Description
What are the essentials of diagnosis for PPH
User generated content is uploaded by users for the purposes of learning and should be used following Studypool's honor code & terms of service.
Explanation & Answer
Review
Review
Anonymous
Really helped me to better understand my coursework. Super recommended.
Studypool
4.7
Trustpilot
4.5
Sitejabber
4.4
24/7 Homework Help
Stuck on a homework question? Our verified tutors can answer all questions, from basic math to advanced rocket science!
Most Popular Content
Prince Georges Community College Tidal Model of Recovery Questions
1. What is the basic concept of a recovery model?
2. How is recovery suppo ...
Prince Georges Community College Tidal Model of Recovery Questions
1. What is the basic concept of a recovery model?
2. How is recovery supported by peer groups?
3. What is the focus of the Tidal Model of Recovery?
4. What is the goal of crisis intervention?
5. Individuals in crisis need to develop more adaptive coping strategies. How does the nurse provide assistance with this process?
6. What are the expectations of the leader in the initial or orientation phase of group development?
7. What is the difference between therapeutic groups and group therapy?
8. Malpractice and negligence are examples of what kind of law?
9. Name the three major elements of informed consent.
10. Identify four nursing behaviors that should be avoided when working with an interpreter.
11. What is the most common psychiatric diagnosis among homeless people with mental illness?
Walden University Pathophysiology Quiz Questions
1 A 45-year-old male comes to the clinic with a chief complaint of epigastric abdominal pain that has persisted for 2 wee ...
Walden University Pathophysiology Quiz Questions
1 A 45-year-old male comes to the clinic with a chief complaint of epigastric abdominal pain that has persisted for 2 weeks. He describes the pain as burning, non-radiating and is worse after meals. He denies nausea, vomiting, weight loss or obvious bleeding. He admits to bloating and frequent belching. PMH-+ for osteoarthritis, seasonal allergies with frequent sinusitis infections. Meds-Zyrtec 10 mg po daily and takes it year-round, ibuprofen 400-600 mg po prn pain Family Hx-non contributary Social history-recently divorced and expressed concern at how expensive it is to support 2 homes. Works as a manager at a local tire and auto company. He has 25 pack/year history of smoking, drinks 2-3 beers/day, and drinks 5-6 cups of coffee per day. He denies illicit drug use, vaping or unprotected sexual encounters. Breath test in the office revealed + urease. The healthcare provider suspects the client has peptic ulcer disease. 1 of 2 Questions: What factors may have contributed to the development of PUD? 1 points QUESTION 2 A 45-year-old male comes to the clinic with a chief complaint of epigastric abdominal pain that has persisted for 2 weeks. He describes the pain as burning, non-radiating and is worse after meals. He denies nausea, vomiting, weight loss or obvious bleeding. He admits to bloating and frequent belching. PMH-+ for osteoarthritis, seasonal allergies with frequent sinusitis infections. Meds-Zyrtec 10 mg po daily and takes it year-round, ibuprofen 400-600 mg po prn pain Family Hx-non contributary Social history-recently divorced and expressed concern at how expensive it is to support 2 homes. Works as a manager at a local tire and auto company. He has 25 pack/year history of smoking, drinks 2-3 beers/day, and drinks 5-6 cups of coffee per day. He denies illicit drug use, vaping or unprotected sexual encounters. Breath test in the office revealed + urease. The healthcare provider suspects the client has peptic ulcer disease. 2 of 2 Questions: How do these factors contribute to the formation of peptic ulcers? 1 points QUESTION 3 A 36-year-old morbidly obese female comes to the office with a chief complaint of “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea. PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m2) Family history-non contributary Medications-amlodipine 10 mg po qd, dicyclomine 20 mg po, ibuprofen 600 mg po q 6 hr prn Social hx- 15 pack/year history of smoking, occasional alcohol use, denies vaping The health care provider diagnoses the patient with gastroesophageal reflux disease (GERD). Question: The client asks the APRN what causes GERD. What is the APRN’s best response? 1 points QUESTION 4 A 34-year-old construction worker presents to his Primary Care Provider (PCP) with a chief complaint of passing foul smelling dark, tarry stools. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper GI bleed which won’t be confirmed until further endoscopic procedures are performed. Question: What factors can contribute to an upper GI bleed? 1 points QUESTION 5 A 64-year-old steel worker presents to his Primary Care Provider (PCP) with a chief complaint of passing bright red blood when he had a bowel movement that morning. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some left lower quadrant pain for several weeks but described it as “coming and going”. He says he has had a fever and abdominal cramps that have worsened this morning. The likely diagnosis is lower GI bleed secondary to diverticulitis. Question: What can cause diverticulitis in the lower GI tract? 1 points QUESTION 6 A 48-year-old man presents to his gastroenterologist for increasing abdominal girth and increasing jaundice. He has a long history of alcoholic cirrhosis and has multiple admissions for encephalopathy and GI bleeding from esophageal varices. He has been diagnosed with portal hypertension and tells the APRN that he was told he had chronic, non-curable cirrhosis. Question: How does cirrhosis cause portal hypertension? 