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Help me study for my Nursing class. I’m stuck and don’t understand.

Case and Discussion

Kathryn

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• What additional questions would you ask to learn more about his cough?

What factors may have prompted the cough? (any respiratory infections or exposure to noxious agents)

Is there a seasonal pattern?

Is it related to any hobbies or work?

Does the cough occur on arising? At night? During exercise? Throughout the night?

What factors stimulate the cough?

Does anything aggravate the cough?

Does cold air, exercise, certain chemicals or exercise cause an increase in coughing?

Do you have any reactive airway disease?

Does anything relive the cough?

What have you tried to alleviate the cough?

Can you describe the quality of the cough? Is it dry, wet, raspy, deep, throaty or hacking?

Is the cough productive?

If it is productive, can you describe the sputum that is produced with the cough?

How much sputum do you cough up a day?

What color and consistency is the sputum?

When is the cough the most productive?

Do you have any symptoms associated with the cough? Such as dizziness, fever, wheezing, edema, chills, dyspnea.

Do you smoke?

Do you have any shortness of breath?

Do you take any over the counter drugs?

What prescriptions do you currently take?

• How would you classify his cough based on the duration to help with the diagnosis?

Coughs can be classified based on the duration. Acute coughs are coughs that are present less than three weeks and subacute are coughs that are present 3-8 weeks (Sharma, Hashmi & Alhajjaj, 2019). Chronic coughs are coughs that a present greater than 8 weeks (Sharma, Hashmi & Alhajjaj, 2019). Based on this classification and the patient having his cough for three months, his cough would be considered chronic. It is important to classify the cough based on duration because it helps with making a diagnosis. Acute coughs are usually self-limiting and typically resolve within three weeks. It often occurs due to upper respiratory tract infections (Mahashur, 2015). Chronic coughs should be diagnosed accurately because it can lead to disturbance of sleep, cough syncope, urinary stress incontinence, exhaustion and work absenteeism (Mahashur, 2015).

• What diagnostic tests do you want to include to help you with your diagnosis?

Diagnostic tests that should be ordered to help decide on a diagnosis for this patient include, a chest x-ray, chest CT, spirometry, complete blood count (CBC) with differential, arterial blood gas, oximetry, EKG, complete pulmonary function testing and peak expiratory flow rate. A chest x-ray and complete pulmonary function testing are diagnostic measures that should help with making a diagnosis. But if both of these are normal and there is no other information from the history and physical examination are leading to a certain diagnosis then the patient may require a referral to a pulmonologist for further evaluation (Sharma, Hashmi & Alhajjaj, 2019).

Create a differential diagnosis flow sheet for this patient for this patient and include the diagnostics as well as the pharmacological management and rationale related to the differentials. Support your discussion with evidence-based research.

1. Asthma:

Diagnostics: spirometry, oximetry, peak expiratory flow rate, chest x-ray, arterial blood gas, CBC with differential.

Pharmacological management: Once daily controller medication: inhaled corticosteroid: fluticasone metered dose inhaler (44mcg/puff), once daily.

Inhaled beta-2 agonist as needed: albuterol metered dose inhaler (90mcg/puff), 2 puffs every 4-6 hours PRN.

Rationale: Patient states he has frequent nasal congestion especially when he is exposed to dust and cold weather. Allergens and environmental factors can cause triggers for asthma. Based on his symptoms and his cough lasting more than 3 months with the cough being dry and more frequent at night, its characteristics point to asthma. One characteristic that helps with the diagnosis of asthma is that his cough is worse at night (Dunphy, Winland-Brown, Porter & Thomas, 2015).

2. COPD:

Diagnostics: spirometry, arterial blood gases, CBC with differential, blood chemistry panel, chest x-ray, oximetry and EKG

Pharmacological management: Inhaled beta-2 agonist as needed: albuterol metered dose inhaler (90mcg/puff), 2 puffs every 4-6 hours PRN.

Inhaled beta-2 agonists are the first line of treatment for COPD stage 1 (Dunphy et al., 2015). If this patient is diagnosed with COPD it will need to be staged so that they proper treatment can be ordered. The medication therapy would be different if the patient was diagnosed with a higher stage. The patient might also need a diuretic if the patient has any evidence of right sided heart failure. Inhaled beta-2 agonists such as albuterol would be prescribed as the treatment if the patient was diagnosed with COPD stage 1.

