
Ethical Considerations: Identify at least two ethical standards from the ACA Code of Ethics that address the inappropriate use of an approach or technique. Discuss specific, potential harmful effects of doing so.
At least two relevant ethical standards are identified, defined, and applied to the potential misapplication of a technique or approach. At least two examples of potential harmful effects are identified. /30 pts.
Technique Application: Provide an example of how you would apply a minimum of two
specifically theoretical techniques to a fictitious client’s need.
The description of implementation correctly aligns with each theory. Specific needs of the client are addressed, and the description of how each theory addresses the specific needs is clear and accurate. /54 pts.
Plan for Development: Describe how you will continue to develop your knowledge and skills related to the selected theory.
The plan includes details and specific resources that will be accessed and utilized to increase and enhance knowledge and skills related to the theory of choice. /10 pts.
Academic Writing
Write in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources (i.e. APA); and display accurate spelling, grammar, and punctuation.
Written in a clear, concise, and organized manner; demonstrated ethical scholarship in appropriate and accurate representation and attribution of sources; and displayed accurate spelling, grammar, and punctuation. Use of scholarly sources aligns with specified assignment requirements. /28 pts.

End of Life Decisions Assignment
End of Life Decisions Assignment
The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.
Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.
Provide a 1,500-2,000-word ethical analysis while answering the following questions:
How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
Given the above, what options would be morally justified in the Christian worldview for George and why?
Based on your worldview, what decision would you make if you were in George’s situation?
Remember to support your responses with the topic study materials.
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is required.
This assignment uses a rubric.You are required to submit this assignment to LopesWrite.
1. Bioethics: A Primer for Christians
Read Chapters 6 and 12 in Bioethics: A Primer for Christians.
2. Called to Care: A Christian Worldview for Nursing
Read Chapters 10-12 in Called to Care: A Christian Worldview for Nursing.
3. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death
Read the Introduction and Chapters 1-3 of “Defining Death: Medical, Legal and Ethical Issues in the Determination of Death” by the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1984).
Rubric
Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.12%
Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
Evaluation of which options would be justified in the Christian worldview for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
Reflection hypothesis of which personal choices would be make if faced with ALS based on personal worldview is clear, relevant, and insightful. 10%
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%
Writer is clearly in command of standard, written, academic English. 5%
All format elements are correct.5%
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5%

diagnosis of chronic myelogenous leukemia
diagnosis of chronic myelogenous leukemia
Permalink:
Question 1
A 70-year-old woman has received a diagnosis of chronic myelogenous leukemia (CML) after a clinical investigation sparked by the presence of leukocytosis in her routine blood work. What clinical course should her care provider tell her to expect?
Answers:
A. “It’s likely that this will give you chronic fatigue and malaise for the rest of your life, but that will probably be the extent of your symptoms.”
B. “Unfortunately, your leukemia will likely enter a crisis mode within a few weeks if we don’t treat it immediately.”
C. “You could remain the chronic stage of CML for several years before it accelerates and culminates in a crisis.”
D. “You can expect your blood results, fatigue, and susceptibility to infection to gradually worsen over a few years.”
Question 2
Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the
Answers:
A. erythrocytes.
B. basophils.
C. neutrophils.
D. albumin.
Question 3
Which of the following diagnostic findings is likely to result in the most serious brain insult?
Answers:
A. Moderate decrease in brain tissue volume secondary to a brain tumor removal
B. High intracellular concentration of glutamate
C. Increased ICP accompanied by hyperventilation
D. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
Question 4
Which of the following patients would be most likely to be experiencing an increase in renal erythropoietin production?
Answers:
A. A 70-year-old woman admitted with dehydration secondary to an overdose of her potassium-wasting diuretic
B. A 21-year-old man with acute blood loss secondary to a motor vehicle accident 3 hours prior
C. A 68-year-old man with a long-standing diagnosis of polycythemia vera
D. A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD)
Question 5
A college student has been experiencing frequent headaches that he describes as throbbing and complaining of difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which of the following pathophysiological concepts is likely responsible for his symptoms?
