The scenario is that of an 86-year-old Asian male patience that depend on his daughter for financial assistance, and in taking care of him . However, his daughter is a widow without enough resources or the ability to fully take care of her father. She is poor herself. Improving the quality of life for the old Asian male by identifying his most important health needs and recommendation through thorough health assessment is key. Older adults being more vulnerable to diseases due to low immunity, should be considered for a safe socioeconomic, cultural, spiritual and lifestyle that may prolong their life.

  The first step is for the Nurse Practitioner to develop a respectful and trusting relationship with the patient, in other to obtain a detailed and accurate health history, making sure to use available translator if the patient does not speak English. The future PMHNP should engage in effective communication, such as patience and active listening because the Patient may need more time to process information before answering questions. Also, the NP should not use judgmental or non-patronizing language, in other to develop a connection with the patient (Ball, 2015).

Specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient

Socioeconomic factors: The 86 year old man is financially unable to provide for himself, and is dependent on his daughter, who is a widow and is financially unable to provide for her father, therefor, the patient is socio-economically poor, and may lack a good living standard in relation of having balanced diet, meeting medical expenses and other maintenance that may improve his quality life. The NP has to consider these socio-economic factors while assessing the Patient.

Lifestyle Factor: due to low income status, and lack of financial support from his daughter, the 86 year old Asian man most like lives a low and poor quality of life, which may have contributed to his detoriating health status, lack of of constant medial care, good nutrition and clean healthy environment. The treatment and recommendation from the NP should factor the patient’s lifestyle during treatments.

Cultural factors: Culturally, Asians are known to be very reserved and secretive when it comes to personal health. Such strong cultural factor may influence the patient’s decision is not open about his needs to his daughter and subsequently, to a healthcare professional, The NP must figure out a way to gain his trust. Also, culturally, Asians are mostly group-oriented people that place importance on family connection as the primary source of identity (Carteret, 2010). Asian children are also known to take care of their elderly parents, but in this scenario, the patient’s daughter is equally poor and has difficulty fulfilling her role of a provider and may create emotional burden both for both parties. Religious and cultural practices such as Buddhism for Asians should also be incorporated in managing health.

The Nurse Practitioner may need to make referral to community resources to additional financial and physical needs for the patient and his daughter. The NP should maintain cultural sensitivity while assessing the patient.

Applying cultural competency and diversity are two important factors to consider in treating patients. As an NP, we should have knowledge of different cultural backgrounds, and apply it to the unique needs of the patients while delivering high-quality care. Being culturally competent helps in developing a trusting relationship between the patient and health care provider. This includes being reflective and aware of your own feelings, biases, experiences, and lack of knowledge (Ball, 2015). Cultural competence in nursing involves being curios of, and respect for a patient’s beliefs and values (Ball, 2015).

 Targeted questions:

1. Can you tell me about your current medical history and concern?
2. What is your source(s) of income?
3. Have you inquired with the county offices regarding additional financial and medical resources?
4. What specific things make you feel like you are being a burden?
5. Do you need assistance with activities of daily living such as eating, bathing, toileting, or getting dressed? 

References:

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Carteret, M. (2010). Cultural Values of Asian Patients and Families. Divi. Retrieved from

Cultural Values of Asian Patients and Families

Centers for Disease Control and Prevention. (2015). Cultural competence. Retrieved from

https://npin.cdc.gov/pages/cultural-competence

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

REPLY QUOTE EMAIL AUTHOR 

Read Chapter 9

1. Try taking a different route to class the next time it meets. Before you do this, think about how many changes, large and small, you will have to make to do this.

a-Will you have to leave earlier to be in class on time? 

b-Will you meet different people on your way to class?

c-See different sights?

d-Would you change your route to class on the day of the final exam? 

e-Why or why not? Summarize the positives and negatives of this small change. Relate your responses to this change to the way staff nurses feel when an administrator makes what he or she thinks is a “minor” change. 

2. Think about a change that has occurred in your life. Some examples may be a change of role, a move, a marriage, a birth, a divorce, or a death. 

a-How did you react to the change? 

b-Would you have reacted differently if you had had more information?

c-Using Lewin’s model, describe the basic elements in the situation and how you eventually achieved a comfortable outcome.

