Category: Nursing

  • Ken Fowler ihuman diagnosis

    Ken Fowler ihuman diagnosis

    Diagnosis:
    Acute kidney injury (AKI) secondary to true intravascular volume depletion and medication related side-effect

    (NSAIDS) causing prerenal azotemia.

    The presentation of a rapid increase in creatinine should prompt a consideration of whether the patient has prerenal azotemia intrarenal azotemia or postrenal obstruction. The risk factors for prerenal azotemia include: dehydration, hemorrhage, heart failure, sepsis, anaphylaxis, hepatorenal syndrome or medications. Intrarenal causes include: prolonged prerenal state, acute tubular necrosis, atheroemboli, malignant hypertension, TTP, AIN or posinfectious glomerunephritis. Ken Fowler ihuman diagnosis Post renal causes are causes of obstruction which include: BPH, bladder outlet stones, bilateral renal calculi stones and pelvic malignancies that could block both ureters. The lack of any ultrasound evidence of obstruction or hydronephrosis as well as the lack of heart failure, bleeds, infectious processes or anaphylaxis or intravascular procedures that could release emboli, the use of NSAIDS for his back pain while on his hypertensive medications is the most likely cause.

    ORDER HERE 

    Epidemiology:
    Adverse renal events have been documented to occur in 1-5% of all patients using NSAIDS. In the USA, this translates to approximately 2.5 million people experiencing a nephrotoxic event annually. In Mr. Fowler’s case, he had the added use of a diuretic and ACE inhibitor which are thought to further increase this risk. Added to that was his known previously existing renal insufficiency as highlighted by his elevated creatinine of 1.1 with proteinuria Ken Fowler ihuman diagnosis.

    Mechanism of Action of NSAIDS:
    NSAIDS inhibit the cyclooxygenase (COX) enzymes. This results in a reduction in prostaglandin (PG) synthesis which can lead to reversible renal ischemia, a decline in glomerular hydraulic pressure and AKI

    Clinical manifestations of AKI:
    Patients present with an increase in plasma creatinine usually within 3-7 days of NSAID therapy. Urinalysis that is bland with only hyaline
    cases
    , lack of hematuria or significant proteinuria (> 1 g/day).

    • History of nausea and anorexia with concomitant diuretic use

    • Impaired renal blood flow secondary to use of NSAID and ACE inhibitor. Ken Fowler ihuman diagnosis.

  • NRS-429VN Topic 2 DQ 1

    NRS-429VN Topic 2 DQ 1

    Topic 2 DQ 1

    What is a definition of family that encompasses the
    different family structures
    prevalent today? Discuss the importance of acknowledging nontraditional family structures. Explain how family systems theory can be used to better understand the interactions of a modern family (traditional or nontraditional). 

    The word “family” can mean different things to different people. For some, family is simply defined as a group of people who are related by blood. Others may define family as a group of people who live together and care for one another. There are many different family structures prevalent today NRS-429VN Topic 2 DQ 1. Some families are traditional, with a mother, father, and children. Other families may be single-parent households or may be headed by grandparents or other relatives. There are also families of choice, which may include close friends or others who are not related by blood. What all of these different family structures have in common is that they are a group of people who care about and support one another. “Much of the research exploring family structure differences has focused on resources available within nuclear families”( Marks et al,1993). NRS-429VN Topic 2 DQ 1 No matter what form they take, families provide a source of love, security, and stability.

    BUY  PLAGIARISM-FREE PAPER HERE

    Nontraditional family structures should be acknowledged because they are just as valid as traditional families. They provide the same love, support, and stability as any other family. Additionally, acknowledging nontraditional families can help to break down stereotypes and misconceptions about them. Acknowledging nontraditional family structures can help people feel more included and accepted. It can also help to create a more inclusive society overall. By seeing the family as a system, family systems theory may be utilized to effectively understand the relationships of a contemporary family. This means that each member of the family is seen as part of the whole, and their individual actions can affect the entire system. By understanding how the family system works, we can better understand the dynamics at play in any given family. This may help us understand why families behave the way they do and how we can best assist them NRS-429VN Topic 2 DQ 1. For instance, if a family is going through a difficult time, family systems theory can help us to understand how each member of the family is affected. We can also use this theory to develop interventions that will support the entire family system, rather than just individual members. Family systems theory can be used in both traditional and nontraditional families. However, it may be especially helpful in understanding nontraditional families, as they often have more complex dynamics at play.

    References:

    St. Vil, N. M., St. Vil, C., & Fairfax, C. N. (2019). Posttraumatic slave syndrome, the patriarchal nuclear family structure, and African American male-female relationships. 
    Social work
    , 
    64
    (2), 139-146.

    Kerig, P. K. (2019). Parenting and family systems. 
    Handbook of parenting
    , 3-35.

    Marks, N. F., & McLanahan, S. S. (1993). Gender, family structure, and social support among parents. 
    Journal of marriage and family
    , 
    55
    (2), 481 NRS-429VN Topic 2 DQ 1.

     

    NRS-429VN Topic 2 DQ 1 sample 2

    The traditional definition of a family is the parents and offspring living together with the same ancestry.
    Family
    has been classified as those residing in a housing unit related by birth, marriage, or adoption; however, these definitions of family by bloodline or household cannot encompass the components of modern families. Family of choice indicates people chosen by an individual to care, love, and trust rather than the family of origin NRS-429VN Topic 2 DQ 1. Today’s family reaches beyond the traditional definition and encompasses society units of single parent families, such as LBGTQ+ and children raised by grandparents or other relatives and friends. It is important to acknowledge nontraditional family structures because it is significant to include all forms of family as everyone has a different vision of what family is. Nures need to involve and incorporate the patient’s family in the patient’s plan of care regardless of the family structure. Having family members involved in patient care helps ensure that the patient is following prescribed orders and instructions leading to positive patient outcomes (
    Health Promotion: Health & Wellness Across the Continuum
    , 2018), (Ahmed, 2020). A family systems approach to individuals and their families provides a means to better understand the interactions of a societal family unit. Viewing the family as a system provides perspective on influences within and outside of the family (
    Health Promotion: Health & Wellness Across the Continuum
    , 2018)
    NRS-429VN Topic 2
    DQ 1.

    References:

    Ahmed, A. A. (2020, June 24). 
    Involve Family Members in Patient Care for Better Outcomes
    . ChenMed. Retrieved August 10, 2022, from 
    https://www.chenmed.com/blog/involve-family-members-patient-care-better-outcomes#:~:text=Psychological%20benefits%20of%20patient%20and%20family%20engagement&text=A%20trusted%20family%20member%20can,them%20out%20of%20the%20hospital
    .

    Health Promotion: Health & Wellness Across the Continuum
    . (2018). [E-book]. Grand Canyon University. Retrieved August 1, 2022, from 
    https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/1
    NRS-429VN Topic 2 DQ 1

  • Middle Range Nursing Theory

    Nursing just like any other profession is guided by theories that are formed by predecessors. These theories are very useful and helpful in the line of duty. Nursing theories define what nursing is, describe what nurses are to do, and provide goals and outcomes of care for the patients.

    The middle-range nursing theory just like grand theories amongst others provides a number of benefits to nurses in different departments or specializations. Most nursing students, clinical researchers, and registered nurses usually refer to nursing theories often for guidelines and case studies. The middle-range theory offers enough space for scholars to criticize and analyze some concepts in the grand theory.

    Being acquitted with nursing theories is very valuable to the nursing fraternity as it contains undisputed information about the best practices in nursing. In this article, we want to expand on the middle-range nursing theory and how it is used.

    Middle-range theory nursing definition

    Middle-range nursing theory
    is defined as the nursing theory that focuses on more definitive subjects. This theory is less than grand nursing theories. Most of the people who develop this theory refer more to the grand nursing theory because of the additional contribution to the already recorded research. The scholars tend to add the new experiences faced continuously.

    What is a middle-range theory in nursing?

    A middle-range nursing theory is used by nursing students because it provided an angle view of reality to the main concepts. The theory also gives more specific generalized concepts and this helps the nurses in their day-to-day duties.

    There are three major types of middle-range theories.

    Middle-range descriptive theories are mostly the basic type.

    In this type, each descriptive theory describes a phenomenon that is surrounded by one concept. When a middle-range descriptive theory describes a concept, it automatically contains several common finding that is relatable. They are categorized using given parameters.

    Middle-range explanatory theories.

    These explanatory theories are based on two or more theories giving the basis of the relationship. This explanation theory expands further to the relationship between the two concepts. These theories are derived from scholarly research using quantitative design, tested, and proven beyond a shadow of a doubt. One good example of the middle-range explanation theory is Watson’s theory of humans.

    Middle-range predictive theories.

    There is a slight difference between predictive theories and middle-range explanatory theirs. The major difference is in predictive theory the concept is more predictable and more precise, unlike the explanatory concept.  This concept enlightens further the relation from one concept to the other or more. One good example is Orlando’s theory of the deliberative nursing process.

    Middle-range nursing theory is important for students of nursing because it provides a middle reality view and more specifically generalized practice areas for the nurses.

    It also provides the nurses with concrete ideas which are limited but very useful for them. Some of the middle-range theory of nursing examples are:

    Theory of maternal role attainment

    The framework of systemic organization

    Synergy model

    Theory of maternal role attainment

    Nurse as wounded Healer

    Theory of comfort and many

    The theory of unpleasant symptoms

    The theory of self-efficacy

    Theory of empathy

    Theory of pain

    The theory of chronic sorrow

    Theory of social support

    The theory of interpersonal relations

    The theories of reasoned action and planned behavior

    Theory of group power within organizations

    The theory of modeling and role-modeling

    The theory of comfort

    Theory of health-related quality of life

    The theory of health promotion

    The theory of the deliberative
    nursing process
    ,

    Theory of self-efficacy

    Theory of resilience

    Theories of uncertainly in illness

    Theory of self-efficacy among other middle-range theories.