Answers:
A. Localized ischemia with areas of necrosis noted on CT angiography
B. High pressure and local hemorrhage of the venous system
C. Hydrocephalus and protein in the cerebral spinal fluid
D. Increased tissue perfusion at the site of the malformation
Question 6
A group of nursing students were studying for their pathophysiology exam by quizzing each other about disorders of WBCs and lymphoid tissue. When asked what the first chromosomal abnormality that identified cancer was, one student correctly answered Answers:
A. interleukin cells.
B. Philadelphia.
C. PSA.
D. BRCA-1.
Question 7
A 47-year-old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis? What assessments and interventions should the nursing staff of the unit prioritize in their care?
Answers:
A. Regular pain assessment and administration of opioid analgesics as needed
B. Cardiac monitoring and administration of inotropic medications
C. Assessment and documentation of cognitive changes, including confusion and restlessness
D. Assessment of swallowing ability and respiratory status
Question 8
A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment?
Answers:
A. To increase the amount of oxygen distributed by his red blood cells
B. To reduce the viscosity of his blood
C. To reduce the mean size of his red cells
D. To control his hypertension
Question 9
During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action?
Answers:
A. Thalamus
B. Cerebellum
C. Frontal lobe
D. Basal ganglia
Question 10
The family members of an elderly patient are wondering why his “blood counts” are not rising after his last GI bleed. They state, “He has always bounced back after one of these episodes, but this time it isn’t happening. Do you know why?” The nurse will respond based on which of the following pathophysiological principles?
Answers:
A. “Don’t worry about it. We can always give him more blood.”
B. “Due to stress, the red blood cells of older adults are not replaced as promptly as younger people.”
C. “Everything slows down when you get older. You just have to wait and see what happens.”
D. “The doctor may start looking for another cause of his anemia, maybe cancer of the bone.”
Question 11
A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient’s bleeding?
Answers:
A. Hemophilia B
B. Vitamin K deficiency
C. Excess calcium
D. Idiopathic immune thrombocytopenic purpura (ITP)
Question 12
Your ESRD patient is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2). Twenty minutes into the first transfusion, the nurse observes the patient has a flushed face, hives over upper body trunk, and is complaining of pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56.What is the nurse’s priority action? Answers:
A. Recheck the type of blood infusing with the chart documentation of patient’s blood type. B. Discontinue the transfusion and begin an infusion of normal saline.
C. Slow the rate of the blood infusion to 50 mL/hour.
D. Document the assessment as the only action.
Question 13
A 5th grade elementary student asks the school nurse how much blood is in an entire body. The nurse should respond that the average grown-up adult has
Answers:
A. 2 to 4 cups of blood in his or her body.
B. 5 to 6 L of blood throughout his or her body.
C. 3 pints of blood in total.
D. 3 to 4 quarts of blood in his or her body.
Question 14
The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client’s medication regimen. What is the most likely focus of the pharmacologic treatment of the man’s health problem?
Answers:
A. Preventing demyelination of the efferent cerebellar pathways
B. Preventing axonal degradation of motor neurons
C. Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions
D. Increasing the functional ability of the underactive dopaminergic system
Question 15
A student makes the statement to a colleague, “Blood plasma is essentially just a carrier for the formed elements like red blood cells and white blood cells.”What would be the most accurate response to this statement?
Answers:
A. “Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis.”
B. “Actually, plasma plays a significant role in nutrient and waste transport.”
C. “Actually, plasma is integral to the proper function of the liver and maintenance of acid–base balance.”
D. “That’s not really true. Plasma is crucial in the immune and inflammatory responses.”
Question 16
Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?
Answers:
A. Central cord syndrome
B. Conus medullaris syndrome
C. Brown-Séquard syndrome
D. Anterior cord syndrome
Question 17
A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL has been ordered a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which of the following blood types would be least likely to produce a transfusion reaction?
Answers:
A. A–
B. A
C. B–
D. B
Question 18
Which of the following clients’ signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult
Answers:
A. has vomited and complained of a severe headache.
B. states that his left arm and leg are numb, and gait is consequently unsteady.
C. has experienced a sudden loss of balance and slurred speech.
D. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days.
