Posts in category: Uncategorized

Hematopoietic:
J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy.

Past Medical History (PMH):
Upon reviewing her past medical history, the gynecologist notes that her patient is a G5P5with four pregnancies within four years, the last infant having been delivered vaginally four months ago. All five pregnancies were unremarkable and without delivery complications. All infants were born healthy. Patient history also reveals a 3-year history of osteoarthritis in the left knee, probably the result of sustaining significant trauma to her knee in an MVA when she was 9 years old. When asked what OTC medications she is currently taking for her pain and for how long she has been taking them, she reveals that she started taking ibuprofen, three tablets each day, about 2.5 years ago for her left knee. Due to a slowly progressive increase in pain and a loss of adequate relief with three tablets, she doubled the daily dose of ibuprofen. Upon the recommendation from her nurse practitioner and because long-term ibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on a regular basis to prevent gastrointestinal bleeding. Patient history also reveals a 3-year history of HTN for which she is now being treated with a diuretic and a centrally acting antihypertensive drug. She has had no previous surgeries.

Case Study Questions

1. Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.
2. Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.
3. Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells?
4. The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia.
   In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.
5. If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.
6. Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.

Cardiovascular
Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and having had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. In route to the hospital, the patient was placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills.

Case Study Questions

1. For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors.
2. What would you expect to see on Mr. W.G. EKG and which findings described on the case are compatible with the acute coronary event?
3. Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarct, which would be the most specific laboratory test you would choose and why?
4. How do you explain that Mr. W.G temperature has increased after his Myocardial Infarct, when that can be observed and for how long? Base your answer on the pathophysiology of the event.
5. Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarct. Elaborate and support your answer.

Submission Instructions:

• Include both case studies in your post.
• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
• All replies must be constructive and use literature where possible. 

• Use the facilitators and barriers to the implementation of practice change projects that you list from the Furtado et al., 2024, article and specifically apply them to your current setting or a healthcare setting with which you are familiar. Provide details. Besides these eight facilitators and barriers, what changes in your setting would provide better support for practice change projects?   
• The best strategy for continuing to deepen your understanding of research is to regularly read reports of research studies. How are you going to set aside time each week to read at least one study that applies to your practice? What day and time will work best for you? How will you modify this plan for weeks when you cannot read the study at this time?

work is attached

 Reply the following discussion, APA style, 2 references or more, turniting less tha 10 %, no AI

Acknowledgment of spirituality as part of comprehensive nursing care has birthed many developed instruments aimed at evaluating and addressing the spiritual needs of patients. The Spiritual Assessment Scale (SAS) is one such important instrument in nursing practice that assesses various aspects of spirituality, including personal faith, meaning-making, and significance to the spiritual community.

The SAS enables nurses to discern particular spiritual issues and strengths within their patients; hence, they can draw up tailored care plans that incorporate the spiritual dimensions of the patient alongside the healthcare provided. Nurses are much better equipped to have meaningful conversations with patients about their belief systems when they use the SAS. This, in turn, fosters a therapeutic relationship that may eventually go a long way toward enhancing patient satisfaction and emotional well-being.

Another important tool is the Spiritual Well-Being Scale (SWBS), created by Piper et al. in 2020. The scale measures the dimensions of spiritual and existential well-being, including purpose and satisfaction in life (Erickson et al., 2022). The SWBS helps reveal how beliefs are involved in influencing health behaviors, coping mechanisms, and quality-of-life experiences among patients receiving nursing care. Incorporating the SWBS into nursing assessments allows health care professionals to better understand what role spirituality plays in a patient’s experience of illness.

This knowledge is vital as it enables nurses to tend to care with empathy and relevance so that the delivery of care aligns with what the patient expects spiritually. Other studies also indicate that using such tools results in better clinical outcomes. For example, in the work of Deshpande et al. , 2021 use of spiritual assessment tools not only augments the emotional support offered to patients but also significantly contributes to better coping strategies and overall health outcomes of patients, especially those with chronic or terminal illnesses.

 Besides this, according to Erickson et al. , 2022 administration of SWBS has resulted in improved patient satisfaction as well as emotional resilience when facing health challenges. The two instruments underscore the imperative need for nurses to recognize and affirm their patients’ spiritual beliefs and even practices, hence contributing more to a holistic healthcare approach while honoring various perspectives on health and wellbeing.
Besides the SAS and SWBS, another increasingly popular tool in nursing practice is the FICA Spiritual History Tool, which stands for Faith, Importance, Community, and Addressing spiritual issues in care (Baldacchino & Draper, 2020).

The FICA offers a formalized approach that allows nurses to investigate the spiritual dimensions of their patients in an open discussion about faith and its health implications. Through the use of the FICA tool, nurses gain much more insight into their patients’ viewpoints which results in a deeper connection as well as informed care planning.

