Category: Nursing homework help

PLEASE RESPOND TO THE FOLLOWING CLASSMATE’S POST IN 50 WORDS OR MORE:
Discussion #2 week 3 
Option 1) 
 L.G. is a 5-year-old boy being seen in the pediatric clinic for a yearly physical .
Subjective Data 
The patient is accompanied by a parent (mother) 
The mother said that the child takes no medications and is healthy. 
Patient attends preschool 
Plays T-ball 
There are no smokers in the house 
Lives with mother and father 
Objective Data 
Vital signs: T 37 P 124 R 12 BP 104/64 
Weight: 35 lb 
Height: 52 inches
Immunizations: Up to date   
Questions 
What should the nurse include in the general inspection of this patient? 
General inspection should begin the minute the nurse lays eyes on L.G. and his mother. The mother should be included in the general inspection because at age 5, the child relies on his mother to provide shelter, nutrition, and a safe environment.  
Four main areas should be considered for the general inspection of L.G. 
Appearance, body structure, mobility, and behavior. 
General appearance should include inspection of the head, eyes, ears, nose, neck, teeth, hair. Facial structure should be symmetric. It’s important to note symmetry of eyebrows and eyes, puffy face, goiter, flat midface, short nose, low nasal bridge etc. These can be signs of congenital hypothyroidism, down syndrome or even fetal alcohol syndrome. Skin should be free from discoloration, lesions, or wounds. 
When a child gets to 5-6 years of age, primary teeth may start to fall out. 
Clothes should be appropriate for the weather and occasion. 
Body structure should be appropriate for the age group. Limbs are equal in length bilaterally. For toddlers, it is generally normal to have a potbelly, but by the time they reach school age, the potbelly should disappear, and bodies become more proportional. In addition, the nurse should assess whether L.G. appears well nourished, undernourished, or overnourished for his age group. Also assess whether L.G.’s height and weight are appropriate for a 5-year-old. 
Mobility includes balance, gait should be steady. At this age, a 5-year-old can hop and may be able to skip, use a fork and spoon, uses the toilet independently, and can swing and climb.  
Behavior- Nurse should note that L.G. responds appropriately to stimuli, Is alert and oriented. The nurse should also assess for any signs of slow mental processes or hyperactivity. In addition, mood/affect should also be assessed. Does L.G. appear happy or withdrawn? 
How does L.G. interact with mother and other family members?  
What observations are important regarding physical appearance and hygiene? 
According to the CDC’s growth chart, L.G.’s BMI is severely underweight. His calculated BMI was 9.1. This means that L.G.’s BMI for this age group is less than the first percentile, meaning his BMI is less than 99.99% of the average 5-year-old boy.  
Healthy weight for this age range and sex should range from the fifth percentile to less than the eighty fifth percentile. L.G. most likely appears undernourished for his age. The nurse should assess diet followed at home, food intolerances/ allergies, and eating patterns of the child.  
Hygiene is also important at this age and is mostly provided by parents. Evidence of good hygiene would be groomed and washed hair, and skin. Clothes that fit appropriately and are clean. Good hygiene is usually a good indicator of overall health. 
How should a 5-year-old child be assessed? 
It is important to first understand differences between school-aged children and adults. This understanding will help guide strategies the nurse will need during the assessment process and plan of care.  
Differences in school-aged children include: 
Different developmental stages  
Child is part of a family unit. At this age, the nurse will speak to the child and the family. It is important to promote independence and include the child in the discussion as appropriate. 
Anatomical differences. Examples are that children have bigger heads and a shorter neck, thinner skin, narrow airway, and softer bones. 
Differences in how medications interact and are administered. Medications are weight based. 
For the assessment of a 5-year-old child, the clinical setting should provide an engaging environment appropriate for children. Books, toys, play space, and even the color of the walls can provide a more relaxing environment that can facilitate clinician and child interaction. After establishing a safe and engaging environment, the nurse should begin the general survey by observing appearance, facial expression, level of consciousness, body structure, poster and movement, behavior, and nutritional status. At this age, children want to know what is happening and may ask a lot of questions. The nurse should use play and explanation to introduce equipment. In addition, the child may feel more comfortable if they are included in their assessment. It’s important to discuss the child’s developmental milestones or any areas of concern with family. 
Assess the head for symmetry and size. Yearly measurements are recommended up to age 6. 
Musculoskeletal assessment should include balance, motor control and any involuntary movements. 
Assessment of the lungs should include inspection, auscultation, and palpitation. Assess normal chest movement, respiratory effort and rate, oxygen saturation and size and shape of chest.  
Cardiac assessment includes auscultation and palpation. Assessment of heart rate and sounds, perfusion, signs of edema and skin temperature are also important. 
Gastrointestinal/Genitourinary assessment also includes inspection of contour, bowel sounds, and palpation for tenderness or masses.  
Assess skin for any abnormalities such as rashes or lesions. 
The fifth vital sign (pain) should also be assessed. Children at this age can express pain or discomfort.  
What teaching is appropriate for this age group?  
Children at this age are eager to learn new things and explore their environment. Appropriate topics for the nurse to teach for this age group include: 
 Nutrition and encourage healthy eating habits.  
Exercise and play. 
Dental health and hygiene.  
Safety  
Screen time  
Disabled World. (2023, September 2). Average height to weight chart: Babies to teenagers. https://www.disabled-world.com/calculators-charts/height-weight-teens.php#mcLinks to an external site.   
Your teeth (for kids) – nemours kidshealth. (n.d.-b). https://kidshealth.org/en/kids/teeth.htmlLinks to an external site. 
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019, January). Clinical practice guidelines for assessment of children and adolescents. Indian journal of psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345125/Links to an external site. 
Potbellies and toddlers. Mount Sinai Health System. (n.d.). https://www.mountsinai.org/health-library/special-topic/potbellies-and-toddlers#:~:text=It%20is%20generally%20normal%20for,feel%20soft%20and%20NOT%20tenderLinks to an external site.. 
Centers for Disease Control and Prevention. (2023, September 14). BMI Calculator Child and teen. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/bmi/calculator.htmlLinks to an external site. 
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019, January). Clinical practice guidelines for assessment of children and adolescents. Indian journal of psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345125/Links to an external site. 
Your 5-year-old. ucsfbenioffchildrens.org. (n.d.). https://www.ucsfbenioffchildrens.org/education/your-5-year-old