    Difference between grand theory and middle range theory in nursing?

    Grand nursing theories are most of the time regarded as very detailed and always regarded as very complex. The theories under grand might require thorough research to attain the in-depth results intended on a particular concept. The transcultural nursing theory is an example of a grand nursing theory.

    On the contrary, middle-range nursing theories are typically less theoretical work as compared to grand nursing theories due to the absolute nature of the concept. The middle-range nursing theories tend to elaborate more on grand nursing theories by clearer elaboration.

    Middle-range nursing theories are more all-inclusive and systematic. They are more descriptive as compared to grand theories where the concepts are brought about in part explanation.

    Characteristics of middle-range theory nursing

    Middle-range theories are having a number of characteristics. Below are a number:

    Middle-range theories are more precise and narrower than grand theories

    They are consisting of a limited number of concepts and hypotheses that are written in proportionately specific standards

    Its content is dependent on another concept there cannot stand without a prior concept

    Middle-range theories are regarded more as hypotheses and a work in progress

    Middle-range theories are considered to be conclusive and systematic in design

    The theory is considered to be unified in nature

    Middle range theory in nursing practice

    The middle-range theory is very instrumental in nursing practice because of the added research on the concepts. The scholars who add to the already established grand theories through thorough research have been very instrumental to the nursing fraternity.

    Nurses face the adverse situation on daily basis in their line of duty. A middle-range theory like the theory of self-efficacy is very useful in the nursing practice. This theory reminds the nurses of their own self-care, self–monitoring, and self-management.  This theory promotes good self-care for patients and psychological health and other chronically ill patients. Below are some of the middle-range nursing theories developed by some scholars.

    Modeling and role-modeling theory in nursing practice

    Another middle-range theory in nursing practice is modeling and role-modeling theory. This theory is based on the ideology that all are meant to want to live a comfortably happy and meaningful life.  This is literally true. When plans that focus on the strength of our clients are taken into consideration we help them become more alive thereby living their lives fully and enjoyable. (Erickson, 2001, p. 309).

    Theory of group power within organizations

    The theory of group power within an organization is a very effective example of middle-range theories that are in use in the nursing carrier and was researched by Christina Sieloff. This theory emphasizes togetherness and working as a team amongst the nurses’ personnel. It is proved beyond doubt that working together yields good results and they tend to be the
    supporting system
    to each other.

    This theory improves competency, and teamwork and above all promotes the organization’s excellence in service delivery among nurses. This theory is another word for harmony in a work environment.

    Theory of empathy

    The dictionary definition of empathy is the ability to be able to understand, comprehend and share the feelings of another.

    Just like this middle-range theory of empathy, nurses are expected to show understanding and affection to the patients.  This theory is based on the fact that human beings have emotions. It further alludes that empathy comprises perceptions, self-awareness, and enlightenment, it is a self-esteem booster, promotes understanding, and is also a source of learning as it opens platforms for sharing.

    Empathy also offers a therapeutic and mutual understanding between the patient and the healthcare provider. This gives the patient a sense of belonging. The health care providers could use words such as I would do the same if I was in your position: I totally understand how you feel; You must be feeling so bad; I can feel the pain in how you explain it; I understand how it feels;  such kind words not only, make the patient feel better but creates a band between the patient and the nurse.

    The theory of interpersonal relations

    The theory of interpersonal relationships in nursing is a descriptive middle-range theory. This theory puts much emphasis on the interrelationship between a person and her environment around. There are four major components of this theory that are applicable to nurses on the day to day basis.

    Environmental needs are the forces outside the being of a person but still play an important role in his life. Nurses are required to use their interpersonal skills to manage the patient’s state of emotion. The skills such as
    nursing leadership
    would come in handy as the patient would want to hear a rather affirmative voice. 

    Listening is also a skill that is highly recommended, in their sorry state patients need a listening ear, someone to listen to them this somehow gives them hope. Negotiation and a positive attitude amongst others are some of the interpersonal skills nurses must possess.

    The theory of chronic sorrow

    Dictionary describes chronic sorrow or pain as the periodic recurrence of permanent, pervasive sadness or other grief-related feelings associated with a significant loss

    The theory of chronic sorrow is usefully considered for analyzing how patients cope with the pain that comes with chronic illnesses. Nurses are vetted in this as caregivers. Chronic sorrow theory urges nurses to view it as a normal occurrence and should not succumb to the pressure that comes with it and the emotional breakdown accompanied.

    Nurses are encouraged to come up with coping tactics for the affected and offer support. In this way, nurses are able to be the source of comfort. In the cases of the loss of a loved one nurses are to be the source of encouragement to the believer.

    Nurses are expected to offer support and explain that that is just a normal phenomenon. In chronic illnesses that are accompanied by excess pain. The nurses offer an explanation to the patients that the kind of pain they are experiencing is just normal and they should not think that it is something out of the ordinary.

    Summary

    Middle-range nursing theories are developed from the grand theories. Comparing grand theory vs middle range theories nursing grand theory tend to cover a discipline in a wider perspective as compared to a middle range which focuses more on expounding on a concept. Nurses and scholars have continuously influenced the grand concept from time to time. The middle-range theories have been improved by both scholars and nurses as the centuries unfold.

    Are you searching for the nursing theories encompassed in the middle-range nursing theory?
    https://onlinenursingpapers.com/
    has thoroughly researched nursing theories on Middle range theories and the concepts from grand theories among other nursing theories

  • Diabetes and Drug Treatments Essay

    Diabetes and Drug Treatments Essay

    Differences between Type 1, Type 2, Juvenile, and Gestational Diabetes

    Diabetes results from defects in insulin action, insulin secretion, or both (McCance & Huether, 2019). The two major types of diabetes are type 1 and type 2, but there is a type that arises during pregnancy called gestational diabetes. Type 1 used to be called juvenile-onset diabetes but is no longer called that since more cases of type 2 diabetes are arising in children than they have in the past (Burchum & Rosenthal, 2021). Type 1 is typically an autoimmune etiology where it attacks the beta cells in the pancreas that are responsible for insulin synthesis and secretion (Burchum & Rosenthal, 2021). Type 2 diabetes has an unknown etiology, but genetic factors seem to play an important role (Burchum & Rosenthal, 2021). There are many differences between the two major types, but management goals are the same with each and will use the same types of medications in treatment Diabetes and Drug Treatments Essay. Type 1, unlike type 2, has a rapid onset with more definitive presenting symptoms such as polydipsia, polyphagia, and polyuria; whereas in type 2 the onset is gradual, and symptoms may take not be present initially (Burchum & Rosenthal, 2021). Once diagnosed with either one of these two major types they are going to need life-long treatment and management, unlike gestational diabetes which is usually relieved once the baby is delivered (Burchum & Rosenthal, 2021). According to the CDC (2021), “during pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance.” Gestational diabetes is also managed similarly to the other two types of diabetes (Burchum & Rosenthal, 2021) Diabetes and Drug Treatments Essay.

    BUY A PLAGIARISM-FREE PAPER HERE

    Insulin Lispro (Humalog) and Type 1 Management

    This type of insulin is short-acting and great for covering the postprandial rise caused by meals due to its rapid onset of 15-30 minutes (Burchum & Rosenthal, 2021). This can be given either before meals or after meals due to this rapid onset as well (Burchum & Rosenthal, 2021). This insulin is usually administered via subcutaneous injection but can be administered through I.V. as well (Burchum & Rosenthal, 2021). Diabetes and Drug Treatments Essay Insulin lispro is very similar to natural insulin and the only real difference is the amino acids places are switched (Burchum & Rosenthal, 2021). This medication can be used for all types of diabetes.

    When treating type 1 diabetes, there is a basal/bolus strategy used in the management of the disease (Burchum & Rosenthal, 2021). This means that there is the use of longer-acting insulin covering the basal insulin needs and a short-acting, such as lispro, that covers the increased glucose levels due to meals, snacks, and any other spike in blood glucose. This strategy in management usually has great success in keeping blood glucose ranges in a safe effective zone.

    Dietary Considerations

    Along with the management of type 1 diabetes with insulin, there needs to be strict dietary control as well (Burchum & Rosenthal, 2021). Diabetes and Drug Treatments Essay Carbohydrates are the big key to managing and keeping consistent with intake from day to day to avoid major fluctuations in blood glucose levels making it difficult to manage (Diabetes Institute University of Florida, n.d.). It is also important to pick foods that are fiber-dense carbohydrates (Diabetes Institute University of Florida, n.d.). Everybody has different unique needs to meet with their foods and that is especially true for diabetics.

    References

    CDC. (2021). Gestational diabetes. Retrieved from 
    https://www.cdc.gov/diabetes/basics/gestational.html#:~:text=What%20Causes%20Gestational%20Diabetes%3F,body%20for%20use%20as%20energy
    .

    Diabetes Institute University of Florida. (n.d.). Type 1 diabetes nutrition. Retrieved from 

    Type 1 Diabetes Nutrition

    McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

    Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier Diabetes and Drug Treatments Essay.

     

    Discussion: Diabetes and Drug Treatments

    Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.

    For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

    Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/

    To Prepare

    Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.

    Select one type of diabetes to focus on for this Discussion.

    Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.

    Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.

    By Day 3 of Week 5

    Post
     a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.

    By Day 6 of Week 5

    Read
     a selection of your colleagues’ responses and 
    respond 
    to 
    at least two
     of your colleagues on 
    two different days
     who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.

     

    Diabetes and Drug Treatments Essay sample 2

    Diabetes and Drug Treatments

    Diabetes is the 7th leading cause of death in the United State, with approximately 30 million people actively living with the disease. In the United States, about 37.3 adults diagnosed with diabetes don’t know they have it. In addition to that, the number of adults diagnosed with diabetes has more than doubled in the past 20 years (CDC, 2021).

    There are three main types of diabetes. The first is Type 1, The second is Type 2 and the third is gestational diabetes. Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. It was once known as juvenile diabetes or insulin-dependent diabetes Diabetes and Drug Treatments Essay. Type 1 diabetes is most often diagnosed in children, teens, and young adults. Its symptoms usually develop quickly and there is currently no known measure for preventing it. Type 1 diabetics will require insulin daily for survival. Thus, insulin levels in type 1 diabetes patients severely decrease and eventually fall to zero (Rosenthal & Burchum, 2021). Whereas with type 2 diabetes, the body is unable to use insulin well to keep blood sugar levels at the normal range. Type 2 diabetes is mostly diagnosed in adults though becoming more common in children and young adults. It develops over time, and about 90-95 % of people with diabetes have type 2 (CDC, 2021). People with type 2 diabetes may not have symptoms which therefore makes it important for those at high risk to get tested since it can be delayed or prevented with healthy lifestyle changes (e.g eating healthy, being active, and weight loss). Gestational diabetes develops during pregnancy with an unknown cause and usually goes away after the baby is born but increases the woman’s chances of developing type 2 diabetes later in life. Every year, gestational diabetes affects nearly ten % of pregnancies in the U.S (ADA, 2022). By working with your doctor closely, you can have a healthy pregnancy and a healthy baby Diabetes and Drug Treatments Essay.

    There has been considerable progress toward diabetes management within the past twenty years. Even with such progress, fewer than half of diabetic patients are unable to reach their target blood sugar goals (Harvard Health Publishing, 2020). When it comes to medications for managing type 2 diabetes, Metformin has been the number 1 drug of choice that has been used for many decades to manage type 2 diabetes. Metformin is a tried and tested drug, recommended by many experts as 1st line therapy which is safe, affordable, effective, and well-tolerated by most people (Harvard Health Publishing, 2020)). Metformin works by lowering glucose production in the liver while improving the body’s sensitivity to insulin. This helps the body to use insulin more effectively. Possible side effects of metformin are nausea, bloating, diarrhea, and abdominal pain which may get better as time goes by. Vit. B-12 deficiency may be experienced by some patients, thus needing supplements (ADA,2022). Another medication must be added if metformin alone cannot adequately control blood sugar levels.

    Type 2 diabetes can be well managed by following a healthy meal plan, exercising, losing weight, and taking the necessary prescribed medications to avoid short and long-term complications associated with it. Hypoglycemia and hyperosmolar hyperglycemic nonketotic syndrome (HHNS) are examples of short-term complications associated with type 2 diabetes (Rosenthal & Burchum, 2021). Long-term complications may develop over time causing damage to both tiny and large blood vessels. The complications from damage to blood vessels include eyes, kidneys, nerve disease, the heart, and brain.

    With type 2 diabetes, it is important to work hard and stay consistent in keeping your blood glucose level under control by practicing healthy eating habits, exercising, and keeping a healthy weight as well as taking prescribed medications. This will help prevent the above-mentioned complications or help prevent them from getting worse if they already exist.

    References

    American Diabetes Association (ADA), (2022). What Are My Options? 
    https://www.diabetes.org/healthy-living/medication-treatments/oral-medication/what-are-my-options

    Centers for Disease Control and Prevention (CDC), (2021). What is Diabetes? 
    https://www.cdc.gov/diabetes/basics/diabetes.html

    Harvard Health Publishing (2020). Type 2 Diabetes: Which Medication is Best for Me. 
    https://www.health.harvard.edu/blog/type-2-diabetes-which-medication-is-best-for-me-2020110521256#:~:text=Metformin%20is%20a%20tried%20and,well%20tolerated%20by%20most%20people
    .

     

    Rosenthal, L. D., & Burchum, J. R. (2021). 
    Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants 
    (2
    nd
     ed.) St. Louis, MO: Elsevier.

     

    Diabetes and Drug Treatments Essay sample 3

    Differences in Types of Diabetes

    As we intake carbohydrates our blood glucose levels rise. The pancreatic β cells secrete insulin in response to rising glucose levels to allow cells to take in glucose and convert it into energy or to be stored as fat. When people have impairments in their body’s ability to make insulin, respond to insulin, and generally regulate their blood glucose levels they are considered Diabetic. Type one diabetics make up the smallest group and often people develop this type as juveniles. Adults can also abruptly get this type of diabetes and thus it is no longer referred to as juvenile diabetes. This autoimmune disease attacks the β cells of the pancreas impairing their ability to make insulin Diabetes and Drug Treatments Essay. Type two diabetes is characterized by insulin resistance and insulin secretion from the pancreas not coupled with increased glucose levels in the blood. Like type one diabetes, type two usually gets to the point that there is no insulin secretion by the pancreas. Gestational diabetes occurs due to placental hormones such as estrogen and cortisol increasing glucose levels and blocking insulin. Another way it occurs is due to the mother having hyperglycemia which increases fetal glucose levels resulting in hyperinsulinemia in the fetus. For all of these types tight glycemic control is important and occurs with frequent monitoring, medication, and lifestyle changes.

    ORDER A PLAGIARISM-FREE PAPER NOW

    Drug Therapy for Type 1 Diabetics

    All type one diabetics are treated with insulin. To help maintain tight glycemic control a long acting insulin is helpful for basal coverage during times of fasting (Retnakaran & Zinman, 2021). Our liver continues to send out glucose when we are not eating and long acting insulin can help keep glucose levels in a safe range. A common long acting insulin type one diabetics use is insulin glargine (U-100) which is generally only needed once a day. It has no peak and lasts 18-24 hrs. Some people may need to administer twice a day (Rosenthal & Burchum, 2021). Patients should administer this insulin with a subcutaneous injection at the same time each day, rotate sites of administration, and use a new needle each time. Prior to using an insulin vial or pen it should be stored in a refrigerator and then used within 28 days after being kept at room temperature. The insulin should be kept out of direct light and away from heat Diabetes and Drug Treatments Essay.

    To cover glucose spikes during prandial times regular or fast acting insulin injections can be given. Regular short-acting insulin should be given one hour prior to eating, whereas fast acting insulin can be given within 15 mins before or after eating. As with long acting insulin, doses are given through subcutaneous injections rotated to different sites. It is important for patients to check their blood sugar levels prior to administering insulin to properly dose it. The dose is also dependent on the number of carbohydrates expected to be consumed. This close matching of insulin to carbohydrate intake helps maintain tight glycemic control. Lifestyle and dietary choices greatly affect glucose control as well.

    Dietary Considerations

    Since carbohydrates increase blood glucose rates it is important for individuals to know what foods contain them and to monitor the amount they consume. In addition to carbs, proteins have a correlating effect on postprandial glycemic spikes (Paterson et al., 2019). The American Diabetes Association (2019) recommends the Diabetes Plate Method for choosing meals- fill one half of the plate with non-starchy vegetables, one quarter with lean proteins, and one quarter with carbohydrate foods. They recommend using this method to increase compliance without all the hassle of counting each carb and protein. Working with a registered dietician can help get patients started in the right direction.

    Short and Long-Term Impact

    The short term impact of type one diabetes is hypoglycemia and hyperglycemia. Both are very dangerous and thus people need to not fast for very long, but eat small meals throughout the day to maintain adequate blood glucose levels. Patients need to properly dose their insulin so that they do not cause hypoglycemia as well. By following a diabetic diet hyperglycemia and diabetic ketoacidosis can be prevented Diabetes and Drug Treatments Essay. When individuals with type one diabetes do not have dramatic spikes and lows in their glucose levels they decrease the long-term impacts of diabetes.

    High blood glucose levels are bad for our arteries and over time cause damage to the walls of them. Many people develop diabetic retinopathy which can cause loss of vision. These vessels are so tiny and are often the first ones affected by hyperglycemia. The kidneys can also be affected and people often get nephropathy which will affect the body’s ability to eliminate waste and regulate blood pressure. Cardiovascular disease needs to be treated in diabetic patients with the recommended angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker (Rosenthal & Burchum, 2021). With so many possible complications as a result of this autoimmune disease if is important to work closely with a provider who can monitor the various body systems affected by it Diabetes and Drug Treatments Essay.

    Conclusion

    The various types of diabetes require different treatment approaches. They all require tight glucose control to help reduce the risk of sometimes life threatening complications. Type one diabetics need to inject themselves with insulin to make up for what their pancreas is no longer able to do. Through constant monitoring of levels, making healthy lifestyle choices, diabetic patients can live good lives and avoid many of the adverse effects that can happen. Genetics plays a big role in who gets diabetes, but through modifiable factors it is no longer a death sentence. Medications continue to be developed and studied that can mimic our body’s own natural release of insulin. These new findings are helping more and more people be compliant and in control of this disease. It is exciting to see what more we can learn as we educate and treat the millions of diabetics in this country.

     

    Resources

    American Diabetes Association. (2019). 
    What is the diabetes plate method? 
    https://www.diabetesfoodhub.org/articles/what-is-the-diabetes-plate-method.html#:~:text=The%20Diabetes%20Plate%20Method%20is,you%20need%20is%20a%20plate
    !

    Paterson, M. A., King, B. R., Smart, C. E., Smith, T., & Lopez, R. (2019, August 27). Impact of dietary protein on postprandial glycaemic control and insulin requirements in type 1 diabetes: A systematic review. 
    Diabetic Medicine, 36
     (12), 1585-1599.  
    https://doi.org/10.1111/dme.14119

    Retnakaran, R., & Zinman, B. (2021, September 16). The ongoing evolution of basal insulin therapy over 100 years and its promise for the future. 
    Diabetes, Obesity and Metabolism: A Journal of Pharmacology and Therapeutics, 24
    (51).  
    https://doi.org/10.1111/dom.14552

    Rosenthal, L. D., & Burchum, J. R. (2021). 
    Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants
    (2nd ed.) St. Louis, MO: Elsevier Diabetes and Drug Treatments Essay.

  • Cognitive Bias Case Scenarios Test

    Cognitive Bias Case Scenarios Test

    User

    xxx

    Course

    Scholarly Skills Community

    Test

    Assessment | Cognitive Bias Case Scenarios

    Started

    10/14/22 2:26 PM

    Submitted

    10/14/22 2:41 PM

    Status

    Completed

    Attempt Score

    20 out of 20 points

    Time Elapsed

    15 minutes

    Results Displayed

    Submitted Answers, Feedback, Incorrectly Answered Questions

    Question 1

    2 out of 2 points

    Kris, a student who has recently started their academic program, is returning to graduate school after more than 10 years. While they have some experience with using library databases from their undergraduate studies, they are not very familiar or comfortable with using the databases and other evidence-based tools available through the Library. To accomplish any assignments requiring a search through the literature, they have been using Google Scholar as it seems more intuitive and convenient. They have expressed some frustration with the search engine as it does not have robust filters to help sort through the thousands of results. They also have a hard time trying to access the full text when using Google Scholar. Which of the following cognitive biases is represented in this scenario? Cognitive Bias Case Scenarios Test

    Selected Answer:

    Automation bias

    Response Feedback:

    You are correct! Kris had been over-relying on an internet search engine, Google Scholar, in this case. While Google Scholar can be very useful for finding full-text articles available on the open web, this search engine does not nearly the same robust search features of a research database or the Library’s Search USA engine that are specifically designed to assist researchers and practitioners to find and access scholarly articles Cognitive Bias Case Scenarios Test . By depending too much on Google Scholar and other internet search engines, they may not be taking advantage of the Library’s comprehensive subscriptions to scholarly literature otherwise unavailable on the internet.

    ORDER HERE

    Question 2

    2 out of 2 points

    Uchenna, a health practitioner, is treating an Asian American patient for seizures. After looking at the available evidence, he prescribes the patient with a seizure medication shown to be a commonly used and effective therapy. Later on, the patient is admitted to the hospital with a nearly fatal skin reaction. While the patient is recovering from the sudden reaction, Uchenna investigates the evidence and realizes that exposure to the medication can lead to severe skin damage for many Asians and Asian Americans. The evidence that he initially looked at had focused primarily on homogenous population samples, namely white male patients. Which of the following cognitive biases manifested in Uchenna’s initial literature search?

    Selected Answer:

    Attribute substitution

    Response Feedback:

    You are correct! Uchenna may have oversimplified the search without considering the patient’s ethnic and racial background, and instead sought out evidence based on largely homogenous samples for treatment options. There is a real seizure medication known as Carbamazepine that has been shown to cause higher risk for skin damage and even internal organ failure for some Asian populations due to a genetic marker Cognitive Bias Case Scenarios Test .

    Reference:
     Ferrell, P. B., & McLeod, H. L. (2008). Carbamazepine, HLA-B*1502 and risk of Stevens–Johnson syndrome and toxic epidermal necrolysis: US FDA recommendations. 
    Pharmacogenomics
    , 
    9
    (10), 1543-1546. [
    Access full text through ProQuest
    ]

    Question 3

    2 out of 2 points

    Ali, a gerontology specialist in California, is an avid proponent of evidence-based practice. She makes it an essential part of her practice to look through the current literature to help inform her approach and skills with patients. While she notices a great deal of literature that appears relevant to her clinical work, she specifically seeks out research conducted and published in the United States, which Ali believes is a good indication of the evidence’s quality and reliability. Which of the following cognitive biases is reflected in this scenario?

    Selected Answer:

    “Not invented here” bias

    Response Feedback:

    You are correct! While focusing on research published in one’s home country can be appropriate in certain contexts, it can also lead to evaluating the quality of search results based on place of publication. It can bias the search under the assumption that countries like the United States are somehow are more advanced in the movement of evidence-based medicine and practice when that is not necessarily the case. Also, it is important to consider evidence in countries where there is a better scholarly understanding regarding a specific health condition or therapeutic intervention.

    Question 4

    2 out of 2 points

    Your colleague comes to you with a problem at the cafeteria. He is conducting research on the prevention of medical errors. Yet his searches through the medical and health sciences literature, using PubMed, do not retrieve any relevant results. Your colleague is surprised to see this scarcity of information on the topic. He is desperate for a solution. What would be the best recommendation to resolve this issue to reduce the manifestation of cognitive bias?

    Selected Answer:

    Explore literature in other disciplines or fields.

    Response Feedback:

    You are correct! While the other techniques can be useful, their value in this scenario may not be as applicable. The most effective technique in this context would be to explore the literature beyond what is indexed in PubMed. In fact, this scenario is inspired by a real-life case when physician, Dr. Lucian Leape, was researching the prevention of medical errors, but found very little scholarly literature on the topic. It was only until a consultation with a librarian pointed him toward the psychological and social sciences databases, leading to an abundance of literature. This example would ultimately help lead to the patient safety movement.

    Reference: Watchter, R. (2006, August 1). In conversation with…Lucian Leape, MD. 
    AHRQ Patient Safety Network
    . 
    https://psnet.ahrq.gov/index.php/perspective/conversation-withlucian-leape-md

    Question 5

    2 out of 2 points

    Camila is a speech language pathologist with a new patient. The patient is a trans woman seeking voice and communication services to enrich her ability to live a healthy, satisfying life. Despite having years of professional experience, Camila has rarely worked with transgender patients. Camila admits to having little familiarity or knowledge on current evidence-based approaches to providing quality transgender care. Nonetheless, Camila looks forward to updating her practice with the latest evidence, but she is unsure how or where to start. What would you recommend to Camila?

    Selected Answer:

    Involve the patient in the literature search, consulting them for insight and feedback.

    Response Feedback:

    You are correct! Camila’s enthusiasm to learn about transgender care to improve her practice and the patient’s outcomes will lend well to mitigating the appearance of cognitive bias. By involving the patient in the search, Camila can benefit from the patient’s insight into transgender community and appropriate terminology to develop effective search strategies. Mental simulation can also bolster Camila’s critical thinking skills as she navigates health research in which transgender participation and perspectives remain underrepresented.

    Question 6

    2 out of 2 points

    You are a physical therapist treating a high school student. The student plays baseball at school, and recently suffered an injury to their knee. While treating the knee injury, the student asks your opinion about ulnar collateral ligament (UCL) reconstruction. The student explains that their coach had mention that surgery of the UCL could improve the pitching performance for players without an elbow injury. The student even conducted a search on the internet for information to support this perspective. Knowledgeable about cognitive bias and the lack of critical appraisal or regulation in internet information, how would you help this student in debiasing their search for information about UCL reconstruction?

    Selected Answer:

    All of the others

    Response Feedback:

    You are correct! All three strategies would be beneficial to the high school student as they search for information. Online health information is particularly difficult to navigate in terms of sorting through legitimate evidence and identifying potentially misleading, false, and/or dangerous information. Information about UCL reconstruction available on the internet is apt in reflecting this issue regarding the wealth of online information combined with its lack of critical appraisal. The student would do well to consider alternative search keywords, evaluating the websites’ legitimacy more closely, and consulting experts for advice.

    Reference:
     Johnson, C. C., Garcia, G. H., Liu, J. N., Stepan, J. G., Patel, R. M., & Dines, J. S. (2016). Internet resources for Tommy John injuries: What are patients reading? 
    Journal of Shoulder and Elbow Surgery
    , 
    25
    (12), e386-e393. [
    Access full text through the Library
    ]

    Question 7

    4 out of 4 points

    Victoria, an allied health sciences student, is working on a course assignment that requires a miniaturized literature review. For their literature review, she is tasked with finding a minimum of 10 peer-reviewed research articles. While performing an initial search through PubMed, she finds an article that is very relevant to her topic. Based on her previous experience with using PubMed, Victoria knows that the database has a “Similar Articles” search, which allows the user to find articles that the database identifies as similar to the initial article. Victoria has come to often rely on this search feature, using it find the next nine articles to meet the minimum criteria of the assignment. She sees that there are several articles of relevance to her topic, but she believes that the articles she had found will be adequate. Which of the following cognitive bias(es) are reflected in this scenario. 
    Select all that apply.

    Selected Answers:

    Automation bias

    Overconfidence

    Premature closure

    Search satisficing

    Response Feedback:

    You are correct! While PubMed’s Similar Articles feature is certainly very useful in identifying potentially relevant evidence, Victoria should not rely solely on the results retrieved from it. Victoria is not considering alternative databases, search strategies, or other resources relevant to her topic. Instead, she ended the search as soon as the assignment’s minimum criteria were met, interpreting it as a maximum. This cognitive error does not consider the various other sources of information available, which may have been of a higher level of evidence, or otherwise contradicted the information she had found or revealed gaps in the extant literature.