1 points QUESTION 7 A 48-year-old man presents to his gastroenterologist for increasing abdominal girth and increasing jaundice. He has a long history of alcoholic cirrhosis and has multiple admissions for encephalopathy and GI bleeding from esophageal varices. He has been diagnosed with portal hypertension. The increased abdominal girth has been progressive, and he says it is getting hard to breathe. The APRN reviews his last laboratory data and notes that the total protein is 4.6 gm/dl and the albumin is 2.9 g/dl. Upon exam, he has icteric sclera, jaundice, and abdominal spider angiomas. There is a significant fluid wave when percussed. The APRN tells the patient that he has ascites. Question: Discuss how ascites develops as a result of portal hypertension. 1 points QUESTION 8 A 45-year-old man with known alcoholic cirrhosis, portal hypertension, and ascites is brought to the ED by his family due to increasing confusion. The family states that he had been stumbling for several days but had not fallen. The family also noted that he had been “flapping his hands” as well. Labs in the ED reveal Hgb 9.4 g/dl, Hct 28.0 %, ammonia (NH3) level is 159 μmol/L. The APRN informs the family that the patient has developed hepatic encephalopathy (HE). Question: Explain how hepatic encephalopathy develops in patients with cirrhosis of the liver. 1 points QUESTION 9 A 65-year-old man with a history of atrial fibrillation presents to his PCP’s office 2 months after suffering from a myocardial infarction. He declined anticoagulation due to fear he would bleed to death. He has had sudden-onset, moderately severe diffuse abdominal pain that began 18 hours ago. He has been vomiting, and he has had several episodes of diarrhea, the last of which was bloody. He has a fever of 100.9 ˚ F. CBC reveals WBC of 15,000/mm3. Question: What is the most likely mechanism behind his current symptoms? 1 points QUESTION 10 A 46-year-old Caucasian female presents to the PCP’s office with a chief complaint of severe, intermittent right upper quadrant pain for the last 3 days. The pain is described as sharp and has occurred after eating french fries and cheeseburgers and radiates to her right shoulder. She has had a few episodes of vomiting “green stuff”. States had fever and chills last night which precipitated her trip to the office. She also had some dark orange urine, but she thought she was dehydrated. Physical exam: slightly obese female with icteric sclera as well as generalized jaundice. Temp 101˚F, pulse 108, respirations 18. Abdominal exam revealed rounded abdomen with slightly hypoactive bowel sounds. + rebound tenderness on palpation of right upper quadrant. No tenderness or rebound in epigastrium or other quadrants. Labs demonstrate elevated WBC, elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Serum bilirubin (indirect) 2.5 mg/dl. Abdominal ultrasound demonstrated enlarged gall bladder, dilated common bile duct and multiple stones in the bile duct. The APRN diagnoses the patient with acute cholecystitis and refers her to the ED for further treatment. Question 1 of 2: Describe how gallstones are formed and why they caused the symptoms that the patient presented with. 1 points QUESTION 11 A 46-year-old Caucasian female presents to the PCP’s office with a chief complaint of severe, intermittent right upper quadrant pain for the last 3 days. The pain is described as sharp and has occurred after eating french fries and cheeseburgers and radiates to her right shoulder. She has had a few episodes of vomiting “green stuff”. States had fever and chills last night which precipitated her trip to the office. She also had some dark orange urine, but she thought she was dehydrated. Physical exam: slightly obese female with icteric sclera as well as generalized jaundice. Temp 101˚F, pulse 108, respirations 18. Abdominal exam revealed rounded abdomen with slightly hypoactive bowel sounds. + rebound tenderness on palpation of right upper quadrant. No tenderness or rebound in epigastrium or other quadrants. Labs demonstrate elevated WBC, elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Serum bilirubin (indirect) 2.5 mg/dl. Abdominal ultrasound demonstrated enlarged gall bladder, dilated common bile duct and multiple stones in the bile duct. The APRN diagnoses the patient with acute cholecystitis and refers her to the ED for further treatment. Question 2 of 2: Explain how the patient became jaundiced. 1 points QUESTION 12 Ruth is a 49-year-old office worker who presents to the clinic with a chief complaint of abdominal pain x 2 days. The pain has significantly increased over the past 6 hours and is now accompanied by nausea and vomiting. The pain is described as “sharp and boring” in mid epigastrum and radiates to the back. Ruth admits to a long history of alcohol use, and often drinks up to a fifth of vodka every day. Physical Exam: Temp 102.2F, BP 90/60, respirations 22. Pulse Oximetry 92% on room air. General: thin, pale white female in obvious pain and leaning forward. Moving around on exam table and unable to sit quietly. CV-tachycardic. RRR without gallops, rubs, clicks or murmurs Resp-decreased breath sounds in both bases with poor inspiratory effort Abd- epigastric guarding with tenderness. No rebound tenderness. Negative Cullen’s and + Turner’s signs observed. Hypoactive bowel sounds x 2 upper quadrants, and no bowel sounds heard in both lower quadrants. The APRN makes a tentative diagnosis of acute