Provide examples of experimental and nonexperimental research design. Contrast the levels of control applied to each.

1)  What are anabolic steroids? Why are they abused?
 

2) Why do some people crave drugs more than others?

Each question should be more than 100 words. (need to be done separately)

No plagiarism

proper citation and reference In Apa Formate 

 Medications

All data addressed for medications your client received that day in clinical

Rationales appropriate for your client 

Part I: Write your Philosophy of Health

This week’s discussion board assignment requires you to write and share your personal philosophy of health. Your philosophy needs to be at least 250words long. Since this is a personal statement, it is appropriate to write in first person tense (I, you, me etc.). If you use any sources, such as an inspiriting quotation, be sure to use APA format to document the quotation and cite it in a reference list at the end of your statement. Quotes do not count in the 250-word minimum.  Be creative, succinct, and clear. I would like to read your unique thoughts. 

As a future health professional, it’s important to explore your own views about health. There is no doubt that as you go along in your academic major, and have experiences in the field, that your philosophy will change. However, as you begin your journey into health education, you should summarize your views thus far as a starting point. You can use this written health philosophy for your professional portfolio and expand and change your health philosophy as you learn and experience more.

I need a 4-5 page paper on the movie Wall-E. 

this thesis below needs to be used

Throughout the main storyline of WALL-E, symbols or representations of a vast dystopian society are shown, which is a leading theme and reoccurring image.

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

TASK

Post your initial response to one of the two topics below.

Epidemiology’s Role in Infectious and Communicable Diseases

Topic 1: Disease Outbreak

Select an infectious disease and research the CDC website for information about the disease including: 

• its natural history,
• presenting symptoms, and
• outbreak characteristics
• Identify an occurrence of the disease by searching the Internet for recent reports of this disease and compare that episode or occurrence with information from the CDC website.
• How closely did that outbreak resemble the case definition?

Topic 2: Epidemiological Applications

• Describe how the concept of multifactorial etiology relates to the natural history of disease and the different levels of prevention.
• How should the nurse incorporate these concepts into health promotion of clients in community settings?
• How should the nurse approach client risk in these health promotion activities?

Peer 1

In this week lecture we focus on the concept of epidemiology and the role it plays when dealing with communicable and infectious diseases. In addition, we also learned about environmental health in terms of disease prevention as it related to the 3 levels referred to as primary, secondary, tertiary prevention. Hence, disease prevention are important concepts to understand when dealing with infectious diseases (South University Online, 2019). In my discussion, the infectious disease I choose to talk about is Tuberculosis, also known as “TB”. TB is a bacterial disease caused by the bacterium known as Mycobacterium Tuberculosis. TB is known to primary cause damage in the lungs but can also affect other vital organs within the body spreading to the kidneys, brain, bones, and spine. TB is spread from person to person through “airborne Transmission”. Therefore, TB is spread through the air by an infected person when they cough, talks, or sing (Division of Tuberculosis Elimination, 2016). Common presenting symptoms of TB include sneezing, consistent coughing (that last more than 3 weeks) night sweats, fever, chills, and unexplained loss of appetite (National Health Concil , 2020). 

TB is not generally known to cause outbreaks, which can be described as the detection of more than 3 TB cases that has a epidemiology link associated with its transmission. In the years from 2009-2015, there were 21 outbreak cases of TB. Of these 21 cases reported over 80% of the individuals used drugs and illegal substances, which included some who also suffered from mental illness, and or were homeless. Hence, almost all of the TB outbreaks were due to a delayed diagnosis of the disease (Mindra et al., 2017). On the CDC website, there was a reported occurrences of TB outbreaks from 2002-2008.  In there report they found that the majority of outbreaks occurred among drug users and people who drink an excess amount of alcohol. Hence, both studies revealed that the majority of TB outbreaks was among the homeless, and people suffering with mental health conditions (Division of Tuberculosis Elimination, 2019).

References

Division of Tuberculosis Elimination. (2019, September 6). Data & Statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/tb/statistics/default.htm. 

Division of Tuberculosis Elimination. (2016, March 17). Signs & Symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm. 

