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  • Health Policy Proposal – Best Assignment Solutions(2022)

    This article provides sample Health Policy Proposal.

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    For this Assignment, you will write a position paper in which you will choose and support a policy change which reinforces the role of the nurse as a leader in ensuring access to quality health care in developed and underdeveloped countries.

    You should approach this assignment from the perspective of your specialty track. Information which may be helpful in selecting a proposed policy change can be found in your textbook Health Policy and Politics: A Nurse’s Guide 

    The word count for your position paper will be 1000 to 1600 words. You must support your work with at least eight scholarly peer reviewed articles. Your paper must include the following topics:

    …

    Solution

    Health Policy Proposal

                The globalization of healthcare creates and sustains care systems and processes that provide care and improve the outcomes of people across the world. Globalization as a concept has revolutionized evidence-based care, by facilitating the development and integration of care systems and structures that span across international boundaries (Bryant‐Lukosius et al. 2015).

    The unique yet influential position of nurses across the globe continues to be an avenue to shape current and future healthcare delivery systems that nurses’ best understand. Moreover, globalization has led to rapid and critical advances in nursing research, nursing education and practice, with the roles of nurses shifting to more influential care positions across the globe.

    Current nursing issues related to the globalization of healthcare

                In both developed and underdeveloped countries, the need for more investment in nursing education, and capacity building of existing nurses to take up leadership opportunities continues to be a top priority. Besides, engaging nurses in design and development of care processes and improvement of care systems continue to be a critical issue as nurses hold a unique position that could help bridge the gap between the patient and community with care systems in any care settings across the world (Oldenburger et al., 2017).

    Furthermore, one of the most influential effects of globalization has been on the changing roles of nurses ranging from advocacy to more clinical roles of APNs and nursing leaders. Collaborative nursing research coupled with standardized nursing education brought about by globalization in healthcare continues to verse these drastic changes.

    The proposed policy change

                With the changing roles of nurses and the unique position of nurses in care, the adoption and integration of APNs into the country-level human resources for health (HRH) to facilitate the delivery more sustainable and effective models of care. The proposed policy change entails the integration of APN roles across both developed and underdeveloped countries. The International Council of Nurses (ICN, 2016) policy brief notes that introducing APN roles contributes to better health outcomes for individuals, communities and populations while reducing the costs of care. Subsequently, the policy change would increase access to care in both developed and underdeveloped while also improving the individual experience of patients as they report high satisfaction rates when working with APNs.

                The proposal intends to improve access to care by empowering APNs, who are either Clinical Nurse Specialist (CNS) or the Nurse Practitioner (NP) to clinical roles and leadership positions. In particular, a shift in nursing education and career progression of nurses could help developed a highly experienced and skilled set of nurses in underdeveloped countries to serve underserved communities in both rural and urban settings to improve access to care, health outcomes of populations and facilitating community health.

    As Bryant-Lukosius and Martin-Misener (2016) note, CNSs play the critical non-clinical role of facilitating education, capacity building and quality improvement in their respective care settings thereby optimizing care processes to meet the demands of populations. On the other hand, NPs’ clinical scope that allows them to autonomously order diagnostic tests, make diagnoses, and prescribe treatments and medications, makes them a key addition to the healthcare delivery system in both developed and underdeveloped countries (DiCenso, & Bryant-Lukosius, 2010). Moreover, the proposal helps address global access to care and reduce the shortage of concern in global nursing.

    Agenda setting strategies

                The proposal advances the role of nurses in care settings. While the media offer a wide reach that would help improve awareness on the use of APNs in care systems, the best approach to agenda-setting would be through collaboration with nursing organizations and stakeholders within the healthcare continuum. To adopt the policy, most countries need to improve their nursing education capability, which requires coordination with international nursing organizations such as ICN and other nursing organizations oriented towards global nursing such as ANA and the World Health Organization (WHO).

    Working with the organization to create awareness through extensive nursing research on the area would help facilitate and communicate evidence-based practices in APN role implementation ((Miranda et al., 2018). Besides, nursing organizations and WHO are a highly credible organization that can influence policy adoption in individual countries. The support, involvement and endorsement of these nursing organizations will equip the proposal with the best driving mechanism to adoption and implementation in both developed and underdeveloped countries.

    Model or theory that can be used to bring about the change

                The change can be brought about by adopting the innovation diffusion theory, which incorporates all stakeholders and moves from a point of innovation to conformation and adoption (Udod, & Wagner, 2018). Also known as Rogers’ five-step theory begins with exposing the individual health systems to the innovation of using APNs in care processes. The second stage involves the persuasion which ensures each stakeholder fully understands the role of APNs and the potential impact they would have in care.