    Question 8

    4 out of 4 points

    Mei (occupational therapist), Seth (speech-language pathologist), and Alex (physical therapist) are working together as part of an interdisciplinary team to address the needs of patients with Parkinson’s disease. Despite being part of a team, they are disagreeing on the approach to treating patients, which is affecting the parameters of the search for evidence. Mei is primarily focused on evidence supporting interventions for daily activities such as leisure behaviors and self-care. Seth is more interested in communication skill development and maintenance. Alex is seeking out evidence regarding gait, walking stability, and balance. Rather than working together to synthesize their differing outcomes to treat the patients holistically, the practitioners are instead competing to highlight the value of their respective domain of expertise through the evidence. Which cognitive bias(es) are at work in this scenario? 
    Select all that apply.

    Selected Answers:

    Availability bias

    Confirmation bias

    Focusing effect

    Framing effect

    Response Feedback:

    You are correct! 
    The three health practitioners had engaged in a form of clinical territorialism, seeking to support modalities and outcomes based on their discipline-specific approaches rather than engaging in interprofessional collaboration. None of the therapists were wrong to highlight different health dimensions and outcomes for patients with Parkinson’s disease, but their efforts to search the literature were ultimately divided and prevent synthesis of multiple sources of evidence. Cognitive Bias Case Scenarios Test Consider how this lack of collaboration may affect their patients’ health.

    Question 1

    2 out of 2 points

    Leon, a nursing student, cannot seem to find any relevant qualitative studies on their topic about hydrotherapy and total hip replacement. They are hesitant to ask a librarian for help because they have already tried searching the databases with no good results. Leon is left frustrated and assumes no such studies exist, and they worry about their upcoming course assignment. Leon is exhibiting which of the following cognitive biases?

    Selected Answer:

    Premature closure

     

    Response Feedback:

    You are correct! Leon concluded the literature search before considering other alternatives, and instead assumed that no information existed matching their criteria. Leon could have benefitted from considering other relevant keywords or resources, as well as consulting a librarian for expert guidance on improving their search strategies.

    Question 2

    2 out of 2 points

    Kris, a student who has recently started their academic program, is returning to graduate school after more than 10 years. While they have some experience with using library databases from their undergraduate studies, they are not very familiar or comfortable with using the databases and other evidence-based tools available through the Library. To accomplish any assignments requiring a search through the literature, they have been using Google Scholar as it seems more intuitive and convenient. They have expressed some frustration with the search engine as it does not have robust filters to help sort through the thousands of results. They also have a hard time trying to access the full text when using Google Scholar. Which of the following cognitive biases is represented in this scenario?

    Selected Answer:

    Automation bias

     

    Response Feedback:

    You are correct! Kris had been over-relying on an internet search engine, Google Scholar, in this case. While Google Scholar can be very useful for finding full-text articles available on the open web, this search engine does not nearly the same robust search features of a research database or the Library’s Search USA engine that are specifically designed to assist researchers and practitioners to find and access scholarly articles. By depending too much on Google Scholar and other internet search engines, they may not be taking advantage of the Library’s comprehensive subscriptions to scholarly literature otherwise unavailable on the internet.

    Question 3

    2 out of 2 points

    Uchenna, a health practitioner, is treating an Asian American patient for seizures. After looking at the available evidence, he prescribes the patient with a seizure medication shown to be a commonly used and effective therapy. Later on, the patient is admitted to the hospital with a nearly fatal skin reaction. While the patient is recovering from the sudden reaction, Uchenna investigates the evidence and realizes that exposure to the medication can lead to severe skin damage for many Asians and Asian Americans. The evidence that he initially looked at had focused primarily on homogenous population samples, namely white male patients. Which of the following cognitive biases manifested in Uchenna’s initial literature search?

    Selected Answer:

    Attribute substitution

     

    Response Feedback:

    You are correct! Uchenna may have oversimplified the search without considering the patient’s ethnic and racial background, and instead sought out evidence based on largely homogenous samples for treatment options. There is a real seizure medication known as Carbamazepine that has been shown to cause higher risk for skin damage and even internal organ failure for some Asian populations due to a genetic marker.

    Reference:
     Ferrell, P. B., & McLeod, H. L. (2008). Carbamazepine, HLA-B*1502 and risk of Stevens–Johnson syndrome and toxic epidermal necrolysis: US FDA recommendations. 
    Pharmacogenomics
    , 
    9
    (10), 1543-1546. [
    Access full text through ProQuest
    ]

    Cognitive Bias Case Scenarios Test  Question 4

    2 out of 2 points

    Camila is a speech language pathologist with a new patient. The patient is a trans woman seeking voice and communication services to enrich her ability to live a healthy, satisfying life. Despite having years of professional experience, Camila has rarely worked with transgender patients. Camila admits to having little familiarity or knowledge on current evidence-based approaches to providing quality transgender care. Nonetheless, Camila looks forward to updating her practice with the latest evidence, but she is unsure how or where to start. What would you recommend to Camila?

    Selected Answer:

    Involve the patient in the literature search, consulting them for insight and feedback.

     

    Response Feedback:

    You are correct! Camila’s enthusiasm to learn about transgender care to improve her practice and the patient’s outcomes will lend well to mitigating the appearance of cognitive bias. By involving the patient in the search, Camila can benefit from the patient’s insight into transgender community and appropriate terminology to develop effective search strategies. Mental simulation can also bolster Camila’s critical thinking skills as she navigates health research in which transgender participation and perspectives remain underrepresented.

    Question 5

    2 out of 2 points

    You are a physical therapist treating a high school student. The student plays baseball at school, and recently suffered an injury to their knee. While treating the knee injury, the student asks your opinion about ulnar collateral ligament (UCL) reconstruction. The student explains that their coach had mention that surgery of the UCL could improve the pitching performance for players without an elbow injury. The student even conducted a search on the internet for information to support this perspective. Knowledgeable about cognitive bias and the lack of critical appraisal or regulation in internet information, how would you help this student in debiasing their search for information about UCL reconstruction?

    Selected Answer:

    All of the others Cognitive Bias Case Scenarios Test

     

    Response Feedback:

    You are correct! All three strategies would be beneficial to the high school student as they search for information. Online health information is particularly difficult to navigate in terms of sorting through legitimate evidence and identifying potentially misleading, false, and/or dangerous information. Information about UCL reconstruction available on the internet is apt in reflecting this issue regarding the wealth of online information combined with its lack of critical appraisal. The student would do well to consider alternative search keywords, evaluating the websites’ legitimacy more closely, and consulting experts for advice.

    Reference:
     Johnson, C. C., Garcia, G. H., Liu, J. N., Stepan, J. G., Patel, R. M., & Dines, J. S. (2016). Internet resources for Tommy John injuries: What are patients reading? 
    Journal of Shoulder and Elbow Surgery
    , 
    25
    (12), e386-e393. [
    Access full text through the Library
    ]

    Question 6

    2 out of 2 points

    You are a faculty member and you have assigned a literature review project for your students. The due date for the assignment is coming up in the next few days. During your office hours, a student consults with you about the project. Despite working on the project across several days, even pulling a couple all-nighters, they indicate having made very little headway. They are visibly tired and frustrated, as they report not being able to find any evidence-based information meeting the criteria for their literature review. What can you recommend to help improve their search through the scholarly literature to mitigate the effects of cognitive bias?

    Selected Answer:

    All of the others

     

    Response Feedback:

    You are correct! The student still has several options to pursue in their literature search. The student should take a moment to consider their approach to the topic and what exactly they are seeking from the literature. A librarian can provide expert guidance in developing effective search strategies and identifying relevant databases. Fatigue and stress can increase the risk of cognitive bias in the search, so the student can certainly benefit from self-care resources while working on their assignment.

    Question 7

    4 out of 4 points

    Cognitive Bias Case Scenarios Test

    Victoria, an allied health sciences student, is working on a course assignment that requires a miniaturized literature review. For their literature review, she is tasked with finding a minimum of 10 peer-reviewed research articles. While performing an initial search through PubMed, she finds an article that is very relevant to her topic. Based on her previous experience with using PubMed, Victoria knows that the database has a “Similar Articles” search, which allows the user to find articles that the database identifies as similar to the initial article. Victoria has come to often rely on this search feature, using it find the next nine articles to meet the minimum criteria of the assignment. She sees that there are several articles of relevance to her topic, but she believes that the articles she had found will be adequate. Which of the following cognitive bias(es) are reflected in this scenario. 
    Select all that apply.

    Selected Answers:

    Automation bias

    Overconfidence

    Premature closure

    Search satisficing

     

    Response Feedback:

    You are correct! While PubMed’s Similar Articles feature is certainly very useful in identifying potentially relevant evidence, Victoria should not rely solely on the results retrieved from it. Victoria is not considering alternative databases, search strategies, or other resources relevant to her topic. Instead, she ended the search as soon as the assignment’s minimum criteria were met, interpreting it as a maximum. This cognitive error does not consider the various other sources of information available, which may have been of a higher level of evidence, or otherwise contradicted the information she had found or revealed gaps in the extant literature.

    Question
    8

    4 out of 4 points

    Kendra, a nurse practitioner, receives a patient presenting with hemiparesis. Kendra, based on a previous experience earlier in the day working with a patient recovering from a stroke, believes the current patient’s diagnosis is acute ischemic stroke. A brief search through the evidence and guidelines regarding stroke informs Kendra to develop a treatment plan within minutes. The evidence also suggested a course of thrombolytic therapy. The treatment results in bleeding. While treating the bleeding, Kendra continues to investigate additional treatment options for the stroke. At which point, while taking the patient’s history, Kendra discovers that the patient has a history of epilepsy, which would explain the hemiparesis and that it does not require treatment. In this scenario, Kendra exhibited which of the following bias(es)? 
    Select all that apply.

    Selected Answers:

    Attribute substitution

    Availability bias

    Overconfidence

    Premature closure

     

    Response Feedback:

    You are correct! 
    Kendra exhibited several cognitive errors in this scenario. Rather than addressing the patient with an open-minded approach, Kendra instead drew on an unrelated experience from earlier that day to inform her search through the evidence. Even after the bleeding effect from the thrombolytic therapy, Kendra continued to proceed in her literature search without adapting to the new development. She had closed any alternative diagnosis or treatment modalities that would have been more appropriate to the patient’s condition Cognitive Bias Case Scenarios Test .

  • NRS-434VN Health Assessment GCU

    NRS-434VN Health Assessment GCU

    Topic 1 DQ 1

    Assessment Description

    Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low-birth-weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community or a population in your community. Provide the link to the resource in your post.

    Extremely low birth weight babies have a birth weight less than 2500 g. Infants that are affected by extreme low birth weight have a higher risk for complications. Complication includes neurodevelopment abnormalities, immature lungs that leads to respiratory problem, problems with temperature regulations, trouble feeding, and gaining weight. These issues have negative impacts on families which may cause depression and anxiety as well as postpartum depression in mothers. Short-term impact for low-birth-weight babies serious breathing, heart, and brain problems. Babies will need special care in the NICU until they gain weight. Long term, babies can suffer from subnormal growth, mental retardation, visual and hearing impairments, SIDS, ADHD poor health and growth. Necrotizing enterocolitis, intraventricular hemorrhage, neurodevelopmental anomalies and retinopathy are comorbidities associated with prematurity (Mayo clinic,2021).

    BUY HERE

    In the United States, low birth rate is recognized as one of the primary factors contributing to racial/ ethnic disparities in the African American followed by Asian/ pacific islander due to living in rural areas or environmental hazards. Special supplemental nutrition program for women, infants, and children better known as WIC. WIC provides nutritious foods, education breastfeeding support, and referrals to health care and social services for millions of low-income families. WIC plays a crucial role in the communities to improve the health of women, infant, and children (Carson & Neuberger, 2021).

    Resource

    Carlson , S., & Neuberger , Z. (2021, January 27). 
    WIC works: Addressing the nutrition and health needs of low-income families for more than four decades
    . Center on Budget and Policy Priorities. Retrieved September 7, 2022, from https://www.cbpp.org/research/food-assistance/wic-works-addressing-the-nutrition-and-health-needs-of-low-income-families NRS-434VN Health Assessment GCU

    Mayo Clinic, S. (2021, April 14). 
    Premature birth
    . Mayo Clinic. Retrieved September 7, 2022, from https://www.mayoclinic.org/diseases-conditions/premature-birth/symptoms-causes/syc-20376730

    NRS-434VN
    Health Assessment
    GCU sample 2

    The development of a child’s brain throughout his or her first three years of life is regarded as critical. Events that occur during this era may have long-term consequences for intellectual, emotional, and social development. It might be claimed that a child’s first year of existence, including time spent in the womb, is the most formative. They often struggle to breathe on their own, have difficulty managing their body temperature, and lack strength and, on occasion, reflexes to suck and swallow. Breathing difficulties, feeding difficulties, and weak muscles are common short-term complications. These symptoms fade as the individual develops and their body catches up. It may take more time to notice the long-term repercussions of a condition. There are several developmental problems and delays (Hee Chung et al., 2020). When compared to ordinarily growing infants, children with later-onset neurological impairments perform worse on tests. Behavior and mental health issues.

    Some immigrant groups have been demonstrated to be healthier on average than native-born Americans, and this surprising health advantage may be passed on to the children of immigrant moms. Even after accounting for common pregnancy complications, women of certain ethnic and cultural origins who were born outside the United States had a lower

    likelihood of having a baby with low birth weight.

    Community service can play a key role in the enablement of adequate service  NRS-434VN Health Assessment GCU

    provision for preterm infants and their families. NICU is one of the community services programs that help parents to understand and go through the process of bringing up preterm infants. The hospital personnel are also provided with continuing education through NICU Family Support. Throughout their time in the NICU, the newborns are provided with an education that emphasizes the need of providing care that is focused on the family. The team is supported with an education that is grounded in best practices and evidence-based care (The NICU Family Support Program, n.d.)

    References.

    Hee Chung, E., Chou, J., & Brown, K. A. (2020). Neurodevelopmental outcomes of preterm infants: A recent literature review. , (Suppl 1), S3–S8. Translational Pediatrics 9
    https://doi.org/10.21037/tp.2019.09.10

    The NICU Family Support program. (n.d.). Retrieved 4 September 2022, from http://www.marchofdimes.org/baby/the-nicu-family-support-program.aspx NRS-434VN Health Assessment GCU

     

    NRS-434VN Health Assessment GCU 
    Topic 1 DQ 2

    Consider the following
    patient scenario
    :

    A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).

    Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

     

    This nine-month-old baby girl is healthy according to the CDC recommendations. Having a smaller than normal weight, length, and head circumference do not mean the child has health problems. Children grow and develop differently at different paces and times. Developmental milestones are those things the child must complete at a certain age. In this case, the child must complete certain fine and gross motor skills, and emotional and sensory development. The mother should observe the child’s ability to fine motor skills: drinks from a cup with assistance, flipping pages of books or scribbling. Gross motor skills taking objects out of a container, getting into a sitting position without assistance standing alone, walking holding onto furniture, looking at familiar objects, distinguishing between familiar and unfamiliar voices, crying, focusing on objects, and exploring the environment. The mother or caregiver must provide a loving and nurturing environment needed for the child’s growth and development. If by nine months the child is unable to reach for objects or put objects in their mouth, play games ( pee-a-boo), and be involved in back and forth or sit with help. If the child is unable to accomplish these goals, that is a call for concern. The nurse can request development, screening, and assessment. Nurses can provide resources such as the CDC website for parents to learn more about infant development.

     

    References

    www.cdc.gov/ncbddd/childdevelopment/positiveparenting/infants.html

    https://www.healthline.com/health/parenting/9
    …

    Developmental Monitoring and Screening. (n.d.). 
    www.cdc.gov
    .

     

    NRS-434VN Health Assessment GCU SAMPLE 2

    Numerous checks would have to be performed to make sure the kid is developing normally. It’s possible that the infant is simply on the small side if their birth weight, height, and head circumference were all in the 5th percentile. But if the baby dropped from the 60th to the 20th percentile for birth weight, that would be cause for alarm. In that situation, I’d examine the infant’s diet and eating pattern and see if the mother is breastfeeding if she hasn’t already. If she is nursing, it is crucial to make sure she is getting enough to eat and that her milk supply is sufficient. By nine months, infants should be eating baby meals and, if drinking juice, should be consuming 100% fruit juice, as not doing so could stunt their growth (Green, 2018)

    Weight, height, head circumference, chest circumference, and mid upper arm circumference are all examples of anthropometric measurements. The size, shape, and make-up of a child’s body can be measured with anthropometric scales to identify any lags in development.

    A nurse should evaluate the following developmental indicators in a 9-month-old girl:

    A complete nursing assessment of a newborn should measure more than just weight and length and head circumference. The evaluation should start with a thorough visual inspection of the infant’s posture, movement, color, and breathing.

    Weight-8.5kg (normal infant weight is 0.75 kg)

    Average Height: 72 centimeters (normal infant height is 75 cm)

    Size 44 cm in terms of the circumference of the head (normal head circumference is 45 cm)

    The following are some suggestions for what to tell the mother:

    Make sure to keep breastfeeding even as you start introducing new meals.

    The mother should be made aware of the various weaning meals available.

    Taking into account the kid’s input and knowledge of their own eating habits.

    Create kid-pleasing snacks in a rainbow of hues and a wide range of fun shapes and sizes.

    Constipation, vomiting, and diarrhea are all things to watch out for while trying new foods.

    Sleep has a role in a child’s growth and development, so make sure he or she gets plenty of it.

    Hydrocephalus and other neurological conditions require medical attention.

    It’s important to keep an eye on a child’s development, so suggest that mom bring her little one in for a checkup every month.

    Share with the mother the importance of maintaining a clean feeding environment for the boy.

    Therefore, improving the child’s growth and development stages can be facilitated by sharing these evidence-based advice with the mother.

    Centers for Disease Control and Prevention. (2017b). Developmental milestones. Retrieved September 5th from 
    https://www.cdc.gov/ncbddd/actearly/milestones/index.html

    Antoniuk, D. (2006). The CDC Guide to Breastfeeding Interventions. retrieved sept. 5th from 
    Journal of Human Lactation
    , 
    22
    (3), 351-352.

    Green, S.Z. (2018). 
    Health assessment: Foundations for effective practice. 
    Retrieved on sept.5th from 
    https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/

     

    NRS-434VN Health Assessment GCU Topic 2
    DQ 1

    Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. Identify two factors that increase the vulnerability of a child for abuse in the age group you have selected. NRS-434VN Health Assessment GCU

     

    NRS-434VN Health Assessment GCU Topic 2 DQ 2

    Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement. NRS-434VN Health Assessment GCU

  • NRS-434VN Health Assessment GCU Topic 1 DQ 1

    NRS-434VN Health Assessment GCU Topic 1 DQ 1

    Assessment Description

    Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low-birth-weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community or a population in your community. Provide the link to the resource in your post.