Mindra, G., Wortham, J. M., Haddad, M. B., & Powell, K. M. (2017, February 1). Tuberculosis Outbreaks in the United States, 2009-2015. Public health reports (Washington, D.C. : 1974). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349481/. 

National Health Concil . (2020, March 9). Living With Tuberculosis. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/symptoms-diagnosis. 

Talwar, A., Tsang, C. A., Prince, S. F., Pratt, R. H., Walker, W. L., Schmit, K. M., & Langer, A. J. (2019, March 21). Tuberculosis – United States, 2018. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/68/wr/mm6811a2.htm.

Peer 2 

The infectious disease that I have chosen is Tuberculosis. The bacteria called Mycobacterium tuberculosis is what causes TB. Tuberculosis normally attacks the lungs, but it can also attack other body parts like the brain, kidney, or spine. Tuberculosis is spread through the air from one person to the next. The signs and symptoms that the person presents with usually depends on where in the body that the TB is. The signs and symptoms of pulmonary TB are: pain in the chest, coughing up blood or sputum, a bad cough that lasts 3 weeks or longer, no appetite, weight loss, fever, chills. sweating at night, weakness, fatigue. Other signs and symptoms depend on which body part is affected. There are also people who have TD and don’t get sick or presents with any signs and symptoms that are called Latent TB.

When it comes to outbreaks that pertain to TB, they do not happen often. Usually, the infectious period begins about 3 months before the initiation of any symptoms and usually ends when treatment starts. I did find one.  On an Indian Reservation, there were 5 people who tested positive. When the investigation begins the was doing contact tracing to see 1) who did these people come in contact with and 2) where did this all stem from. They were in contact with a total of 126 people, 121 of them did receive a PPD test. 21 of those had latent TB and 19 were started on treatment. The people were in contact with each other at a party where they were really close to each other. This case does resemble most outbreaks and how they present. The first five had a productive cough and sputum.

References

Basic TB Facts. (2016, March 20). Retrieved September 30, 2020, from https://www.cdc.gov/tb/topic/basics/default.htm

Tuberculosis Outbreak on an American Indian Reservation — Montana, 2000–2001. (2002). Retrieved September 30, 2020, from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5111a3.htm

Cigarette smoking leads to disease and disability and harms nearly every organ of the body. Smoking causes cancer, heart disease, stroke, lung diseases, type 2 diabetes, and other chronic health conditions. The impact also extends beyond the smoker.                                                  

1-Give an Overview about Cigarette smoking in Saudi Arabia? 

2- How our Ministry of health is collaborate with other ministries in the kingdom in ordered to encourage people to stop smoking? 

Guidelines:

1. Font should be 12 Times New Roman

2. Heading should be Bold

3. The text color should be Black 

4. Line spacing should be 1.5

5. Length of the write-up should be not more than 500 words.

6. Avoid Plagiarism

7. Assignments must be submitted with the filled cover page

8. All assignments must carry the references using APA style. Please see below web link about how to cite APA reference style.

9. https://guides.libraries.psu.edu/apaquickguide/intext. Click or tap to follow the link.

Assignment: Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

Photo Credit: Getty Images/Caiaimage

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for this Assignment.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
• Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

• Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. 
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Required Media (click to expand/reduce)

Introduction to Advanced Pharmacology
Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m)
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Nature Video. (2016). The evolution of oral anticoagulants [Video]. https://www.youtube.com/watch?v=Gp-ucDRiaUA
Note: This media program is approximately 5 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2017).  Pharmacology – Diuretics (Made Easy) [Video]. https://www.youtube.com/watch?v=9OBvNpnS0h4&t=664s
Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Pharmacology – Antiarrhythmic Drugs (Made easy) [Video]. https://www.youtube.com/watch?v=9xSqezCMHnw&t=1205s
Note: This media program is approximately 23 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2016). Pharmacology – Adrenergic receptors & agonists (MADE EASY) [Video]. https://www.youtube.com/watch?v=KtmV-yMDYPI&t=372s
Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Drugs for Hyperlipidemia (Made Easy) [Video]. https://www.youtube.com/watch?v=Of1Aewx-zRM&t=24s
Note: This media program is approximately 14 minutes.

pls use three resources for this assignment