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    Health Policy Proposal
    Health Policy Proposal

    Upon examining the information and examining data from countries that have already adopted the policy, a decision would be made depending on the weight of the advantages and the disadvantages as well as cost implications. Approval is followed by implementation, which is adjusted iteratively to fit the specifics such as the needs of patients in the region. The last stage would involve the incorporation of APNs in different leadership positions and adoption.

    The Rogers’ five-step theory is beneficial as it allows iterative implementation and a change process can be resurrected after some time if unsuccessful. Besides the theory acknowledges the affinity of different entities to change with some being innovators eager to implement and laggards who are last to adopt the change (Udod, & Wagner, 2018).

    Design strategies

                To effectively design the proposal, the focus will be on APN development and education, APN role deployment, and APN role integration. The policy change would include frameworks to support the education and development of APNs to meet set standards of practice (Bryant-Lukosius et al., 2017). Coupling nursing education and nursing research would help improve the capacity of nurses to display their skills and competencies.

    The second aspect would be the definition of the roles of APNs and the priority areas for deployment such as to underserved communities to improve healthcare outcomes. The policy would support optimal APN role by establishing aspects such as legislation, regulation, competencies and education per international guidelines. However, the design would mirror the globalization approach of “thinking global and acting local” by acknowledging the international standards but also analyzing community and population needs to ensure the change is adjusted to meet the specific needs of the population.

    Implementation strategies

                In the implementation stage, the study will aim to work with nursing education systems locally and internationally to equip and train qualified nurses to become APNs. On the other hand, other healthcare staff and leaders will be engaged in the role of APNs and their role in care. The support of key stakeholders such as governments and global health organizations will be critical to the effective implementation of the policy change.

    The final stage of implementation would be to train and empower APNs with not only clinical knowledge but also on leadership and important organization systems such as the communication systems and resource management to effectively administrate and also optimize the care processes.

    Evaluation strategies

                Upon implementation, the evaluation would be established by monitoring the health outcomes, patient satisfaction rates, and through the feedback of APNs in practice (Miranda et al., 2018). Health outcomes would highlight the impact of APNs on care compared to physicians. Patient satisfaction rates would determine the experience of patients with APNs compared to physicians and how this could improve the performance of APNs. Lastly, direct feedback from the APNs would help iteratively improve their position and optimize care processes.

    Conclusion

                Globalization in healthcare has led to rapid and critical advances in nursing research, nursing education and practice, with the roles of nurses shifting to more influential care positions across the globe. APNs offer an avenue for influencing care processes positively by improving the healthcare outcomes to complex and underserved populations, improve chronic disease management through health promotion and prevention by APNs in touch with the community, improving the quality and safety of care, improving patient satisfaction and cumulatively advancing nurses through nursing research, education and practice in the nursing continuum.

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    Health Policy Proposal
    Health Policy Proposal

    References

    Bryant-Lukosius, D., & Martin-Misener, R. (2016). ICN policy brief: advanced practice nursing: an essential component of country level human resources for health. In ICN.

    Bryant‐Lukosius, D., Carter, N., Reid, K., Donald, F., Martin‐Misener, R., Kilpatrick, K., … & DiCenso, A. (2015). The clinical effectiveness and cost‐effectiveness of clinical nurse specialist‐led hospital to home transitional care: a systematic review. Journal of evaluation in clinical practice, 21(5), 763-781.

    Bryant-Lukosius, D., Valaitis, R., Martin-Misener, R., Donald, F., Peña, L. M., & Brousseau, L. (2017). Advanced practice nursing: a strategy for achieving universal health coverage and universal access to health. Revista latino-americana de enfermagem, 25.

    DiCenso, A., & Bryant-Lukosius, D. (2010). Clinical nurse specialists and nurse practitioners in Canada. Canadian Health Services Research Foundation.

    Miranda Neto, M. V. D., Rewa, T., Leonello, V. M., & Oliveira, M. A. D. C. (2018). Advanced practice nursing: a possibility for Primary Health Care?. Revista Brasileira de Enfermagem, 71, 716-721.

    Oldenburger, D., De Bortoli Cassiani, S. H., Bryant-Lukosius, D., Valaitis, R. K., Baumann, A., Pulcini, J., & Martin-Misener, R. (2017). Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean. Revista Panamericana de Salud Pública, 41, e40.

    Udod, S., & Wagner, J. (2018). Common Change Theories and Application to Different Nursing Situations. Leadership and Influencing Change in Nursing.

    Question

    For this Assignment, you will write a position paper in which you will choose and support a policy change which reinforces the role of the nurse as a leader in ensuring access to quality health care in developed and underdeveloped countries.

