Case Study: John RileyAn inner-city emergency department (ED) receives a report about an incoming 72-year-old man found disoriented, smelling of alcohol, and with a suspected hip fracture. Upon arrival to the ED, the patient, John Riley, has a blood alcohol level (BAL) of 0.17. He is 6 feet 1 inch tall and weighs 180 pounds. The ED doctor completes and x-ray of John’s hip and does not find a fracture; however, the doctor notes old bruising on his arms and legs. His liver function tests of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are elevated (ALT = 53 IU/L and AST = 40 IU/L) so an additional gamma-glutamyltransferase (GGT) is ordered, indicating an elevated level at 72 IU/L.1. What are the characteristic signs and symptoms of impaired liver function?The psych liaison nurse, Rob Pearson, RN, is paged to complete a psych evaluation on John to find out more about his alcohol consumption. John reports he only had two glasses of wine today.2. Rob knows that John is minimizing his alcohol use and refers to https://www.csbsju.edu/chp/health-promotion/alcohol-guide/understanding-blood- alcohol-content-(bac) to estimate his actual consumption from the BAC Table for Men. Rob finds John has really consumed how many drinks?3. What does Rob realize about the importance of accurate alcohol screening?4. Rob understands that his questions should focus on which of the following?a. Making John admit to his “real” alcohol consumptionb. Increasing Johns’ feelings of guilt over his drinking, which will help him learn to stopc. John’s perceptions of his drinking behaviors and the consequences of his drinkingd. Teaching John the alcohol content in one drinkRob finds that John is drinking daily by administering the CAGE questionnaire (Ewing, 1984). He asks:Have you ever felt you should Cut down on your drinking?Have people Annoyed you by criticizing your drinking?Have you ever felt bad or Guilty about your drinking?Have you ever had and Eye-opener drink first thing in the morning to steady your nerves or get rid of a hangover?John states that he feels like he should cut down on his drinking and his daughter is constantly “on his case” about how much he drinks. He states, “If only I had the resources and ability to stop.” John feels that he began drinking after his wife died two years ago. John relates when he tries to stop drinking, his hands start to shake, and he drinks a glass of wine to steady his nerves. He reports drinking seven to eight glasses of wine, on average, daily. The maximum amount John reports consuming is one gallon of wine.5. What is one alcoholic drink defined as?6. What are the potential risks with habitual and/or excessive alcohol use?7. What additional signs and symptoms of alcohol-related abuse or dependence might be evident in the initial assessment?Rob completes the Short Michigan Alcoholism Screening Test – Geriatric Version (SMAST-G) on John (https://www.westongroupinc.com/westime/ops_docs/PQ...Alcoholism%20Screening%20Test%20Geriatric%20Version.pdf ; Blow, 1991). John scores 9 out of 10,indicating alcohol is a problem. Rob also knows John has been drinking daily since his wife’s death.The American Psychological Association (APA) published the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May, 2013. A major change from the earlier edition was that alcohol use disorders were broken down into two categories: alcohol abuse and alcohol dependence. According to the APA, the distinction between abuse and dependence was based on the concept of abuse as a mild or early phase, and dependence as the more severe manifestation. The most recent manual has a single diagnosis of alcohol abuse disorder which, according to the APA, will better match the symptoms that patients experience (Buddy, 2013).8. Use the following web link to determine what criteria of the 11 identified must be met for John to be classified as having an alcohol abuse disorder: http://alcoholism.about.com/od/professionals/a/Dsm-5-Substance-Abuse-Disorders-Draws-Controversy.htm.John states he will simply stop drinking on his own at home.9. Rob strongly encourages John to transfer to the hospital’s mental health floor and explains to John that receiving additional medical attention is imperative, because, if he attempts to stop drinking at home, he is at the highest risk for the following:a. Withdrawalb. Continuing to drinkc. Becoming nutritionally impairedd. Increasing his isolation, putting him at risk for depression.John agrees to enter the detox program and signs in voluntarily for a transfer to the unit.Suggested ResourcesBlow, F. C. (1991).Short Michigan Alcohol Screening Test-Geriatric Version (SMAST-G).Ann Arbor, MI:University of Michigan Alcohol Research Center.Buddy, T. (2013).DSM-5 substance abuse disorders draws controversy. About.com Alcoholism.Retrievedfromhttp://alcoholism.about.com/od/professionals/a/Dsm-5-Substance-Abuse-Disorders-Draws-Controversy.htm.Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire.Journal of the American MedicalAssociation, 252,1905-1907.

The purpose of this assignment is analyze a dataset and report findings to relevant stakeholders.Read the Topic Material “Analyzing and Reporting Data – Overview” prior to beginning the assignment.For this assignment, you will use IBM SPSS Statistics and one of the three datasets to conduct a basic statistical analysis and report the results by creating a scientific poster. MPH students can use this assignment as an introduction to the option of a larger secondary data analysis for their capstone project.Select a public health topic that is of interest to you and complete the following using the "GCU MPH Poster Template."Review the three datasets provided in the Topic Materials and brainstorm at least one potential research question that could be answered by one of the datasets. The question should be based on a topic that is of interest to you and is supported by existing literature.Select the dataset and organize the data to complete the analysis.Provide descriptive statistics that summarize the sample.Select an appropriate statistical test and conduct the analysis.Interpret the results of your analysis.Prepare your poster presentation putting the results in the context of the larger story surrounding the purpose for the analysis. Consider the data source, assumptions, hypotheses, decision rule, and interpretation.In addition to the poster, write a 1,000-word summary of the analysis that addresses the questions below. The summary should include additional discussion notes you would include for each section if you were presenting your poster at a professional conference. Typically, a poster presentation involves presenting your poster to small groups and providing an oral explanation as the audience reviews your poster.Summary of the data source.Variables used in the analysis.The six steps of hypothesis testing.Prepare and submit the PowerPoint poster and summary as two separate documents.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Topic 3 DQ 1 Identify a population that you will likely serve as an advanced registered nurse that you think is particularly vulnerable to issues of health disparities/inequity. Discuss the contribution of your particular specialty to health promotion and disease prevention for this population. How do issues of diversity and global perspectives of care contribute to your understanding of health equity as it relates to this population?paper should be 500-700 words with at least 2 citations and definitely 2 references