Rationale: Patients that present with COPD usually have a chronic productive cough and increased shortness of breath (Dunphy et al., 2015). This patient states his cough is dry, but over the course of the past 3 months it could have been productive at some point. He also states it is worse at night, and he could also have paroxysmal nocturnal dyspnea which would make his cough more severe. Further diagnostic workup and physical exam will help determining if this patient has COPD.

3. GERD:

Diagnostics: Esophageal pH monitoring

Pharmacological management: antacids and histamine2 receptor antagonists (H2RAs)

Prescribe Maalox 5-30ml every 30-60 minutes for acute management and 5-30ml 1h and 3h after meals and at bedtime for maintenance and famotidine 20mg bid (Woo & Robinson, 2016).

Trial this management and if no improvement in 4 weeks use the step-up treatment guidelines

Rationale: This patient is presenting with cough and no other symptoms were mentioned. Since he has not had any wheezing, weight loss or change in appetite this could be a diagnosis not related to a respiratory condition. GERD can present with atypical symptoms such as chronic cough, adult-onset asthma and a sore throat (Dunphy et al., 2015). GERD is reported to be the cause of chronic cough in 40% of patients (Mahashur, 2015). It causes cough by intraesophageal reflux, laryngopharyngeal reflux and microaspiration. Each of these mechanisms can act directly by triggering a cough or indirectly by sensitization of the cough reflex. In 75% of cases of patients with GERD-related coughs, they present with no other gastrointestinal symptoms (Mahashur, 2015). Until further diagnostic workup is completed, GERD should be considered a possible diagnosis.

4. Medication-induced cough:

Diagnostics: no diagnostic workup is required, just complete history of medications and over the counter drugs

Pharmacological management: If patient is currently on an angiotensin-converting enzyme (ACE) inhibitors switch to a different medication such as angiotensin II receptor blockers (ARB) and prescribe losartan, dosing dependent on dose of ACE inhibitor.

Rationale:

After completing a history and physical and assessing patients’ medications and if he is currently on an ACE inhibitor will help determine if his cough is medication induced. If he is on an ACE inhibitor, then his cough could be a side effect of his medication. 10% of patients that take ACE inhibitors have a cough (Dunphy et al., 2015). Once a complete history of the patient’s current medications is done then it can be determined if his cough is medication-induced.

References

Dunphy, L. M. H., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary Care: The Art and Science of Advanced Practice Nursing (4th ed.). Philadelphia, PA: F.A. Davis Company.

Mahashur A. (2015). Chronic dry cough: Diagnostic and management approaches. Lung India 32(1), 44–49.

Sharma, S., Hashmi, M. F., Alhajjaj, M. S. (2019). Cough. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493221/

Woo, T. M., & Robinson, M. V. (2016). Pharmacotherapeutics for Advanced Practice Nurse Prescribers (4th ed.). Philadelphia, PA: F.A. Davis Company.

I’m stuck on a Management question and need an explanation.

Assignment Details

Quality Improvement in the Health Care Organization Accreditation

The mandate for improving the way in which health care is delivered was stimulated by the public outcry over the estimated 98,000 deaths because of medical errors each year according to the Institute of Medicine in 1999. Since then, health care organizations have sought means by which the public can be reassured that they were meeting quality and safety standards. Accreditation agencies (e.g., The Joint Commission) and quality awards provide a means for the public to evaluate where the agency is meeting minimum standards.

You have been assigned by your manager to determine which accrediting agencies or quality improvement programs your hospital will utilize in its upcoming revenue cycle. Your hospital is a magnet hospital in a large urban area that provides multilayered services. You have previously used The Joint Commission for your accreditation but feel that you might be better served by using another accrediting body. You have three months in which to gather data and present the information to your manager.