    You should approach this assignment from the perspective of your specialty track. Information which may be helpful in selecting a proposed policy change can be found in your textbook Health Policy and Politics: A Nurse’s Guide 

    The word count for your position paper will be 1000 to 1600 words. You must support your work with at least eight scholarly peer reviewed articles. Your paper must include the following topics:

    As you continue, customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Health Policy Proposal)

    Health Policy Proposal
    Health Policy Proposal
    • Current nursing issues related to globalization of healthcare
    • The proposed policy change
    • Agenda setting strategies (Process by which your proposal will gain attention of stakeholders and/or the public)
    • A model or theory that can be used to bring about the change
    • Design strategies
    • Implementation strategies
    • Evaluation strategies
    • Conclusion    

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  • Musculoskeletal Case Study : A 30 year old Latino woman presents for evaluation of wrist pain and swelling – Best Nursing Assignment Solutions(2022)

    This article provides solution to the assignment Musculoskeletal Case Study : A 30 year old Latino woman presents for evaluation of wrist pain and swelling.

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    Musculoskeletal Case Study:

    A 30 year old Latino woman presents for evaluation of wrist pain and swelling. She developed symptoms about 3 months ago and has noted progressive worsening since that time. In addition, she has tenderness across the balls of her feet with any weight bearing. The pain is worse when she is inactive and improves with activity.

    The symptoms have significantly affected her ability to perform her job as a receptionist in a busy office. She denies any recent trauma to her hands or feet or other joint pain. She reports stiffness in the feet and ankles as well as 4 hours of overall morning stiffness that improves only marginally for the rest of the day. She has noted increased fatigue and weakness in activities significantly. She does not recall being bitten by any insects recently.

    PMH: Non-contributory

    SH: Receptionist, single, barely supports herself without assistance from close by family. Denies smoking history, social drinker on the weekends with friends.

    Medications: Birth control pills and MV

    …

    Solution

    Musculoskeletal Case Study

    Index Case

    A 30-year-old Latino woman presents for evaluation of wrist pain and swelling. She developed symptoms about 3 months ago and has noted progressive worsening since that time. In addition, she has tenderness across the balls of her feet with any weight-bearing.

    The pain is worse when she is inactive and improves with activity. The symptoms have significantly affected her ability to perform her job as a receptionist in a busy office. She denies any recent trauma to her hands or feet or other joint pain. She reports stiffness in the feet and ankles and 4 hours of overall morning stiffness that improves only marginally for the rest of the day.

    She has noted increased fatigue and weakness in activities significantly. She does not recall being bitten by any insects recently.

    Most Likely Diagnosis of the Patient in the Case Study

    A review of the patient’s symptoms and the abnormal physical exam where the provider found a moderate bilateral swelling of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP), as well as the bilateral synovitis of the metatarsophalangeal (MTP) joints, are typical manifestations of rheumatoid arthritis (RA).

    Considering the patient’s relatively young age, the individual has young-onset rheumatoid arthritis (YORA) as the elderly onset of rheumatoid arthritis is considered when the patient’s symptoms begin at 60 or more years (Horiuchi et al., 2017). According to Limala et al. (2014), RA is a chronic inflammatory disease that is a progressive, destructive condition of the joints causing decreased physical function, a quality of life that is impaired, increased risk of co-morbidity, and premature death if not treated and effectively managed.

    Like any other conventional RA case, the patient’s symptoms began insidiously for weeks, which turned into three months before the individual presented for a clinical evaluation. The patient initially notices stiffness in one or more joints exacerbated by pain on movement and joint tenderness. The patient reports joint stiffness in the morning, which lasts up to four hours, and the physical exam revealed moderate synovitis of the MCP wrist, PIP, and MTP of both hands. The RA is in the early stages (Stage 2).

    The Patient’s Symptoms that Support RA Diagnosis

    The patient has several clinical manifestations of RA that include but are not limited to wrist pain and swelling which developed over three months together with tenderness across the balls of her feet at the slightest bearing of any weight. The pain gets worse with inactivity but improves when engaged (Qorban et al., 2018).

    Another characteristic symptom of RA that the patient is joint stiffness that lasts up to four hours of the morning slightly improves as the day progresses. Bullock et al. (2018) further note that other nonspecific symptoms like fatigue and general malaise are common features before the onset of RA’s clinical features.

    The physical exam abnormalities like moderate synovitis in the MCP, PIP, and MTP joints in both upper and lower extremities are RA indicators. The limited range of motion also points towards the same RA diagnosis.

    As you continue, customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Musculoskeletal Case Study)

    Musculoskeletal Case Study
    Musculoskeletal Case Study

    Pathophysiology of Rheumatoid Arthritis and the Impact of Environmental and Genetic Factors on the Disease

    Castro- Santos & Diaz-Pena (2016) observe that RA is an autoimmune inflammatory rheumatic illness that attacks many tissues and organs, the main ones being synovial joints. The disease leads to the progressive destruction of articular cartilage and joints ankyloses.

    The resulting pannus formation may destroy the underlying cartilage and erosion of the bones. The risk factors associated with RA include a genetic predisposition where there is sex-linked RA though the triggering mechanism to the sex-linked deformities is not clearly understood (Pradeepkrin, 219).

    Additionally, nongenetic factors like smoking and air pollution are some of the environmental risk factors which, according to Pradeepkrin (2019), double the risk of developing RA. It is essential to acknowledge that RA is a progressive disease with no cure, meaning that treatment goals should target to slow the disease’s progression by decreasing the rate at which the destruction of cartilage and bone occurs.

    The joint damage varies depending on the patient’s genetics, gender, and environmental pollutants (Scherer et al., 2020). Treatment exists that improves patient quality of life. Pharmacological, nonpharmacological, and emerging targeted therapy significantly improve the patient’s outcomes if adhered to.

    References

    Bullock, J., Rizvi, S. A., Saleh, A. M., Ahmed, S. S., Do, D. P., Ansari, R. A., & Ahmed, J. (2018). Rheumatoid arthritis: a brief overview of the treatment. Medical Principles and Practice, 27(6), 501-507.

    Castro-Santos, P., & Díaz-Peña, R. (2016). Genetics of rheumatoid arthritis: a new boost is needed in Latin American populations. Revista Brasileira de Reumatologia (English Edition), 56(2), 171-177.

    Deane, K. D., Demoruelle, M. K., Kelmenson, L. B., Kuhn, K. A., Norris, J. M., & Holers, V. M. (2017). Genetic and environmental risk factors for rheumatoid arthritis. Best practice & research Clinical rheumatology, 31(1), 3-18.

    Horiuchi, A. C., Pereira, L. H. C., Kahlow, B. S., Silva, M. B., & Skare, T. L. (2017). Artrite reumatoide do idoso e do jovem. Revista Brasileira de Reumatologia, 57(5), 491-494.

    Innala, L., Berglin, E., Möller, B., Ljung, L., Smedby, T., Södergren, A., & Wållberg-Jonsson, S. (2014). Age at onset determines severity and choice of treatment in early rheumatoid arthritis: a prospective study: arthritis research & therapy, 16(2), R94.

    Pradeepkiran, J. A. (2019). Insights of rheumatoid arthritis risk factors and associations. Journal of Translational Autoimmunity, 2, 100012.

    Qorban, G. N. M., Badghaish, M. M. O., Albaqami, A. S., Nemer, A. A., Alali, A. J., Yaqoub, A., … & Alasmari, M. A. (2018). Rheumatoid arthritis, pathophysiology, and management. The Egyptian Journal of Hospital Medicine, 70(11), 1898-1903.

    Scherer, H. U., Häupl, T., & Burmester, G. R. (2020). The etiology of rheumatoid arthritis. Journal of Autoimmunity, 110, 102400.

    Question

    Musculoskeletal Case Study:

    A 30 year old Latino woman presents for evaluation of wrist pain and swelling. She developed symptoms about 3 months ago and has noted progressive worsening since that time. In addition, she has tenderness across the balls of her feet with any weight bearing.

    The pain is worse when she is inactive and improves with activity. The symptoms have significantly affected her ability to perform her job as a receptionist in a busy office. She denies any recent trauma to her hands or feet or other joint pain.

    She reports stiffness in the feet and ankles as well as 4 hours of overall morning stiffness that improves only marginally for the rest of the day. She has noted increased fatigue and weakness in activities significantly. She does not recall being bitten by any insects recently.

    As you continue, customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Musculoskeletal Case Study)

    Musculoskeletal Case Study
    Musculoskeletal Case Study

    PMH: Non-contributorySH: Receptionist, single, barely supports herself without assistance from close by family. Denies smoking history, social drinker on the weekends with friends.Medications: Birth control pills and MV

    ROS:

    • Constitutional: Denies fever or chills, denies weight loss
    • Eyes: Denies dry eyes or visual changes
    • ENT: Denies dry mouth
    • Respiratory: Denies difficulty breathing
    • Cardiovacsular: Denies chest pain
    • Genitourinary: Denies bladder changes
    • Gastrointestinal: Denies any bowel changes
    • Endocrine: Denies polyuria, polydipsia, or polyphagia
    • Musculoskeletal: Denies neck or shoulder stiffness
    • Skin/Integument: Denies rashes, lesions, ulcers, changes in hair, skin or nails

    Physical Exam:

    • General: Appears in no acute distress
    • Vitals: 110 lbs, height 63 in., temp orally of 100 degree F, BP is 120/70. HR 64. RR 12 and regular.

    All other exam findings normal except:Neuromuscular: There is moderate synovitis (swelling) of the MCP and PIP joints bilaterally and of the MTP joints bilaterally. The patient has limited ROM of the UE and LE digits due to the pain. There are no nodules noted on any extremities. The Phalen’s, Finkelstein’s, and Tinel’s tests are negative. There is no warmth or redness of any joint. DTR’s are 2+ throughout.

    Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background information

    Discussion Questions:

    1. Review the symptoms and abnormal physical exam above and review readings from Chapter 45, Alterations of Musculoskeletal functions, and support your interpretation of the most likely diagnosis with evidence.
    2. List all the symptoms from the above that support this diagnosis.
    3. Briefly describe the pathophysiology of the disorder and the impact of environmental and genetic factors on this disorder.

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  • Endocrine Case Study of Shirley, 50-year-Old Housewife Diagnosed with Hypothyroidism – Best Assignment Solutions(2022)

    This article provides solution to assignment about Endocrine Case Study of Shirley, 50-year-Old Housewife Diagnosed with Hypothyroidism.

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    Endocrine Case Study

    Shirley, a 50 year old housewife, comes in complaining of progressive weight gain of 20lbs over the last year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance. She is concerned and wants labs to further evaluate her condition.

    PMH: Anxiety disorder diagnosed 1 year ago

    Meds: alprazolam .5 every 6 hours as needed for anxiety

    Allergies: None

    ROS: Negative except as listed above

    …

    Solution

    Endocrine Case Study of Shirley, 50-year-Old Housewife Diagnosed with Hypothyroidism

    Background to the Case Study

    Shirley is a 50-year-old housewife who presents at the clinic with the chief complaint of progressive weight gain over the last 12 months, fatigue, and postural dizziness. Additional symptoms include memory loss, slow speech, deepening voice, and cold intolerance, amongst others.

    Her PMH indicated Anxiety disorder a year ago, is currently on alprazolam medication for the anxiety with no known allergies. Other than the stated symptoms, her ROS reports negative while a physical exam indicates an obese female, while lab results determine the patient has hypothyroidism. This essay explains the action of thyroid hormone and how it affects Shirley’s diagnosis, together with the role of Thyroxine (T4) and triiodothyronine (T3) in the body.

    The action of Thyroid Hormone and how it Impacts the Diagnosis

    THs have been determined to control energy metabolism across ages, meaning that patients with a dysfunction of TH exhibit clinical symptoms of metabolic dysregulation like changes in their weight reported by Shirley over the last 12 months. In the case of hypothyroidism. THs trigger a hypo- metabolic state whose identifying symptoms are decreased energy expenditure, raised cholesterol levels, lowered lipolysis, and gluconeogenesis accompanied by weight gain.

    TH is a critical factor in the regulation of mitochondria respiration as well as biogenesis. It is worth noting that the TH intracellular regulation’s metabolic impact in different tissues ranges from the liver to the pancreas, the hypothalamus, and skeletal muscles, to mention but a few(Cicatiello et al., 2018).

    For example, in the liver, lipid homeostasis is controlled by the local T3 levels, impacting the individual’s susceptibility to liver steatosis and obesity. Additionally, in the hypothalamus, the TH local availability controls feeding behavior and, by extension, the energy expenditure.

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    Endocrine Case Study
    Endocrine Case Study

    Increased Thyroid Stimulation Hormone Levels Rise and the Negative Feedback Mechanism in the Body

    Endocrinologists posit that the thyroid gland is mainly controlled by a feedback mechanism where THs secretion is stimulated by thyrotropin or thyroid-stimulating hormone (TSH) with pituitary thyrotropin secreting them (Fitzgerald & Bean, 2018). Studies have demonstrated that the axis known as the hypothalamic-pituitary axis- controls the TSH release via hypothalamic neurons that secrete thyroid releasing hormones.

    Increased stimulation of thyroxine (T4) secretion at 80% and triiodothyronine or (T3) at 20% has it that when T4 enters into circulation, deiodination occurs, meaning it is converted into T3. After deiodination, T4 and T3 can exert negative feedback on the levels of TSH since high levels of T3/T4 lower the releases of TSH from the anterior pituitary while low levels of T3/T4 increase doe increase the release of TSH.

    Roles of Thyroxine (T4) and Triiodothyronine (T3) In the Body

    According to Teixiera et al. (2020), the THs actions affect peripheral tissues through varied mechanisms. Take the case of T4 (the thyroid gland’s main product, which is converted into an active home. T4 can then be inactivated by type 3 5 deiodinase (D3). Likewise, T3 can also be inactivated by D3, where either T4 or T3 gain access to the cells through particular membrane transporters. Using canonical pathway or non-canonical signaling pathways and a host of TH receptors and subtypes regulate target genes genes’ transcriptional activity.

    Conclusion

    In conclusion, deiodination is arguably the most significant TH activation pathway, with peripheral tissue having several pathways capable of modulating TH availability. Therefore drug development to combat TH dysfunctions should focus on deiodinase action aimed at achieving specific metabolic outcomes.

    References

    Cicatiello, A. G., Di Girolamo, D., & Dentice, M. (2018). Metabolic effects of the intracellular regulation of thyroid hormone: old players, new concepts. Frontiers in endocrinology, 9, 474.

    Fitzgerald, S. P., & Bean, N. G. (2018). Thyroid-stimulating hormone (TSH) autoregulation reduces variation in the TSH response to thyroid hormones. Temperature, 5(4), 380-389.

    Thyroid-stimulating. S., dos Santos, P. B., & Pazos-Moura, C. C. (2020). The role of thyroid hormone in metabolism and metabolic syndrome. Therapeutic Advances in Endocrinology and Metabolism, 11, 2042018820917869.

    Question

    Endocrine Case Study

    Shirley, a 50 year old housewife, comes in complaining of progressive weight gain of 20lbs over the last year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance. She is concerned and wants labs to further evaluate her condition.

    PMH: Anxiety disorder diagnosed 1 year agoMeds: alprazolam .5 every 6 hours as needed for anxietyAllergies: NoneROS: Negative except as listed above

    Physical Exam:

    • General: Obese female
    • Vitals: T 98.6F, HR 58/min and regular, BP 110/60.
    • Head: Normocephalic
    • Eyes: PERRLA, EOMI, puffiness noted around eyes and face
    • Neck: Thyroid gland is non-palpable
    • Skin/Integument: pale, cool, dry, thick skin

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    Endocrine Case Study
    Endocrine Case Study

    The provider checks labs and determines Shirley has hypothyroidism.

    Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background information.

    Discussion Questions:

    1. Explain the action of thyroid hormone and how this impacts the diagnosis. Your answer should contain the impact of the thyroid hormone on functions in the body.
    2. As Thyroid Stimulation Hormone (TSH) levels rise, explain how this impacts the negative-feedback mechanism in the body.
    3. What are the roles of Thyroxine (T4) and triiodothyronine (T3) in the body?

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  • Renal Case Study – Chronic Renal Failure – Best Nursing Assignment Solutions(2022)

    This article provides solution to Renal Case Study – Chronic Renal Failure Assignemnt.

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    A 51 year old Caucasian-American female present to the emergency department with a headache of 8 of 10 on a pain scale. She reported the headache as a pulsation in her ear that is typical when her blood pressure rises. She also reported accompanying visual blurring, intermittent chest pressure, non-exertional shortness of breath, and episodic abdominal pain with nausea. She reports not taking her Labetalol.

    PMH: Type I DM since age 8 with history of impaired renal function that has continued to progress to a chronic stage and hypertension.Family history: Positive for DM, hypertension, CAD and Cancer.SH: Quit tobacco 5 years agoMeds: Labetalol, Lasix 20mg qd prn, Lantus 20 units at hs, Protonix 40mg qd, ASA 81mg qd, and Tylenol prn

    …

    Solution

    Renal Case Study – Chronic Renal Failure

    Chronic kidney disease (CKD) or renal failure is characterized by kidney damage or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 mt2. CKD is ‘silent,’ progressive, and irreversible in the context of glomerular filtration rate (GFR) yet early detection remains a significant challenge because of its asymptomatic nature in early to moderate CKD (Wang & Chen, 2012).

    The renal function is critical in the human body, facilitating fluid regulation, waste excretion, maintaining bone integrity, and bolster electrolyte balance. These processes interlink with the cardiovascular system creating harmony between organ processes to achieve hemodynamic stability.

    As a result, some organizations such as the National Kidney Foundation (NKF) recommend periodic testing for blood pressure measurement, urine protein, and estimated glomerular filtrate (eGFR) to help reduce renal failure cases patients aged between 12 and 70.

    Angiotensin II results from angiotensin I through angiotensin-converting enzyme acts and acts to bind to specific body receptors such as AT1 and AT2. Moreover, Angiotensin II functions to exert action on cardiovascular, neural, and renal functions by increasing blood pressure, body water, and sodium content. Contrastingly, proteinuria characterizes a condition where urine exhibits increased levels of proteins, which is an alarming sign of kidney damage.

    Angiotensin II increases blood pressure as it triggers vasoconstriction of blood vessels; arterioles (Qaseem et al., 2013). It also stimulates kidneys to increase sodium reabsorption; hence kidneys can enhance water retention increasing blood volume and blood pressure. Besides, fluid retention is stimulated by the effect of angiotensin II on the hypothalamus, where it triggers thirst sensation, desire for salt while also stimulating the production of anti-diuretic hormone (ADH).

    As you continue, customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Renal Case Study – Chronic Renal Failure)

    Renal Case Study - Chronic Renal Failure
    Renal Case Study – Chronic Renal Failure

    Lastly, chronic kidney disease affects and possibly harms the integumentary system; skin. Renal failure is accompanied by the inability to balance blood minerals, which results in constant itching and scratching of the skin on the head, legs, and chest area. Kidney failure also affects the blood system through conditions such as anemia and iron deficiency. This is because damaged kidneys slow the release of hormone erythropoietin with symptoms such as dizziness and irritability. The skeletal system is greatly affected by mineral imbalances caused by high hormone parathyroid levels, which draws calcium in the bones into the bloodstream, causing the bones to be malformed and weakened.

    References

    Qaseem, A., Hopkins Jr, R. H., Sweet, D. E., Starkey, M., & Shekelle, P. (2013). Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Annals of internal medicine, 159(12), 835-847.

    Wang, L. J., & Chen, C. K. (2012). The psychological impact of hemodialysis on patients with chronic renal failure. Renal failure-the facts, 217-236.

    Question – Renal Case Study – Chronic Renal Failure

    A 51 year old Caucasian-American female present to the emergency department with a headache of 8 of 10 on a pain scale. She reported the headache as a pulsation in her ear that is typical when her blood pressure rises. She also reported accompanying visual blurring, intermittent chest pressure, non-exertional shortness of breath, and episodic abdominal pain with nausea. She reports not taking her Labetalol.

    PMH: Type I DM since age 8 with history of impaired renal function that has continued to progress to a chronic stage and hypertension.

    Family history: Positive for DM, hypertension, CAD and Cancer.SH: Quit tobacco 5 years ago

    Meds: Labetalol, Lasix 20mg qd prn, Lantus 20 units at hs, Protonix 40mg qd, ASA 81mg qd, and Tylenol prn

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    Renal Case Study - Chronic Renal Failure
    Renal Case Study – Chronic Renal Failure

    ROS:

    • Constitutional: Denies fever or chills
    • Eyes: Reports blurred vision, no floaters
    • ENT: Denies sinus pressure or congestion, denies sore throat
    • Respiratory: Denies cough, non-exertional dyspnea reported
    • Cardiovascular: Admits intermittent chest pressure, denies palpitations

    Physical Exam:

    • General: Alert and oriented in no acute distress
    • Vitals: T 36.7C, BP 193/98, HR-88, Weight 87.5kg
    • Eyes: PERRLA, EOMI, moist mucus membranes
    • Neck: supple, No JVD
    • Lungs: CTA A&P
    • Heart: RRR without MGR
    • Abdomen: soft, non-distended, nromoactive bowel sounds
    • LE: edema to mid-thigh
    • Skin/Integument: no cyanosis or clubbing

    The patient was admitted for hemodialysis due to her progression of renal functioning but also admitted to control the hypertensive urgency and headache.

    Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background information

    Discussion Questions:

    1. Explain what happens physiologically with chronic renal failure and the GFR. Support with evidence. Include important labs that are monitored in the process.
    2. Explain the role of Angiotensin II and proteinuria as they relate to advancing renal disease.
    3. List at least three other body systems that are impacted by chronic kidney disease and why.

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  • Reflection on otelo – Best Sample Solutions(2022)

    This article covers a Reflection on otelo.

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    customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us.(Nursing Care Plans for Thrombocytopenia)

    Plays are meant to be performed rather than read. The purpose of dramatic arts often extends far beyond the words written on a page—staging, lighting, costumes intonation, expression, and audience experience are all part of the experience of a theatrical production. To help develop your understanding of Othello and the cultural role of the dramatic arts, you will view a production of the play this week and write a two-page reflection to explain your viewing experience. Please make sure you review the Assignment Connection portion of this week\’s lesson, as it will provide some additional help. 

    Below, please find two adaptations of Othello.

    Otelo (Links to an external site.) (Spanish version)

    Othello (Links to an external site.)