pancreatitis based on history and physical exam and has the patient transferred to the ER where laboratory and radiographic exams reveal acute pancreatitis. Question: Explain how pancreatitis develops and the role alcohol played in this patient’s case. 1 points QUESTION 13 A 23-year-old bisexual man with a history of intravenous drug abuse presents to the clinic with a chief complaint of fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, and dark urine. He says the symptoms started about a month ago and have gotten steadily worse. He admits to reusing needles and had unprotected sexual relations with a man “a couple months ago”. PMH-noncontributory. Social/family history-works occasionally as a night clerk in a hotel. Parents without illnesses. Admits to bisexual sexual relations and intravenous heroin use. He has refused drug rehabilitation. 3 year/pack history of tobacco but denies vaping. Physical exam unremarkable except for palpable liver edge 2 fingerbreadths below costal margin. No ascites or jaundice appreciated. The APRN suspects the patient has Hepatitis B given the strong history of risk factors. She orders a hepatitis panel which was positive for acute Hepatitis B. Question: What are the important hepatitis markers that indicated the patient had acute hepatitis B? 1 points QUESTION 14 Hannah is a 19-year-old college sophomore who came to Student Health with a chief complaint of lower abdominal pain. She says the pain has been present for 2 months and she has had multiple episodes of diarrhea alternating with constipation, and anorexia. She says she has lost about 10 pounds in these 2 months without dieting. The abdominal pain has gotten worse in the last 2 hours, but she thought she had “the GI bug” like other students at her Synagogue had. Physical exam-noncontributory except for the abdomen which was lightly distended with no visible masses. Normoactive BS x 4. Diffuse tenderness throughout but increased pain on deep palpation LUQ & LLQ. Slight guarding but no rebound tenderness or rigidity. Rectal-tight anal sphincter and patient grimacing in pain during exam. Slightly + guaiac stool. Based on her history and current symptoms, the APN arranges for a consult with a gastroenterologist who diagnoses Hannah with ulcerative colitis (UC). Question: How does ulcerative colitis develop in a susceptible person? 1 points QUESTION 15 A 64-year-old woman with long standing coronary artery disease presents to the clinic with lower extremity swelling, abdominal distension, and shortness of breath. Patient states she has a 30-pound weight gain in 6 weeks and is now requiring 3 pillows to sleep. On physical exam the patient is a well-developed, well-nourished female exhibiting signs of respiratory distress with use of accessory muscles. Blood pressure 150/80, pulse 105, respirations 28 and labored. Body weight 89 kg. HEENT was unremarkable. Cardiac exam had an S1, S2 and S3 without S4 or murmur. Respiratory exam was positive for bilateral rales 1/2 up both lung fields. Abdomen was enlarged with a positive fluid wave. Lower extremities were remarkable for 3+ pitting edema. Laboratory data was significant for an increase in K+ from 3.4 mmol/l to 6.1 mmol/l in 2 weeks, BUN increased from 18 mg/dl to 104 mg/dl, and creatinine increased from 0.8 mg/dl to 6.9 mg/dl. CXR revealed congestive heart failure. The APRN calls the cardiologist on call who admits the patient to the hospital and orders a nephrology consult. She was diagnosed with exacerbation of congestive heart failure (CHF) and acute kidney injury (AKI). Question: What type of acute kidney injury does the patient have and what factors contributed to this diagnosis? 1 points QUESTION 16 The APRN is giving a pathophysiology lecture to APRN students on renal blood flow, related hormones, and glomerular filtration rate. Question: What would be the most important concept of glomerular filtration rate that the APRN should address? 1 points QUESTION 17 The APRN is giving a pathophysiology lecture to APRN students on renal blood flow, glomerular filtration rate, autoregulation, and related hormone factors regulating renal blood flow Question: What would be the most important concept of autoregulation that the APRN should address? 1 points QUESTION 18 The APRN is giving a pathophysiology lecture to APRN students on renal blood flow, glomerular filtration rate, autoregulation, and related hormone factors regulating renal blood flow Question: What would be the most important concept of hormonal regulation that the APRN should address? 1 points QUESTION 19 A 28-year-old female comes to the clinic with a chief complaint of right flank pain, urinary frequency, and foul-smelling urine. The symptoms have been present for 3 days but this morning, the patient states she had a fever of 101 F and thought she should get it checked out. Physical exam noncontributory with the exception of right costovertebral angle (CVA) tenderness upon percussion. Urine dipstick shows + blood, + bacteria and + white blood cells. Renal ultrasound reveals right staghorn renal calculus and the patient was diagnosed with acute pyelonephritis. Question: How does a renal calculi calculus contribute to acute pyelonephritis? 1 points QUESTION 20 Mr. Kent is a 45-year-old African American male with a history of Type 2 diabetes, hypertension, and hyperlipidemia. His renal function has slowly decreased over the past 4 years and his nephrologist has told him that his GFR has decreased to 15cc ml/min and will soon need renal dialysis for chronic renal failure. Question: How does chronic renal failure develop?