Complete the following for this assignment:

• Choose 3 quality improvement or accreditation-related programs to consider in replacing The Joint Commission for your organization, and briefly describe them. Your agency accepts Medicare and Medicaid payments; therefore, you will need to explore, as background, the conditions of participation for Centers for Medicare and Medicaid Services (CMS). This is important information because you will need to compare your list of accrediting agencies and quality improvement programs with the conditions of participation to see if they meet the criteria.
• Analyze the costs and benefits of each quality improvement or accreditation-related program by stakeholder group (e.g., patient, provider, and third-party payer).
• Rank your quality improvement or accreditation-related program suggestions with rationale.

Apa format with 4 apa references

I’m studying for my Management class and need an explanation.

MLA format and the length is 1000 words (minimum) – 1,200 words (maximum). You can choose any topic however let me know the topic before you start l. This must be done on time.

https://poets.org/poem/wanting-die

http://www.cabrillo.edu/~anajarro/classes/TheMoths.pdf

Help me study for my Nursing class. I’m stuck and don’t understand.

View the scenario called “Critical Decision Making for Providers” found in the Allied Health Community media (https://lc.gcumedia.com/hlt307v/allied-health-community/home.html).

In a 750?1,200 word paper, describe the scenario involving Mike, the lab technician, and answer the following questions:

1. What were the consequences of a failure to report?
2. What impact did his decision have on patient safety, on the risk for litigation, on the organization’s quality metrics, and on the workload of other hospital departments?
3. As Mike’s manager, what will you do to address the issue with him and ensure other staff members do not repeat the same mistakes?

A minimum of three academic references from credible sources are required for this assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

** Attached is scenario- but copied and pasted on a word document incase you are unable to access link**

I don’t know how to handle this Law question and need guidance.

On April 23, 2008, the United States Supreme Court, without dissent, determined in the case of Virginia v. Moore that despite unprofessional conduct on the part of the police, there was no violation of Mr. Moore’s civil rights when the police profiled him because they knew that he was driving under a suspended license. A subsequent arrest and search for the suspended driver’s license resulted in the finding of controlled substances and additional charges. Essentially, the court ruled that if the police knew a defendant was committing a motor vehicle violation, regardless of their personal bias, then they had the right to stop that person and check to see if probable cause existed to arrest him or her.

Primary Task Response: Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

• Under what conditions do you think, if any, racial profiling should be clearly illegal? Explain your position.
• What is your opinion about the decision that even if an officer was racially profiling, if the stop was based on a motor vehicle violation, then there is no issue?
• Is there a legitimate reason at any stage in an investigation for racial profiling? Explain.
• What impacts on the community do you think can proracial profiling policies have? Explain in detail.

I’m studying and need help with a Management question to help me learn.

I have 2 of my classmates posts. I need you to respond to each one separately. Also, two sources at least for each one of them. Don’t write about how good their posts or how bad. All you need to do is to choose one point of the post and explore it a little bit with one source support for each response. The paper should be APA style.

– pleas use proper APA6 references format and in-line citation.

– Minimum words for every respond 300

-Minimum refernces 2

All the details in the attached below

I need support with this Political Science question so I can learn better.

1. Drawing on the material presented in your Open to Debatee-text and the corresponding power point lecture outlines and lectures or video lecture clips, explain, why judges, who are not popularly elected, have such wide authority to strike down popular laws; why do judges have such enormous power with so little public accountability? Why does the U.S. have such an undemocratic institution in its democracy?
2. Drawing on Saffell, Meese, and Brennan in ch. 13 of your American Government: Examined reader (you may also find the material presented in the Judiciary chapter of your Open to Debate e-text and the corresponding power point lecture outline and lectures or video lecture clips to be helpful), do you think Justices should act according to the dictums of judicial activism or judicial restraint? You will want to include direct references to Meese and Brennan in your response.
3. Pretend you are a Supreme Court Justice who must render a decision in the three LGBT cases currently before the Supreme Court: Altitude Express v. Zarda, Bostock v. Clayton County, and Harris Funeral Home v. EEOC. I want you to act as a S.C. Justice and, drawing on what you have already in this assignment, the U.S. Constitution, and other relevant course materials, render a decision. How would you rule? Why? On what are you basing your decision? Which parts of the Constitution or other documents are relevant? Remember you are acting as a justice, not simply expressing your personal opinions.

Here is a link to the U.S. Supreme Court website:?http://www.supremecourt.gov, you can find many other resources online.

Tips for Success:

– I will be looking for direct references to assigned readings (author and page # citations are adequate). Please limit yourself to the assigned materials.

– More thoughtful analyses utilizing critical thought will earn higher scores.

Materials:

Open to Debatee-text: https://www.nsspress.com/php/startup_braunwarth_ot… -chapter 13 (account will be given to an assigned tutor)

American Government: Examined reader https://www.nsspress.com/php/startup_braunwarth_reader.php5 -chapter 13 (account will be given to an assigned tutor)

Power point lectures: attached below.

Video lecture clips:

https://youtu.be/OkD-iC5S_Bc

https://youtu.be/e-cJwKeL25k

https://youtu.be/mdbAFSG2ELU

https://youtu.be/xfuFZh7xIxA

https://youtu.be/mRGLb1dQ9Ms

Need help with my Nursing question – I’m studying for my class.

1. Explain the role of accreditation in mitigating risk compliance issues. Provide an example of a health care organization that was placed on probation by its accrediting body or by CMS within the last 3 years for a risk compliance issue. What caused the probation or loss of accreditation and how could it have been prevented?

2.Briefly describe how the risk management program at the organization where you work (or at that of a typical health care organization) addresses social media and patient information privacy. Provide three examples of risk management steps your health care organization (or another health care organization) could take to further protect patient information. Support your analysis with a minimum of one peer-reviewed reference.

I’m trying to study for my English course and I need some help to understand this question.

N THIS POEM, Oliver connects her argument to the reader’s own life by asking, “Tell me, what is it you plan to do / with your one wild and precious life?”

YOUR PROMPT IS:

Drawing on the question that this poem raises, please write a complete five-paragraph essay in which you explore three things you can do in your life to have a positive impact on the natural world. You must quote from the poem at least two times in your essay, using MLA format.

This is a five-paragraph essay that is related to the poem “The Summer Day” by Mary Oliver.

The essay needs to be about 800 words.

Grading will emphasize the skills as following:

1. solid and complete essay and paragraph structure

2. a clear thesis statement and topic sentences

3. quoting from poetry in MLA format

The link to the poem is: https://wordsfortheyear.com/2015/06/21/the-summer-day-by-mary-oliver/?from=singlemessage&isappinstalled=0

Also, I will paste the poem here.

“The Summer Day” by Mary Oliver

Who made the world?

Who made the swan, and the black bear?

Who made the grasshopper?

This grasshopper, I mean-

the one who has flung herself out of the grass,

the one who is eating sugar out of my hand,

who is moving her jaws back and forth instead of up and down-

who is gazing around with her enormous and complicated eyes.

Now she lifts her pale forearms and thoroughly washes her face.

Now she snaps her wings open, and floats away.

I don’t know exactly what a prayer is.

I do know how to pay attention, how to fall down

into the grass, how to kneel down in the grass,

how to be idle and blessed, how to stroll through the fields,

which is what I have been doing all day.

Tell me, what else should I have done?

Doesn’t everything die at last, and too soon?

Tell me, what is it you plan to do

with your one wild and precious life?

I’m trying to study for my Social Media Marketing course and I need some help to understand this question.

Four (4) times during this semester, you will submit a 150-200-word summary [not a copy] of a news story from any reputable state or national news source in print, on radio, on TV, or online. Use Times New Roman, 12-pt. type, double-spaced. The story will be about the intersection of media and the First Amendment in the United States—no stories from foreign countries. Not part of the 150-200 words will be a description of where you found this news item (N.Y. Times, CNN on TV, etc.), the title of the story, the date, and URL, if applicable, although I need to have this info. Just don’t count these words toward you 150-200 range. The story must appear in the news media during the week you will be submitting it. In addition to the summary of the story, I’m looking for any insights you might have on why this is an important case or issue and any implications for journalists, organizations, the media in general, corporations, etc. Be sure to include your contact info at upper left: name, date, which week’s summary, email address. Remember: If your story has nothing to do with the First Amendment or nothing to do with the media, it will count as a zero. The story must include BOTH. You will have no more chance to submit a summary that week.

There will be NO ability to submit to a particular week once that