Question 19
Amniocentesis has suggested that a couple’s first child will be born with sickle cell disease. The parents are unfamiliar with the health problem, and their caregiver is explaining the complexities. Which of the following statements by the parents would suggest a need for further teaching or clarification?
Answers:
A. “Our baby’s red cells are prone to early destruction because of his or her weak membranes.”
B. “Our son or daughter likely won’t show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies.”
C. “Not all of his or her red cells will be sickled, but low oxygen levels can cause them to become so.”
D. “Sickled cells can block his or her blood vessels, especially in the abdomen, chest, and bones.”
Question 20
During science class, a student asks, “What’s the difference between plasma and serum in the blood?” The nurse responds that the primary difference between plasma and serum is that plasma contains
Answers:
A. hydrogen ions.
B. heparin.
C. white blood cells.
D. fibrinogen.
Question 21
During a flu shot clinic, one of the questions the student nurse asks relates to whether the patient has had Guillain-Barré syndrome in his medical history. The patient asks, “What is that?” How should the nursing student reply?
Answers:
A. “A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles”
B. “Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot”
C. “A degenerative disease where you have trouble walking without the help of a cane or walker”
D. “Swelling of your arm where you got your flu shot, and maybe your eyes and lips had some swelling as well”
Question 22
A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?
Answers:
A. Excess acetylcholinesterase production; treatment with thymectomy
B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins
C. Cerebellar lesions; surgical and immunosuppressive treatment
D. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids
Question 23
A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a “coup”injury. How will the nurse explain this to the family so they can understand?
Answers:
A. “It’s like squeezing an orange so tight that the juice runs out of the top.”
B. “When the bat hit his head, his neck jerked backward causing injury to the spine.”
C. “Your son has a contusion of the brain at the site where the bat hit his head.”
D. “Your son has a huge laceration inside his brain where the bat hit his skull.”
Question 24
Which of the following glycoproteins is responsible for treating such diseases as bone marrow failure following chemotherapy and hematopoietic neoplasms such as leukemia? Answers:
A. Growth factors and cytokines
B. T lymphocytes and natural killer cells
C. Neutrophils and eosinophils
D. Natural killer cells and granulocytes
Question 25
While being on subcutaneous heparin injections for deep vein thrombosis during her latter pregnancy, a patient begins to experience major side effects. Her OB-GYN physician has called in a specialist who thinks that the patient is experiencing heparin-induced thrombocytopenia. The nurse should anticipate which of the following orders?
Answers:
A. Immediately discontinue the heparin therapy
B. Switch to Coumadin 2.5 mg once/day
C. Decrease the dose of heparin from 5000 units b.i.d to 3000 units b.i.d
D. Infuse FFP stat
Question 26
Which of the following individuals would most likely experience global ischemia to his or her brain?
Answers:
A. A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater
B. A male client who has just had an ischemic stroke confirmed by CT of his head
C. A woman who has been admitted to the emergency department with a suspected intracranial bleed
D. A man who has entered cardiogenic shock following a severe myocardial infarction
Question 27
A new mother and father are upset that their 2-day-old infant is requiring phototherapy for hyperbilirubinemia. The pediatrician who has followed the infant since birth is explaining the multiplicity of factors that can contribute to high serum bilirubin levels in neonates. Which of the following factors would the physician be most likely to rule out as a contributor?
Answers:
A. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)
B. Hepatic immaturity of the infant
C. Hypoxia
D. The fact that the infant is being breast-fed
Question 28
A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms?
Answers:
A. Viruses are killing some of his B cells and becoming incorporated into the genome of others.
B. The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.
C. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.
D. The EBV inhibits the maturation of white cells within his peripheral lymph nodes.
Question 29
A 16-year-old female has been brought to her primary care physician by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the physician to rule out infectious mononucleosis?
Answers:
A. Chest auscultation reveals crackles in her lower lung fields bilaterally.
B. Her liver and spleen are both enlarged.
C. Blood work reveals an increased white blood cell count.
D. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.