    Extremely low birth weight Infants are babies with a weight of less than 1000 grams. They pose a unique kind of stress to a family and society. Parents of such an infant often experience wide swings of emotion and stages of grief, from denial to acceptance. These babies are born with lots of complications from which they might not survive in the long term, and with other developmental defects and congenital abnormalities like congenital heart diseases.

    BUY AN ESSAY HERE

    In addition, the strain on the marriage relationship caused by the birth of an extremely low birth weight infant can be tremendous and may result in divorce if not anticipated early in the course of the infant’s life. Socio-economically, they pose a financial stress to the parents, community, and government in the course of their hospitalization and general care. According to reports, it can cost over $100,000 in the United States to care for extreme prematurity, between $10,000 and $30,000 for moderate prematurity, and less than $4,500 for late prematurity. Ethnic and cultural disparities can lead to low birth weight due to differences in cultural belief and lifestyle during pregnancy. Most ethnic groups do have a high rate of hypertension in pregnancy, diabetes, and other chronic infections, which are the causes of low birth weight but are neglected during pregnancy, which were some of the findings noted from the study conducted by the University of Washington School of Public Health. The results were not far from reality. Some of the support groups are the Grahams Foundation and March of Dimes. These groups provide some community services, like providing education and other related materials to empower preterm parents to navigate through NRS-434VN Health Assessment GCU Topic 1 DQ 1.

    References

    Johnston KM, Gooch K, Korol E, Vo P, Eyawo O, Bradt P, et al. The economic burden of prematurity in

    Canada. 
    BMC Pediatr
    . 2016 Apr 5. 14:93. 
    [QxMD MEDLINE Link]
    .

    Racial and ethnic disparities in low birth weight differ by maternal birthplace. Washington School of Health (Ed. 2017). Retrieved from: 
    https://sph.washington.edu/news-events/news/racial-and-ethnic-disparities-low-birth-weight-differ-maternal-birthplace
    .

     

    NRS-434VN Health Assessment GCU Topic 1 DQ 1 sample 2

    There are several factors that are involved with low birth weight infants. Some are environmental, others are genetic. Some maternal exposures to toxins in the environment can also result in low birth weight. Toxins such as tobacco consumption while pregnant, use of illicit drugs, or alcohol are also factors that can increase the risk of low birth weight infants. Low birth weight infants can either be born at term, or before term. LBW infants are not always premature. The vast majority of LBW infants have little to no long term deficits, although having chances for higher rates of infections, illnesses, and compromised immune systems. Different cultures proclaim different types of prenatal care. Which as nurses, we should be educated and informed regarding their cultural differences. On the other hand, some mothers are not able to receive prenatal care due to their lifestyle. Other mothers are unaware they are pregnant, and therefore were not able to receive the proper prenatal care they would have received if known they were pregnant. One of the support services that is available for infants of low birth weight if the Neonatal Intensive Care Unit. This unit is not only for primate infants, like the stigma has formed. The NICU is also for infants with low birth weight, full term infants who need more cautious care, and infants who may be going through withdrawal, or born with substance abuse addiction at birth. The NICU allows for more monitored care, and also is known for building better rapports with the infant and their family members NRS-434VN Health Assessment GCU Topic 1 DQ 1.

    Hack, M., Klein, N. K., & Taylor, H. G. (1995). Long-term developmental outcomes of low birth weight infants. 
    The Future of children
    , 
    5
    (1), 176–196.

    Grand Canyon University (Ed). (2018). 
    Health assessment: Foundations for effective practice.
    Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/ NRS-434VN Health Assessment GCU Topic 1 DQ 1

  • Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU

    Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU

    Extremely low birth weight babies (ELBW) are at risk for numerous hospital visits, medical and neuro-developmental complications, when compared to normal birth weight babies. ELBW babies faced a much greater risk for visual, hearing impairment, speech delays, attention disorders, poor feeding and growth, respiratory complications and neurocognitive difficulties. Families are faced with numerous medical and developmental needs that are way beyond what a healthy full term baby is required. High levels of care are required where parents must take the child for medical appointments, therapies, and communication between the pediatrician and other healthcare providers. Studies have shown, that preterm births and hospitalization have an adverse effect on the families finances. Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU During the time the baby is hospitalized, families are associated with having to take time off from work, having increased debt, financial worries, unsafe home environment and social isolation. The intensity of care and high vigilance that is required to meet the needs of the baby, have an adverse effect on the family’s’ quality of life and within the overall family unit (Laksmanan et al, 2017).

    There are several disparities among the ethnic and cultural groups which is a contributory factor to extremely low birth weight babies. Chronic stress has shown to be higher in daily lived experiences within the minority population when compared among other groups. Other factors are the impact of the economic downturn, increasing rates of opioid use and addiction, variable access to prenatal care, variation in smoking rates and other bio-psychosocial stressors. Structural factors such as, state health policies, can also impact racial disparities in birth outcomes (Goldfarb et al.,2018).

    ORDER AN ESSAY HERE

    In Florida, there are several support services where preterm infants and families can obtain assistance. The Healthy Start System was enacted in 1991, and is considered to be the most comprehensive maternal and infant health care program. The main goal is to reduce infant mortality, reduce the number of low birth weight babies, and to improve health and developmental outcomes. Some of the key components are to identify pregnant women and infants at risk for adverse birth, health, and development outcomes. The services are outreach, care coordination. childbirth education, parenting education and support, nutrition counseling, tobacco education and cessation, breast feeding education and support, and interconceptional education and counseling. The Healthy Start initiative is to ensure that all pregnant women and all young children will have access to prenatal and child health care services necessary to reduce risk for poor outcome. Women and parents of children birth to 3 years who believe that they are in need for services, can also apply Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU.

    floridahealth.gov/programs-and-services/childrens-health/healthy-start/index.html#heading_4

    References:

    Floridahealth.gov. (2021).The Healthy Start Program. Retrieved from https://www.floridahealth.gov

    Goldfarb, S. S., Houser, K., Wells, B. A., Brown-Speights, J. S., Beitsch, L. & Rust, G.(2018). 
    Pockets of progress amidst persistent racial disparities in low birth weight rates.
     PLoS ONE 13 (7):e0201658.https://doi/10/1371/journalpone.0201658

    Lakshmanan, A., Agni, M., Leiu, T., Fleegler, E., Kipke, M., Friedlich, P. S., McCormick, M. C. & Belfort, M. B.(2017). The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge form neonatal intensive care unit: Health and Quality of Life Outcomes. 15 (38). https://doi/10.1186/s12955-017-0602-3 Topic 1 DQ 1 Assessment Description Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low-birth-weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community or a population in your community. Provide the link to the resource in your post.   Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU sample 2 Based on recent studies, one out of every ten babies born in the United States is born early. Pre-term infant before 37 weeks is considered premature. The leading cause of infant mortality in the United States continues to be low birth weight and premature births. The percentage varies drastically for many cultural, ethnic, and racial groups. Babies born before term are at risk for a variety of medical issues. There really wasn’t enough time for them to mature within the mother. Problems are breathing independently, maintaining an average body temperature, lacking muscle tone, and, in some cases, reflexes to suck and swallow are among the symptoms they frequently exhibit. Sometimes babies just need a little time in the NICU to get fed and grow, but sometimes they have to stay there longer and run into problems. The risk of long-term problems increases with the gestational age at birth. The common cause of infant mortality is delivery at a preterm stage. Advances in neonatal care and treatments for premature babies have made it much more likely for even the smallest babies to live. Nonetheless, there are additional metrics that can be used to evaluate success. Babies born before 37 weeks are still at risk for several short- and long-term repercussions of premature delivery, including an increased chance of death. Premature infants have a higher chance of developing significant health issues. *Premature infants that are barely four to six weeks old may have problems like trouble breathing, trouble eating, jaundice, and changes in how their brains work. It is common for premature infants to need treatment in the NICU (NICU). More time will be spent in the NICU for premature infants born at an earlier gestational age since they are more likely to require life support. Babies born prematurely have a greater chance of dying or being readmitted to the hospital after being discharged.Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU Premature birth causes several complications, but respiratory distress and underdeveloped brains are two of the worst. Premature babies often have trouble breathing and may need to be put on life support if they continue to have difficulty (ventilators). These babies may have trouble breathing in their first year of life, and they may be more likely to get asthma. The brain develops very last among the primary body systems in infants. The baby’s brain keeps growing even after birth. When a baby is born pre term, there is a higher risk that bleeding or other stress symptoms will adversely affect the brain. The brain only weighs about two-thirds of its full-term weight at 35 weeks (approximately 40 weeks). This crucial brain development is disrupted if the child is born a few weeks early (outside the womb). Babies born before term are at high risk for developmental delays, health problems, and even death later in life. Late preterm (between 34 and 36 weeks) infants frequently experience long-term complications such as: Issues with behavior and social interaction, difficulties in Learning Possibility of developing ADD or other hyperactivity disorders (ADHD) Sudden Infant Death Syndrome is more likely to happen (SIDS) There is an increased need for early intervention and special education services for children who are born prematurely. Babies born prematurely face a greater danger of developing cardiovascular disease, hypertension, and diabetes later in life. When many risk factors overlap, they can lead to preterm birth. Many other types of environmental, socioeconomic, societal, medical, and even biological elements have been hypothesized to play a role in its development. These tend to occur in clusters, especially for the poor and for members of racial and ethnic minorities. Community-based interventions may involve: promoting healthier practices and care seeking among communities and families; recruiting and training local community people to work with qualified health-care professionals; including members of the public in service provision (diagnosis, treatment, and referral), among other possible activities. CHWS, TBAs, health campaigns, school-based health promotion, home-based care, and even community franchise-operated clinics are all examples of interventions that fall under these umbrella terms Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU. Low-resource communities need access to a whole spectrum of care, and community-based services play a crucial role in this. Women’s health, infant health, and child development are all intertwined. Babies delivered to moms who are hungry, sick, or otherwise not properly cared for are at increase risk for contracting and dying from preventable illnesses. When a mother dies while giving birth, it greatly increases the likelihood that her kid will not survive, especially in low- and middle-income countries. California Department of Public Health. (n.d.). Maternal and infant environmental exposure project (MIEEP). Retrieved from https://biomonitoring.ca.gov/projects/maternal-and-infant-environmental-exposure-project-mieep American Academy of Pediatrics. (2016). SIDS and other sleep-related infant deaths: Updated 2016 recommendations for a safe infant sleeping environment.  Pediatrics ,  138 (5), 1-12. doi: 10.1542/peds.2016-2938 Ronsmans C, Chowdhury M E, Dasgupta S K, Ahmed A, Koblinsky M. 2010. “Effect of Parent’s Death on Child Survival in Rural Bangladesh: A Cohort Study.” The Lancet 375 (9730): 2024–31 Low Birth Weight Babies Essay – NRS-434 Topic 1 DQ 1 GCU.