    …

    Solution

    Reflection on otelo

                I selected the ‘otelo’ performance (Bittencourt, 2014). After reviewing the first ten minutes of each performance, I chose to continue watching the Portuguese adaptation ‘otelo’ for its contemporary yet outstanding performance. Othello, written by William Shakespeare (1564-1616), is a historical piece that has transcended over time and adapted to be performed to diverse audiences and in different languages. This ‘otelo’ performance, a production from Persona Cia de Teatro, stands out because it adopts Shakespeare’s work from a different historical time and presents it to a modern audience through visuals and performances that are relatable to the contemporary audience. The adaptation utilizes modern lighting, staging, costumes as well as characters, to create a relatable version of the play, highly appealing to a modern audience.

    Performance

                Otelo is set on a modern theater platform set to model a modern layout. With two desks, chairs and storage units, the stage mirrors a typical contemporary office, and living room setting. The staging allows the audience to feel more immersed in the production. Given “Othello” was written in a historical context, adapting the play in a modern context is interesting to most of the audience, and will make them understand the play better. Lighting is used to help underline all those within the play at any given time and advance specific themes. The lighting also takes a contemporary approach with the use of a spotlight and general lighting. Unlike most Othello adaptations, this performance uses modern formal wear as costumes. Each character has costumes that are similar to modern wear. The use of suits for men, and formal dressing for women, ensure that the audience can relate to each character based on their visual representation.

    Mood and tone

                One of the outstanding aspects of the play is the devices it uses to create a mood or amplify a tone. Dramatic sound in the beginning set, set to create suspense, and amplify the changes in the tones of the characters, as well as additions such as contemporary celebratory music, make the play lively and engaging. Besides, the play creates a tone of cynicism and manipulation. It highlights how the actions and beliefs of one can hurt others around him. The play also shows how manipulative words, gestures, and actions can be used to influence the beliefs of others. Lara, the secretary, embodies the tone and uses it to influence the beliefs of Othello on his marriage, instigating cynicism in love and jealously themed story.

    Parts of the play easier to understand

                The performance’s display of emotion using modern visuals and displays, such as having characters smoke cigarettes as they reflect on their understanding of the world around them, makes it easier to understand a relationship. The detail especially on lighting and visuals, such as displaying lighting to show daybreak and the murder of Othello’s wife using a pillowcase as well as his grief after the murder. The inclusion of a musical in the final scene is also exemplary, thought-provoking, and helps portray the emotion and substance in the play. The detail of the visual, sound and music, and character actions stand out, leading to one excellent adaption of the original work.

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    Reflection on otelo
    Reflection on otelo

    Role of theater in contemporary culture

                Theater provides a platform to understand the past, present, and even future societies. In particular, this performance highlights the need to create relatable yet appealing and engaging depictions. The performance highlights the role of theater in informing contemporary culture on how human interactions influence individual actions and the collective impact it has on society. By adopting a script more than 400 years old and performing it in a contemporary way, the performance suggests that theater has the role of depicting ancient stories in a way that’s relatable and appealing to contemporary societies. The creativity of theater, as such, should in performing contextual pieces in a manner that connects to the contemporary audience.

    References

    Bittencourt, J. (2014). Otelo [Film]. Florianópolis, Santa Catarina, Brazil: https://globalshakespeares.mit.edu/otelo-bittencourt-jefferson-2014/.

    Question

    Plays are meant to be performed rather than read. The purpose of dramatic arts often extends far beyond the words written on a page—staging, lighting, costumes intonation, expression, and audience experience are all part of the experience of a theatrical production. To help develop your understanding of Othello and the cultural role of the dramatic arts, you will view a production of the play this week and write a two-page reflection to explain your viewing experience. Please make sure you review the Assignment Connection portion of this week\’s lesson, as it will provide some additional help. 

    Below, please find two adaptations of Othello.

    Otelo (Links to an external site.) (Spanish version)

    Othello (Links to an external site.)

    (1981, William Marshall version)

    You may also find this short interview helpful:Is Othello a Racist Play?  (Links to an external site.)

    For this assignment, you will view one of the above versions of Othello. You will also find this website (Links to an external site.) valuable in helping you understand how to analyze a play. Once you\’ve gone through the website link and watched the play, please complete a reflection that addresses the following.

    • Identify the performance that you have selected and why you chose that performance.
    • Describe the staging, lighting, costumes, and characters of the performance. How do these match or revise the written version of the play?
    • What type of mood and tone does the performance create? How?
    • What parts of the play are easier to understand through performance? What are some details that stood out through the performance?
    • What does the performance suggest about the role of theater in contemporary culture? (Please write a strong paragraph that thoughtfully answers this question

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