Examining Nursing Specialties Discussion
Discussion: Examining Nursing SpecialtiesYou have probably seen one or more of the many inspirational posters about decisi ...
Examining Nursing Specialties Discussion
Discussion: Examining Nursing SpecialtiesYou have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choiceTo Prepare:Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization. Write in APA format with a minimum of 3 current sources (Less than 5 years old), two from the school material. and one from outside. Post an explanation of your choice of a nursing specialty within the program (My field of study is Master of Science in Nursing with a specialization in Psychiatric Mental Health Nurse Practitioner (PMHNP). Currently working in Correctional Health Department). Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member. Learning ResourcesRequired ReadingsBickford, C. J., Marion, L., & Gazaway, S. (2015). Nursing: Scope and standards of practice, third edition - 2015. Retrieved from http://ebooks.iospress.nl/publication/12524Cherry, B., Caramanica, L, Everett, L. Q., Fennimore, L., & Elaine, S. (2019). Leveraging the power of board leadership in professional nursing organizations. JONA: The Journal of Nursing Administration, 49(11), 517-519.Echevarria, I. M. (2018). Make connections by joining a professional nursing organization. Nursing, 48(12), 35–38. Truant, R., & Chan, R. J. (2017). Future ready: Strengthening oncology nursing leadership in the context of professional oncology nursing organizations. Canadian Oncology Nursing Journal, 27(1), 2-4.Walden University. (n.d.). Master of Science in Nursing (MSN). Retrieved November 14, 2018, from https://www.waldenu.edu/masters/master-of-science-...Document: Academic Success and Professional Development Plan Template (Word document)Choose among the following to review your specialization’s Scope and Standards of Practice or Competencies:Nursing InformaticsEbook: Nursing Informatics: Scope and Standards of Practice
American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author.
4 pages
Health Care In Canada
The Canadian health care system gets offered with the assistance of public funded healthcare system. The healthcare system ...
Health Care In Canada
The Canadian health care system gets offered with the assistance of public funded healthcare system. The healthcare system gets extended delivered at ...
RC Health Accessibility & Equity from The International Perspective Case Study
Scenario
As a clinical nursing instructor working in a global health setting, you are creating a case study for your nursi ...
RC Health Accessibility & Equity from The International Perspective Case Study
Scenario
As a clinical nursing instructor working in a global health setting, you are creating a case study for your nursing students to help them better understand access to global healthcare.
Instructions
Based on a current global health problem, develop a case study scenario and two open-ended questions related to the scenario. Provide answers with rationales to the case study questions.
The case study scenario should address: variables affecting access to healthcare in a global population (at least five)
The first question, answer, and rationale should address: how culture and other variables impact global healthcare access
The second question, answer, and rationale should address: how health disparities affect global health populations
5 pages
Wk 8 Existential Therapy 1
The essential skill for Psychiatric Mental Health Nurse Practitioner (PMHNP) is to understand the different types of thera ...
Wk 8 Existential Therapy 1
The essential skill for Psychiatric Mental Health Nurse Practitioner (PMHNP) is to understand the different types of therapies and their ...
Similar Content
St Thomas University Psychopath Presentation
All the points that must be develop can be found on the attached PPT template
Presentation is original work and logi...
AHS6620 Week 2 Wilmington Cultural Diversity for Human Service Professionals Discussion
Culture Clash (Chapter 4). A counselor is challenged by a client who has concerns about the services she will receive.How ...
NUR 700 Chatham University Aesthetic Knowledge Discussion
Compare and contrast the main attributes of personal and aesthetic knowledge development. In your response, describe ho...
NHC case against South Carolina Case Analysis Paper
a. Chapter 12 (pages 396 – 413) in our textbook, Legal and Ethical Issues for Health Professionals by George D. Pozgar (...
NUR 3289 Miami Dade College Mod 3 Epworth Sleepiness Scale Paper
Instructions:Review the list below of assessment. SPICES: An overall assessment tool of older adults Katz Index of Indepen...