Select a research study identified in chapter 13 and go to the literature to find its original source. Describe: a) how the theory of self-reliance is presented in the manuscript, b) what concepts are being studied and c) how the findings guide practice.

 
Pulmonary Function:
D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode.
Case Study Questions
According to the case study information, how would you classify the severity of D.R. asthma attack?
Name the most common triggers for asthma in any given patients and specify in your answer which ones you consider applied to D.R. on the case study.
Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.
 Submission Instructions: 
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources (within the last 5 years). Your initial post is worth 8 points.
APA style writing

  
Part I: Complete the Grossman and Valiga Leadership Characteristics and Skill Assessment Tool (parts I & II). Then complete below:
Perception of what makes a good leader – Post score and interpretation statement (Do not upload the tool or scoring sheet)
Perception of your own ability to lead – Post score and interpretation statement
Reflect on your findings from the Grossman and Valiga Assessment Tool. Write a short statement on the following question:
I was surprised /or/ not surprised by the findings on my perception of what makes a good leader and my perception of my own ability to lead.
Part  II: Answer the questions that follow in paragraph format (1-2  paragraphs for each) using the readings for context and citations.
While  the Covid pandemic has had a significant impact on the public’s image  of nurses, think about the main point in the article that the nursing  profession itself contributes to the negative image of nurses (Childlike  and/or gender biased).
1.    Did you have an awareness of these issues around nursing’s image and their impact on the nursing profession? 
2.    What do you think about this problem? 
Think this is a thing of the past – Look for yourself:
Using  GOGGLE Image – Type in “National Nurses Week” and see the images that  come up. Check out how many hearts and cartoons there are, mostly  focused only on “caring”.  Now, type in Covid and Nurses and note the difference. Include a brief comment in your post on what you noted.
Note:  This first case study allows for more of your opinion but when you  include in-text citations (at least 1 or 2 required) when  paraphrasing/referencing something specific from the article you need to  use APA format.  You also need to use APA for the reference list at the  end of your post.

 
Review the given case study and address the following:
Summary of case study
What is your differential diagnosis? 
Why did you make this diagnosis decision?
What is your treatment plan?
What evidence-based research can you provide to support your decision (choice for differential diagnosis and plan/intervention)?
What resources did you use to meet your best practice guidelines?
Address the ethical dilemmas and/or other issues for your case study:
Ethical issues
Psychological issues
Physical issues
Financial issues

Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients? (Saunders, 2014)
 550 words, at least 2 references APA style

Resources to use.
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 364–371)
Chapter 47, “Drugs for Deficiency Anemias” (pp. 389–396)
Chapter 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
Chapter 51, “Birth Control” (pp. 437–446)
Chapter 52, “Androgens” (pp. 447–453)
Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 454–466)
Chapter 70, “Basic Principles of Antimicrobial Therapy” (pp. 651–661)
Chapter 71, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 662–668)
Chapter 75, “Sulfonamides Antibiotics and Trimethoprim” (pp. 688–694)
Chapter 76, “Drug Therapy of Urinary Tract Infections” (pp. 695–699)
Chapter 78, “Miscellaneous Antibacterial Drugs” (pp. 711–714)
Chapter 79, “Antifungal Agents” (pp. 715–722)
Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
Chapter 82, “Drug Therapy of Sexually Transmitted Diseases” (pp. 763–770)
Roberts, H., & Hickey, M. (2016). Managing the menopause: An updateLinks to an external site.. Maturitas, 86(2016), 53–58. https://doi.org/10.1016/j.maturitas.2016.01.007
This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.
To Prepare:
Review the Resources for this module and reflect on the different health needs and body systems presented.
Your Instructor will assign you a complex case study to focus on for this Discussion.
Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.
Case Study
A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago. 

Respond to two (2) of the following prompts:
1.Which of the three theoretical approaches (functionalist, conflict, or symbolic interactionist) would you use to explain why healthcare injustice and inequity occurs and what to do about it? (USLO 3.4
2.What role does healthcare injustice play in perpetuating the system of stratification? How does the healthcare system maintain social stratification? Is healthcare injustice harming our society as a whole? (USLO 3.4)

 
Prompt #2
A doctor is driving down a road late at night. She sees a car in the opposite lane swerve sharply off the road, and it crashes. There are no other cars around. Her gut reaction as a physician is to stop to assist the victims. However, she quickly remembers that there are no “Good Samaritan laws” on the books in that state to protect her from malpractice lawsuits. Her conscience tells her she is justified in driving on. How would Freud explain the behavior of her conscience in this scenario? Do you believe her conscience was correct? (USLO 3.3)
APA format 

Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients? (Saunders, 2014)
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources