Client Questions

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions. Case Scenario Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure. Subjective Data Is very anxious and asks whether she is going to die. Denies pain but says she feels like she cannot get enough air. Says her heart feels like it is “running away.” Reports that she is so exhausted she cannot eat or drink by herself. Objective Data Height 175 cm; Weight 95.5 kg Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58 Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82% Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin Critical Thinking Questions What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications? IV furosemide (Lasix) Enalapril (Vasotec) Metoprolol (Lopressor) IV morphine sulphate (Morphine) Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials: “About the Affordable Care Act” “Health Care Transformation: The Affordable Care Act and More” What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

During your practicum, determine what clinical problem or issue the   organization is facing. Discuss two implications for nursing.

Select and evaluate a research article on an evidence-based practices that relates to nursing practice and health assessment. Describe and summarize the content and essential argument of the article in a concise format. Select a research article that pertains to the management of health for a specific population. Critique the selected research article related to evidenced-based practice.   The assignment must be 3 pages (not counting resources)  Name of the author (s), title of the article, type of journal, volume number, date, and page numbers.  A paragraph abstract of the article to summarize the essential content/ideas.  A paragraph describing your view of the article’s balance. Did the writer address both sides of the issue? Was there bias involved and if so, slanted towards which side? What is your evidence of this bias or imbalance?  A paragraph describing your opinion of the article’s quality and your own position:  Did the writer do sufficient research?  Is the article technically correct and clearly presented and supported? Are there elements of the argument that could have been enhanced with more detail or more argumentation?  What would a follow-up article contain to be useful to this one?  Did you agree with the article? Did it support or change your opinion? If not, then why?  The final paper should be typed, double-spaced on one side of white standard (8 ½ X 11 inch) paper.

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As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. Write a 2- to 3-page paper that addresses the following: Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements. The scenario for your assignment this week is listed below.  For the assignment, select one the following factors: genetics, gender, ethnicity, age, or behavior factors. Explain how this factor affects pharmacokinetics and pharmacodynamics and make recommendations for changes to pharmacotherapy that are required to optimize this patient’s therapeutic plan.  Patient AO is a 50 year-old African-American male that has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5 mg daily   Hydralazine 10 mg qid   Sertraline 25 mg daily   Simvastatin 80 mg daily

I need a 2-3 page paper to include statistics, a separate cover page and reference page. on topic: Diagnostic Experiences of Children With Attention-Deficit/Hyperactivity Disorder (Article and RUA attached). I need all the yellow highlighted areas on the RUA addressed in the paper. I like to have completed by Monday 7/13/20 12pm.

What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? Discuss your facility’s procedure for reporting these types of abuse.

Part 2: Identifying Research Methodologies After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following: The full citation of each peer-reviewed article in APA format. A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest. A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article. A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific. A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

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