  • NRS-434 Topic 1 DQ 2

    NRS-434 Topic 1 DQ 2

    Topic 1 DQ 2

    Consider the following patient scenario:

    A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).

    Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

    There are different developmental milestones a child should achieve at every stage in life, although there might be some delays at some stages. A 9-month old girl with a 68.5 cm length, 6.75 kg weight, and a 43 cm head circumference is considered minimally underweight per the Center for Disease Prevention and Control (CDC, 2017) standard but not something to worry about. Nurses should assess the baby and recommend that the mother should report to the hospital (pediatricians) if the child is not able to perform some physical and neurological functions, which are as follows: crawl forward or backwards, feeds self, pulls up to stand, uses simple gestures like bye bye, sits without support for a short time, responds to sounds and calls, says small letter words like mama, drinks from a cup, copies others while playing; and many more (GCU, 2018). Evidence has shown that a 9-month old child should be able to achieve all this, but if deviated, further assessment should be conducted physically and neurologically. If a child is not able to attain such a goal at nine months, it means there might be autism or other congenital abnormalities causing the delay in the child’s developmental milestone. Some socioeconomic factors might cause some developmental delays, which are sometimes not easily detectable during assessment NRS-434 Topic 1 DQ 2.

    GET A PLAGIARISM-FREE PAPER HERE

    References

    Center on the Developing Child. (2013). Early childhood mental health (InBrief). Retrieved from https://developingchild.harvard.edu/resources/inbrief-early-childhood-mental-health/.

    Grand Canyon University (Ed. 2018). Health Assessment: Foundation for Effective Practice. Retrieved from: 
    https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/2
    .

    Office of Disease Prevention and Health Promotion. (2017). Early and middle childhood. Retrieved from 
    https://www.healthypeople.gov/2020/topics-objectives/topic/early-and-middle-childhood.

     

    NRS-434 Topic 1 DQ 2 SAMPLE 2

    A mother comes into my care with a 9-month-old

    daughter and this RN assess the patient for developmental milestones as well as

    the vital signs. These milestones fall into different categories such as

    social/emotional, language/communication, cognitive as well as movement/physical

    development milestones.

    The patient’s weight is of concern. She weighs less than ninety-five percent of other babies her age. Her length is in the twenty fifth percentile meaning she is not as long as seventy five percent of other babies. This should be taken into consideration of her weight but does not completely account for low weight.

    In assessing social/emotional milestone the RN will look for the infant’s ability to recognize parents/caregivers. The child should be able to notice when her name is called. When the mother leaves the room the 9-month-old should notice and display behaviors such as looking or reaching around for mom or cries. The girl can display physical signs of emotion like happy, sad, angry, or surprised. The baby is shy, clingy, or fearful of strangers. When peek a boo is played, she smiles and laughs.

    The language/communication milestones at this age are simple. The infant makes a lot of different like “mamama” or “babababa”. The baby girl holds her arms up to communicate that she wants to be picked up.

    There are important cognitive milestones to be assessed as well. If the baby girl drops something, or it is out of sight, she looks around for the object. The infant at this age is banging things together to make sounds. Showing that they understand what is making the sound and how it is made.

    This infant girl has physical/movement milestone that need assessing. The baby can sit up on her own. When sitting up she can hold her position by herself. She can pass an item from one hand to the other. Makes a tool out of the hands by raking food towards her.

    There are other important assessment questions to ask mom on this visit. Does the baby have any skills that she no longer performs? Was the baby premature or have any special healthcare concerns? Does the baby girl do or not do anything that causes concern? Was the baby premature?

    There are specific areas of concern that I would discuss with the mother. The foremost issue I would address is the infant’s weight. This does not correlate with healthy baby growth charts put out by the CDC and WHO. The infant nutritional needs in the first year of life are high due to the rapid growth. I would recommend that mom follow the guidelines set forth by the CDC for nutritional goals for 9 moth old infants. The child needs nutritionally dense foods. Sweets are to be avoided especially high fructose corn syrup. The baby has a small stomach at this age so she will need frequent feedings. Snacks are to be implemented at nine months and should be nutritionally sound. Not meeting the nutritional needs leads to higher incidence of developmental delay, and chronic diseases (Grand Canyon University (ed), 2018). I would recommend that the mom follow the CDC guidelines on milestone markers and relate any issues or discrepancies to the pediatrician.

     

     

    References

    Grand Canyon University (ed). (2018). 
    Health assessment: Foundations for effective practice.
    https://doi.org/https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/

    Important Milestones: Your Baby By Nine Months. (2022, August 9). CDC. Retrieved September 9, 2022, from 
    https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html

     

    NRS-434 Topic 1 DQ 2 SAMPLE 3

    Physical, verbal, emotional, and intellectual milestones are used to assess a person’s

    level of development. A female newborn that is 9 months old should have a length of

    between 68.5 and 71 centimeters and a head circumference of around 44 millimeters. Having

    said that, the information provided suggests that the youngster has a very low body mass

    index (Growth Charts – Clinical Growth Charts, 2019). Crawling, sitting independently,

    pulling herself to standing, standing with help, and making gestures that resembled walking

    were some of the other physical milestones accomplished by the nine-month-old. Aversion to

    unfamiliar people, a need to be near loved ones, and a preference for certain types of toys are

    all examples of emotional signals.

    The responses to the questions on the mother’s child’s growth play a significant role in

    the formulation of the recommendations for the mother. Examining the eating routines of the

    child is necessary in order to have a better understanding of why the youngster is underweight.

    It is beneficial to examine the pattern of the baby’s eating and to ascertain whether the

    mother is breastfeeding. If the woman plans to breastfeed her child, it is very important to

    offer nutritional meals for the infant and to monitor the mother to ensure that she is feeding

    her child often enough and that she is producing an acceptable amount of milk.

    The process of making decisions based on evidence, on the other hand, takes into

    consideration the specifics of each circumstance. The clinical condition provides the

    foundation for any necessary alterations to the recommendations that are based on the facts.

    As a direct result of this, judgments that are founded on evidence have the duty to take into

    account the perspectives of both patients and specialists in the field (Frolek Clark &

    Schlabach, 2013). In order to provide direction that is supported by evidence, studies on the

    characteristics of children of that age have been analyzed.

    References.

    Frolek Clark, G. J., & Schlabach, T. L. (2013). Systematic Review of Occupational Therapy

    Interventions to Improve Cognitive Development in Children Ages Birth–5 Years.

    The American Journal of Occupational Therapy, 67(4), 425–430.

    https://doi.org/10.5014/ajot.2013.006163

    Growth Charts—Clinical Growth Charts. (2019, January 11).

    https://www.cdc.gov/growthcharts/clinical_charts.htm NRS-434 Topic 1 DQ 2

  • Pharmacology Exam 2 Study Guide

    Pharmacology Exam 2 Study Guide

    Be able to calculate a conversion of NPH insulin to insulin glargine

    Know the mechanism of action, side-effect profile, and contraindications for
    all
    classes of diabetic medications

    Recognizing, evaluating, and managing hypoglycemia in diabetic patients

    Which oral medication class is likely to cause hypoglycemia?

    What are potential side effects SGLT2 inhibitors and GLP-1 agonists?

    Know the difference between the various classes of insulin and when to prescribe each class

    How would the nurse practitioner formulate starting a patient on insulin (type 1 and type 2)?

    Be knowledgeable how to treat gestational diabetes

    Which antibiotics are safe in pregnancy for management of common infections?

    Management of viral versus bacterial infections

    Be aware of side effects and safety profile of antibiotics to include sulfonamide, tetracyclines, fluroquinolones, aminoglycosides, cephalosporins

    Which medication class is used for Lyme disease, anthrax, and typhoid fever?

    Know antibiotic choices for common infections

    Review treatment of fungal and viral infections

    Understand bactericidal versus bacteriostatic and the drug classes

    Be able to define how antibacterial medications work and explain bacterial resistance