Loyola University of Chicago Resources to Identify Diabetes Related Outcomes HW
Exercise 2.5 Diabetes affects a growing number of Americans. You have been invited to join a collaborative of community...
Education On Vaccination.edited
Vaccination has been widely considered as among the most significant medical achievements in modern civilization. Both chi...
Answer Health Promotion 2
1. Identify one health-related website that you used to develop your presentation or to which you intend 2. Evaluate the w...
Module 03 Written Assignment Requirementsdocx
Electronic Health Records Systems should fulfill the user’s needs in an easy and secure way. In a pharmacy, for instance...
Related Tags
Book Guides
The Catcher in the Rye
by J. D. Salinger
The Restless Wave
by John McCain
The Rhythm Section
by Mark Burnell
Breakfast at Tiffanys
by Truman Capote
A Wrinkle as Time
by Madeleine L'Engle
I Cant Make This Up - Life Lessons
by Kevin Hart
My Brilliant Friend
by Elena Ferrante
Twelve Years A Slave
by Solomon Northrup
Hiroshima
by John Hersey
Get 24/7
Homework help
Our tutors provide high quality explanations & answers.
Post question
Most Popular Content
Prince Georges Community College Tidal Model of Recovery Questions
1. What is the basic concept of a recovery model?
2. How is recovery suppo ...
Prince Georges Community College Tidal Model of Recovery Questions
1. What is the basic concept of a recovery model?
2. How is recovery supported by peer groups?
3. What is the focus of the Tidal Model of Recovery?
4. What is the goal of crisis intervention?
5. Individuals in crisis need to develop more adaptive coping strategies. How does the nurse provide assistance with this process?
6. What are the expectations of the leader in the initial or orientation phase of group development?
7. What is the difference between therapeutic groups and group therapy?
8. Malpractice and negligence are examples of what kind of law?
9. Name the three major elements of informed consent.
10. Identify four nursing behaviors that should be avoided when working with an interpreter.
11. What is the most common psychiatric diagnosis among homeless people with mental illness?
Walden University Pathophysiology Quiz Questions
1 A 45-year-old male comes to the clinic with a chief complaint of epigastric abdominal pain that has persisted for 2 wee ...
Walden University Pathophysiology Quiz Questions
1 A 45-year-old male comes to the clinic with a chief complaint of epigastric abdominal pain that has persisted for 2 weeks. He describes the pain as burning, non-radiating and is worse after meals. He denies nausea, vomiting, weight loss or obvious bleeding. He admits to bloating and frequent belching. PMH-+ for osteoarthritis, seasonal allergies with frequent sinusitis infections. Meds-Zyrtec 10 mg po daily and takes it year-round, ibuprofen 400-600 mg po prn pain Family Hx-non contributary Social history-recently divorced and expressed concern at how expensive it is to support 2 homes. Works as a manager at a local tire and auto company. He has 25 pack/year history of smoking, drinks 2-3 beers/day, and drinks 5-6 cups of coffee per day. He denies illicit drug use, vaping or unprotected sexual encounters. Breath test in the office revealed + urease. The healthcare provider suspects the client has peptic ulcer disease. 1 of 2 Questions: What factors may have contributed to the development of PUD? 1 points QUESTION 2 A 45-year-old male comes to the clinic with a chief complaint of epigastric abdominal pain that has persisted for 2 weeks. He describes the pain as burning, non-radiating and is worse after meals. He denies nausea, vomiting, weight loss or obvious bleeding. He admits to bloating and frequent belching. PMH-+ for osteoarthritis, seasonal allergies with frequent sinusitis infections. Meds-Zyrtec 10 mg po daily and takes it year-round, ibuprofen 400-600 mg po prn pain Family Hx-non contributary Social history-recently divorced and expressed concern at how expensive it is to support 2 homes. Works as a manager at a local tire and auto company. He has 25 pack/year history of smoking, drinks 2-3 beers/day, and drinks 5-6 cups of coffee per day. He denies illicit drug use, vaping or unprotected sexual encounters. Breath test in the office revealed + urease. The healthcare provider suspects the client has peptic ulcer disease. 2 of 2 Questions: How do these factors contribute to the formation of peptic ulcers? 1 points QUESTION 3 A 36-year-old morbidly obese female comes to the office with a chief complaint of “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea. PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m2) Family history-non contributary Medications-amlodipine 10 mg po qd, dicyclomine 20 mg po, ibuprofen 600 mg po q 6 hr prn Social hx- 15 pack/year history of smoking, occasional alcohol use, denies vaping The health care provider diagnoses the patient with gastroesophageal reflux disease (GERD). Question: The client asks the APRN what causes GERD. What is the APRN’s best response? 1 points QUESTION 4 A 34-year-old construction worker presents to his Primary Care Provider (PCP) with a chief complaint of passing foul smelling dark, tarry stools. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper GI bleed which won’t be confirmed until further endoscopic procedures are performed. Question: What factors can contribute to an upper GI bleed? 1 points QUESTION 5 A 64-year-old steel worker presents to his Primary Care Provider (PCP) with a chief complaint of passing bright red blood when he had a bowel movement that morning. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some left lower quadrant pain for several weeks but described it as “coming and going”. He says he has had a fever and abdominal cramps that have worsened this morning. The likely diagnosis is lower GI bleed secondary to diverticulitis. Question: What can cause diverticulitis in the lower GI tract? 1 points QUESTION 6 A 48-year-old man presents to his gastroenterologist for increasing abdominal girth and increasing jaundice. He has a long history of alcoholic cirrhosis and has multiple admissions for encephalopathy and GI bleeding from esophageal varices. He has been diagnosed with portal hypertension and tells the APRN that he was told he had chronic, non-curable cirrhosis. Question: How does cirrhosis cause portal hypertension? 1 points QUESTION 7 A 48-year-old man presents to his gastroenterologist for increasing abdominal girth and increasing jaundice. He has a long history of alcoholic cirrhosis and has multiple admissions for encephalopathy and GI bleeding from esophageal varices. He has been diagnosed with portal hypertension. The increased abdominal girth has been progressive, and he says it is getting hard to breathe. The APRN reviews his last laboratory data and notes that the total protein is 4.6 gm/dl and the albumin is 2.9 g/dl. Upon exam, he has icteric sclera, jaundice, and abdominal spider angiomas. There is a significant fluid wave when percussed. The APRN tells the patient that he has ascites. Question: Discuss how ascites develops as a result of portal hypertension. 1 points QUESTION 8 A 45-year-old man with known alcoholic cirrhosis, portal hypertension, and ascites is brought to the ED by his family due to increasing confusion. The family states that he had been stumbling for several days but had not fallen. The family also noted that he had been “flapping his hands” as well. Labs in the ED reveal Hgb 9.4 g/dl, Hct 28.0 %, ammonia (NH3) level is 159 μmol/L. The APRN informs the family that the patient has developed hepatic encephalopathy (HE). Question: Explain how hepatic encephalopathy develops in patients with cirrhosis of the liver. 1 points QUESTION 9 A 65-year-old man with a history of atrial fibrillation presents to his PCP’s office 2 months after suffering from a myocardial infarction. He declined anticoagulation due to fear he would bleed to death. He has had sudden-onset, moderately severe diffuse abdominal pain that began 18 hours ago. He has been vomiting, and he has had several episodes of diarrhea, the last of which was bloody. He has a fever of 100.9 ˚ F. CBC reveals WBC of 15,000/mm3. Question: What is the most likely mechanism behind his current symptoms? 1 points QUESTION 10 A 46-year-old Caucasian female presents to the PCP’s office with a chief complaint of severe, intermittent right upper quadrant pain for the last 3 days. The pain is described as sharp and has occurred after eating french fries and cheeseburgers and radiates to her right shoulder. She has had a few episodes of vomiting “green stuff”. States had fever and chills last night which precipitated her trip to the office. She also had some dark orange urine, but she thought she was dehydrated. Physical exam: slightly obese female with icteric sclera as well as generalized jaundice. Temp 101˚F, pulse 108, respirations 18. Abdominal exam revealed rounded abdomen with slightly hypoactive bowel sounds. + rebound tenderness on palpation of right upper quadrant. No tenderness or rebound in epigastrium or other quadrants. Labs demonstrate elevated WBC, elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Serum bilirubin (indirect) 2.5 mg/dl. Abdominal ultrasound demonstrated enlarged gall bladder, dilated common bile duct and multiple stones in the bile duct. The APRN diagnoses the patient with acute cholecystitis and refers her to the ED for further treatment. Question 1 of 2: Describe how gallstones are formed and why they caused the symptoms that the patient presented with. 1 points QUESTION 11 A 46-year-old Caucasian female presents to the PCP’s office with a chief complaint of severe, intermittent right upper quadrant pain for the last 3 days. The pain is described as sharp and has occurred after eating french fries and cheeseburgers and radiates to her right shoulder. She has had a few episodes of vomiting “green stuff”. States had fever and chills last night which precipitated her trip to the office. She also had some dark orange urine, but she thought she was dehydrated. Physical exam: slightly obese female with icteric sclera as well as generalized jaundice. Temp 101˚F, pulse 108, respirations 18. Abdominal exam revealed rounded abdomen with slightly hypoactive bowel sounds. + rebound tenderness on palpation of right upper quadrant. No tenderness or rebound in epigastrium or other quadrants. Labs demonstrate elevated WBC, elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Serum bilirubin (indirect) 2.5 mg/dl. Abdominal ultrasound demonstrated enlarged gall bladder, dilated common bile duct and multiple stones in the bile duct. The APRN diagnoses the patient with acute cholecystitis and refers her to the ED for further treatment. Question 2 of 2: Explain how the patient became jaundiced. 1 points QUESTION 12 Ruth is a 49-year-old office worker who presents to the clinic with a chief complaint of abdominal pain x 2 days. The pain has significantly increased over the past 6 hours and is now accompanied by nausea and vomiting. The pain is described as “sharp and boring” in mid epigastrum and radiates to the back. Ruth admits to a long history of alcohol use, and often drinks up to a fifth of vodka every day. Physical Exam: Temp 102.2F, BP 90/60, respirations 22. Pulse Oximetry 92% on room air. General: thin, pale white female in obvious pain and leaning forward. Moving around on exam table and unable to sit quietly. CV-tachycardic. RRR without gallops, rubs, clicks or murmurs Resp-decreased breath sounds in both bases with poor inspiratory effort Abd- epigastric guarding with tenderness. No rebound tenderness. Negative Cullen’s and + Turner’s signs observed. Hypoactive bowel sounds x 2 upper quadrants, and no bowel sounds heard in both lower quadrants. The APRN makes a tentative diagnosis of acute pancreatitis based on history and physical exam and has the patient transferred to the ER where laboratory and radiographic exams reveal acute pancreatitis. Question: Explain how pancreatitis develops and the role alcohol played in this patient’s case. 1 points QUESTION 13 A 23-year-old bisexual man with a history of intravenous drug abuse presents to the clinic with a chief complaint of fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, and dark urine. He says the symptoms started about a month ago and have gotten steadily worse. He admits to reusing needles and had unprotected sexual relations with a man “a couple months ago”. PMH-noncontributory. Social/family history-works occasionally as a night clerk in a hotel. Parents without illnesses. Admits to bisexual sexual relations and intravenous heroin use. He has refused drug rehabilitation. 3 year/pack history of tobacco but denies vaping. Physical exam unremarkable except for palpable liver edge 2 fingerbreadths below costal margin. No ascites or jaundice appreciated. The APRN suspects the patient has Hepatitis B given the strong history of risk factors. She orders a hepatitis panel which was positive for acute Hepatitis B. Question: What are the important hepatitis markers that indicated the patient had acute hepatitis B? 1 points QUESTION 14 Hannah is a 19-year-old college sophomore who came to Student Health with a chief complaint of lower abdominal pain. She says the pain has been present for 2 months and she has had multiple episodes of diarrhea alternating with constipation, and anorexia. She says she has lost about 10 pounds in these 2 months without dieting. The abdominal pain has gotten worse in the last 2 hours, but she thought she had “the GI bug” like other students at her Synagogue had. Physical exam-noncontributory except for the abdomen which was lightly distended with no visible masses. Normoactive BS x 4. Diffuse tenderness throughout but increased pain on deep palpation LUQ & LLQ. Slight guarding but no rebound tenderness or rigidity. Rectal-tight anal sphincter and patient grimacing in pain during exam. Slightly + guaiac stool. Based on her history and current symptoms, the APN arranges for a consult with a gastroenterologist who diagnoses Hannah with ulcerative colitis (UC). Question: How does ulcerative colitis develop in a susceptible person? 1 points QUESTION 15 A 64-year-old woman with long standing coronary artery disease presents to the clinic with lower extremity swelling, abdominal distension, and shortness of breath. Patient states she has a 30-pound weight gain in 6 weeks and is now requiring 3 pillows to sleep. On physical exam the patient is a well-developed, well-nourished female exhibiting signs of respiratory distress with use of accessory muscles. Blood pressure 150/80, pulse 105, respirations 28 and labored. Body weight 89 kg. HEENT was unremarkable. Cardiac exam had an S1, S2 and S3 without S4 or murmur. Respiratory exam was positive for bilateral rales 1/2 up both lung fields. Abdomen was enlarged with a positive fluid wave. Lower extremities were remarkable for 3+ pitting edema. Laboratory data was significant for an increase in K+ from 3.4 mmol/l to 6.1 mmol/l in 2 weeks, BUN increased from 18 mg/dl to 104 mg/dl, and creatinine increased from 0.8 mg/dl to 6.9 mg/dl. CXR revealed congestive heart failure. The APRN calls the cardiologist on call who admits the patient to the hospital and orders a nephrology consult. She was diagnosed with exacerbation of congestive heart failure (CHF) and acute kidney injury (AKI). Question: What type of acute kidney injury does the patient have and what factors contributed to this diagnosis? 1 points QUESTION 16 The APRN is giving a pathophysiology lecture to APRN students on renal blood flow, related hormones, and glomerular filtration rate. Question: What would be the most important concept of glomerular filtration rate that the APRN should address? 1 points QUESTION 17 The APRN is giving a pathophysiology lecture to APRN students on renal blood flow, glomerular filtration rate, autoregulation, and related hormone factors regulating renal blood flow Question: What would be the most important concept of autoregulation that the APRN should address? 