Question 30
A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client’s husband is confused as to why a disease of coagulation can result in bleeding. Which of the nurse’s following statements best characterizes DIC?
Answers:
A. “The same hormones and bacteria that cause clotting also cause bleeding.”
B. “Massive clotting causes irritation, friction, and bleeding in the small blood vessels.”
C. “So much clotting takes place that there are no available clotting components left, and bleeding ensues.”
D. “Excessive activation of clotting causes an overload of vital organs, resulting in bleeding.”
Question 31
A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate?
Answers:
A. “Our treatment plan will depend on whether your tumor is malignant or benign.”
B. “This is likely a result of a combination of heredity and lifestyle.”
C. “The major risk that you face is metastases to your lungs, liver, or bones.”
D. “Your prognosis will depend on whether we can surgically resect your tumor.”
Question 32
A patient diagnosed with low-risk chronic lymphocytic leukemia (CLL) has recently developed thrombocytopenia. One of the medications utilized to treat this would be Answers:
A. cisplatin, a chemotherapeutic.
B. vincristine, a Vinca alkaloid.
C. dexamethasone, a corticosteroid.
D. doxorubicin, a cytotoxic antibiotic.
Question 33
Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). Which of the students’ following statements best captures an aspect of the two health problems? Answers:
A. “ITP can be either inherited or acquired, and if it’s acquired, it involves an enzyme deficiency.”
B. “Both of them involve low platelet counts, but in TTP, there can be more, not less, hemostasis.
C. “TTP can be treated with plasmapheresis, but ITP is best addressed with transfusion of fresh frozen plasma.”
D. “Both diseases can result from inadequate production of thrombopoietin by megakaryocytes.”
Question 34
A physician is explaining to a 40-year-old male patient the importance of completing his course of antibiotics for the treatment of tuberculosis. The physician explains the damage that could occur to lung tissue by Mycobacterium tuberculosis. Which of the following phenomena would underlie the physician’s explanation?
Answers:
A. Tissue destruction results from neutrophil deactivation.
B. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.
C. Macrophages form a capsule around the Mycobacterium tuberculosis bacteria, resulting in immune granulomas.
D. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.
Question 35
A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which of the following medical diagnoses listed below may be associated with these clinical manifestations?
Answers:
A. Encephalitis
B. Lyme disease
C. Rocky Mountain spotted fever
D. Spinal infection
Question 36
A patient has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The patient asks the nurse what this test will tell the doctor. The nurse replies,
Answers:
A. “They are looking for the presence of antibody or complement on the surface of the RBC.”
B. “They will look at your RBCs under a microscope to see if they have an irregular shape (poikilocytosis).”
C. “They will wash your RBCs and then mix the cells with a reagent to see if they clump together.”
D. “They will be looking to see if you have enough ferritin in your blood.”
Question 37
A 29-year-old construction worker got a sliver under his fingernail 4 days ago. The affected finger is now reddened, painful, swollen, and warm to touch. Which of the following hematological processes is most likely occurring in the bone marrow in response to the infection?
Answers:
A. Phagocytosis by myelocytes
B. Increased segmented neutrophil production
C. High circulatory levels of myeloblasts
D. Proliferation of immature neutrophils
Question 38
A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate?
Answers:
A.“We think that his spleen is inhibiting the production of platelets by his bone marrow.”
B.“We believe that your son’s spleen is causing the destruction of many of his blood platelets, putting him at a bleeding risk.”
C.“Your son’s spleen is holding on to too many of his platelets, so they’re not available for clotting.”
D.“Your son’s spleen is inappropriately filtering out the platelets from his blood and keeping them from normal circulation.”
Question 39 A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which of the following health problems?
Answers:
A. Anemia
B. Blood clots
C. Jaundice
D. Infections
Question 40
A 32-year-old woman presents at her neighborhood health clinic complaining of weakness and a feeling of abdominal fullness. She reports that 6 months earlier she noticed that she had difficulty in maintaining the high level of energy she has relied on during her aerobic workouts over the past few years. Because she felt that she was in overall good health, but knew that women often need additional iron, she added a multiple vitamin with iron and some meat and leafy greens to her diet. She followed her plan carefully but had no increase in energy. Upon examination, her spleen is noted to be enlarged. Which of the following is most likely to be the cause?
Answers:
A. CLL
B. Accelerated CML
C. Infectious mononucleosis
D. Stage A Hodgkin disease
Question 41
A nurse is providing care for several patients on an acute medical unit of a hospital.Which of the following patients would be most likely to benefit from hematopoietic growth factors?
Answers:
A. A 61-year-old female patient with end-stage renal cancer
B. A 55-year-old obese male patient with peripheral neuropathy secondary to diabetes
C. A 51-year-old female patient with liver failure secondary to hepatitis
D. A 44-year-old man with a newly diagnosed brain tumor
Question 42
Misinterpreting her physician’s instructions, a 69-year-old woman with a history of peripheral artery disease has been taking two 325 mg tablets of aspirin daily. How has this most likely affected her hemostatic status?
Answers:
A. The binding of an antibody to platelet factor IV produces immune complexes.
B. The patient’s prostaglandin (TXA2) levels are abnormally high.
C. Irreversible acetylation of platelet cyclooxygenase activity has occurred.
D. She is at risk of developing secondary immune thrombocytopenic purpura (ITP).
Question 43 Which of the following teaching points would be most appropriate with a client who has a recent diagnosis of von Willebrand disease?
Answers:
A. “Make sure that you avoid taking aspirin.”
B. “Your disease affects your platelet function rather than clot formation.”
C. “Clotting factor VIII can help your body compensate for the difficulty in clotting.”
D. “It’s important that you avoid trauma.”
Question 44
A nurse at a long-term care facility provides care for an 85-year-old man who has had recent transient ischemic attacks (TIAs). Which of the following statements best identifies future complications associated with TIAs? TIAs
Answers:
A. are caused by small bleeds that can be a warning sign of an impending stroke.
B. are a relatively benign sign that necessitates monitoring but not treatment.
C. are an accumulation of small deficits that may eventually equal the effects of a full CVA. D. resolve rapidly but may place the client at an increased risk for stroke.
Question 45
Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents?
Answers:
A. “If you or the care team notices any spontaneous eye opening, then we will change our treatment plan.”
B. “Your daughter has lost all her cognitive functions as well as all her basic reflexes.”
C. “Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.”
D. “Your daughter’s condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions.”
Question 46
A couple who is expecting their first child has been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple has approached their caregiver with this request and is seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting it. How can their caregiver best respond to the couple’s enquiry? Stem cells can
Answers:
A. “be used as source of reserve cells for the entire blood production system.”
B. “help treat some cancers and anemias, but they must come from your child himself or herself.”
C. “be used to regenerate damaged organs should the need ever arise.”
D. “help correct autoimmune diseases and some congenital defects.”
Question 47 A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate?
Answers:
A. “Ferritin is a protein–iron complex that allows your red blood cells to make use of the iron that you consume in your diet.”
B. “Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.”
C. “Ferritin is the form of iron that is transported in your blood plasma to red blood cells that need it.”
D. “Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.”
Question 48
A 13-year-old African American boy comes to the ER complaining of fatigue and a rapid heartbeat. In conversation with the father, it becomes apparent to you that the boy has grown 2 inches in the previous 5 months. What is the first problem the health care team would attempt to rule out?
Answers:
A. Aplastic anemia
B. Sickle cell anemia
C. Thalassemia
D. Iron deficiency anemia
Question 49
In which of the following patients, would diagnostic investigations least likely reveal increased thrombopoietin production?
Answers:
A. A 55-year-old man with dehydration secondary to Crohn disease
B. An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive
C. A 66-year-old woman with a diagnosis of lung cancer with bone metastases
D. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia
Question 50
A hospital laboratory technologist is analyzing the complete blood count (CBC) of a patient. Which of the following statements best reflects an aspect of the platelets that would constitute part of the CBC?