1 points QUESTION 18 The APRN is giving a pathophysiology lecture to APRN students on renal blood flow, glomerular filtration rate, autoregulation, and related hormone factors regulating renal blood flow Question: What would be the most important concept of hormonal regulation that the APRN should address? 1 points QUESTION 19 A 28-year-old female comes to the clinic with a chief complaint of right flank pain, urinary frequency, and foul-smelling urine. The symptoms have been present for 3 days but this morning, the patient states she had a fever of 101 F and thought she should get it checked out. Physical exam noncontributory with the exception of right costovertebral angle (CVA) tenderness upon percussion. Urine dipstick shows + blood, + bacteria and + white blood cells. Renal ultrasound reveals right staghorn renal calculus and the patient was diagnosed with acute pyelonephritis. Question: How does a renal calculi calculus contribute to acute pyelonephritis? 1 points QUESTION 20 Mr. Kent is a 45-year-old African American male with a history of Type 2 diabetes, hypertension, and hyperlipidemia. His renal function has slowly decreased over the past 4 years and his nephrologist has told him that his GFR has decreased to 15cc ml/min and will soon need renal dialysis for chronic renal failure. Question: How does chronic renal failure develop?
Examining Nursing Specialties Discussion
Discussion: Examining Nursing SpecialtiesYou have probably seen one or more of the many inspirational posters about decisi ...
Examining Nursing Specialties Discussion
Discussion: Examining Nursing SpecialtiesYou have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choiceTo Prepare:Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization. Write in APA format with a minimum of 3 current sources (Less than 5 years old), two from the school material. and one from outside. Post an explanation of your choice of a nursing specialty within the program (My field of study is Master of Science in Nursing with a specialization in Psychiatric Mental Health Nurse Practitioner (PMHNP). Currently working in Correctional Health Department). Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member. Learning ResourcesRequired ReadingsBickford, C. J., Marion, L., & Gazaway, S. (2015). Nursing: Scope and standards of practice, third edition - 2015. Retrieved from http://ebooks.iospress.nl/publication/12524Cherry, B., Caramanica, L, Everett, L. Q., Fennimore, L., & Elaine, S. (2019). Leveraging the power of board leadership in professional nursing organizations. JONA: The Journal of Nursing Administration, 49(11), 517-519.Echevarria, I. M. (2018). Make connections by joining a professional nursing organization. Nursing, 48(12), 35–38. Truant, R., & Chan, R. J. (2017). Future ready: Strengthening oncology nursing leadership in the context of professional oncology nursing organizations. Canadian Oncology Nursing Journal, 27(1), 2-4.Walden University. (n.d.). Master of Science in Nursing (MSN). Retrieved November 14, 2018, from https://www.waldenu.edu/masters/master-of-science-...Document: Academic Success and Professional Development Plan Template (Word document)Choose among the following to review your specialization’s Scope and Standards of Practice or Competencies:Nursing InformaticsEbook: Nursing Informatics: Scope and Standards of Practice
American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author.
4 pages
Health Care In Canada
The Canadian health care system gets offered with the assistance of public funded healthcare system. The healthcare system ...
Health Care In Canada
The Canadian health care system gets offered with the assistance of public funded healthcare system. The healthcare system gets extended delivered at ...
RC Health Accessibility & Equity from The International Perspective Case Study
Scenario
As a clinical nursing instructor working in a global health setting, you are creating a case study for your nursi ...
RC Health Accessibility & Equity from The International Perspective Case Study
Scenario
As a clinical nursing instructor working in a global health setting, you are creating a case study for your nursing students to help them better understand access to global healthcare.
Instructions
Based on a current global health problem, develop a case study scenario and two open-ended questions related to the scenario. Provide answers with rationales to the case study questions.
The case study scenario should address: variables affecting access to healthcare in a global population (at least five)
The first question, answer, and rationale should address: how culture and other variables impact global healthcare access
The second question, answer, and rationale should address: how health disparities affect global health populations
5 pages
Wk 8 Existential Therapy 1
The essential skill for Psychiatric Mental Health Nurse Practitioner (PMHNP) is to understand the different types of thera ...
Wk 8 Existential Therapy 1
The essential skill for Psychiatric Mental Health Nurse Practitioner (PMHNP) is to understand the different types of therapies and their ...
Earn money selling
your Study Documents