Answers:
A. New platelets are released from the bone marrow into circulation.
B. The half-life of a platelet is typically around 8 to 12 days.
C. Platelets originate with granulocyte colony–forming units (CFU).
D. The ?-granules of platelets contribute primarily to vasoconstriction.

Assignment: Developmental Red Flags
Assignment: Developmental Red Flags
Permalink:
Case Study 1:
A mother brings in her 16-month-old, Brittany, for treatment of an acute illness. During the history, the mother reports that her mother-in-law is concerned about the toddler’s development. Further questioning reveals the following:
•Brittany was a term infant born vaginally with no intrapartum complications. Birth weight was 8 pounds 1 ounce and current weight is 26 pounds 9 ounces.
•She was breastfed until 12 months of age and now drinks 24 ounces of whole milk and eats table foods daily.
•Physical milestones are as follows: Rolled front to back at 6 months, developed pincer grasp at 11 months, crawled at 8 months, and began cruising at 10 months. She does not walk independently.
•Social development includes mimicking adult behavior, four-word vocabulary (mama, dada, baba, and no), follows one-step commands, and quiets easily when comforted.
To prepare:
•Review this week’s media presentations, as well as “Developmental Management of Infants” and “Developmental Management of Toddlers and Preschoolers” in the Burns et al. text.
•Think about how physical, social, and cognitive development vary during infancy, toddlerhood, and the preschool years. Reflect on normal versus abnormal growth and development and consider the decision-making process of identifying and managing red flags of abnormal development.
•Select one of the three case studies provided. Reflect on the patient information included in the case study and consider any developmental red flags.
•Reflect on standardized screening tools, clinical guidelines, and management strategies that would be used to assess and manage the patient in your selected case study.
Post 2 discussion page paper on :An explanation of any developmental red flags that presented in the case study you selected based on the stages of normal physical, social, and cognitive development for infants, toddlers, and preschoolers. Explain how you differentiated between normal and abnormal growth and development for this patient and identify which standardized screening tools, clinical guidelines, and management strategies you might use to assess and manage this patient and why
REFERENCES
Readings
• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.
? Chapter 5, “Developmental Management of Infants” (pp. 59–75).
? Chapter 6, “Developmental Management of Toddlers and Preschoolers” (pp. 76–91
? Chapter 11, “Breastfeeding” (pp. 186-201)
Chapter 17, “Role Relationships” (pp. 334–344)
Hagan, J. F., Jr., Shaw, J. S., Duncan, P. M. (Eds.). (2008). Bright futures: Guidelines for health supervision of infants, children, and adolescents (3rd ed.). Elk Grove Village, IL: American Academy of Pediatrics
Infancy” (pp. 253–380)
?“Early Childhood” (pp. 381–461)

Multiple Organ Dysfunction Syndrome
Multiple Organ Dysfunction Syndrome
Permalink:
Question 14:
Chapter 14, Shock and Multiple Organ Dysfunction Syndrome
Adam Smith, 77 years of age, is a male patient who was admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. The patient has a Foley catheter in place from the nursing home with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. The patient is confused, afebrile, and hypotensive with a blood pressure of 82/44 mm Hg. His respiratory rate is 28 breaths/min and the pulse oximeter reading is at 88% room air, so the physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. The patient has diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for inflammation, is elevated. The patient is being treated with broad-spectrum antibiotics and norepinephrine (Levophed) beginning at 2 mcg/min and titrated to keep systolic blood pressure greater than 100 mm Hg. A subclavian triple lumen catheter was inserted and verified by chest x-ray for correct placement. An arterial line was placed in the right radial artery to closely monitor the patient’s blood pressure during the usage of the vasopressor therapy. (Learning Objectives 6 and 7)
a. What predisposed the patient to develop septic shock?
b. What potential findings would suggest that the patient’s septic shock is worsening from the point of admission?
c. The norepinephrine concentration is 16 mg in 250 mL of normal saline (NS). Explain how the nurse should administer the medication. What nursing implications are related to the usage of a vasoactive medication?
d. Explain why the effectiveness of a vasoactive medication decreases as the septic shock worsens. What treatment should the nurse anticipate to be obtained to help the patient?