The use of spiritual assessment instruments such as SAS, SWBS, and FICA only illustrate the dedication of nurses toward giving holistic care that is also centered on the patient. As spirituality proves to be an important part of health, the finding made that overall well-being and physical health convergence have huge benefits for patient outcomes shall be discussed in line with the provision of systematic care for spiritual needs by nurses. This permits support in a caring environment that therapies just not against physical ailments but also respects the emotional and spiritual aspects of patients’ experiences.

In summary, the use of structured tools like the Spiritual Assessment Scale and the Spiritual Well-Being Scale and guidelines such as FICA are a must when you evaluate spirituality in nursing practice. These tools help to empower health care providers to deliver holistic care that involves spiritual matters which in turn lead to improved patient’s satisfaction and well-being.

TOPIC: Hand, Foot & Mouth Disease – PEDIATRIC PATIENTS

INSTRUCTIONS AND GUIDELINES ATTACHED

Reply to the following discussion, APA style, 2 or more references, less than 10 % turnitin, no AI

The comprehensive care of patients, which includes their physical, emotional, social, and spiritual well-being, is addressed by spirituality, which is why it is important in nursing. Spirituality in healthcare is frequently associated with an individual’s pursuit of meaning, purpose, and a connection to something bigger than themselves—all of which can be extremely important during periods of disease, pain, or end-of-life care. Nurses are in a unique position to include spiritual care into their work as frontline caregivers, which promotes a more thorough approach to healing and patient-centered care.

 The use of spirituality in nursing involves recognizing and respecting the diverse spiritual beliefs and practices of patients. This idea can include providing emotional support, facilitating prayer or meditation, or simply being present to listen to a patient’s concerns. Spiritual care is particularly important in palliative and hospice care, where patients often grapple with existential questions and seek comfort in their beliefs (de Diego-Cordero et al., 2022). By addressing spiritual needs, nurses can help reduce anxiety, improve coping mechanisms, and enhance quality of life for patients.

 To evaluate spirituality in nursing, several tools and assessment frameworks have been developed. One widely used tool is the Spiritual Well-Being Scale (SWBS), which measures a person’s sense of purpose and satisfaction in life, as well as their relationship with a higher power. Another tool is the FICA Spiritual History Tool, which guides nurses in asking structured questions about a patient’s Faith, Importance, Community, and Address in care. This tool helps nurses identify spiritual needs and incorporate them into the care plan. Beyond this, the HOPE Questions for Spiritual Assessment provide a framework for exploring a patient’s sources of Hope, Organized religion, Personal spirituality, and Effects on medical care. These tools enable nurses to systematically assess spiritual needs and provide tailored interventions. However, effective spiritual care also requires nurses to cultivate self-awareness, cultural competence, and empathy (Miller et al., 2023). Training programs and continuing education can help nurses develop these skills, ensuring they are equipped to address the spiritual dimensions of care.

To sum up, spirituality is a crucial component of nursing that improves patient care in a holistic way. Nurses can better support patients’ spiritual needs and aid in their overall recovery process by employing validated evaluation techniques and cultivating a caring approach.

This integration of spirituality into nursing practice underscores the profession’s commitment to treating the whole person, not just the illness.

INSTRUCTIONS AND GUIDELINES ATTACHED

The use of spirituality in nursing practice is not new.  However, it is more studied and utilized in a more structured format in nursing.  Identify and discuss tools used to evaluate spirituality.

Please include 400 words with two or more scholarly articles, APA style less than 10 % Turnitin, AI 0%

TOPIC: POLYCYSTIC OVARIAN SYNDROME (PCOS)

YOU MUST COMPLETE EACH SECTION ON THE TEMPLATE WITH FULL SENTENCES ACCORDING UNIVERSITY LEVEL PLEASE

CANT BE MISSED ANY SECTION PLEASE

REFERENCE NO OLDER THAN 5 YEARS ACCEPTED

DUE DATE MARCH 26,2025

DO YOUR BEST TO ASSIGN MORE LIKE THIS ONE

NO MORE THAN 10 % OF PLAGIARISM OR STUDENT PAPER ACCEPTED, WILL BE SUBMITTED BY TURNIN IN

TEMPLATE ATTACHED

Case Study 2: Antibiotic Stewardship in a Pediatric Patient with Pneumonia

Objective: Explore appropriate antibiotic selection, dosing, and resistance concerns in pediatric care.

Patient Profile:

• Age: 6
• Gender: Female
• Weight: 44 lbs (20 kg)
• Medical History: Recurrent ear infections, no known drug allergies
• Current Medications: None
• Diagnosis: Community-Acquired Pneumonia (CAP)

Instructions for Students:

1. Identify the most likely pathogens causing pneumonia in this age group and discuss antibiotic options.
2. Select an appropriate antibiotic regimen, including dosing, route, and frequency, based on guidelines for pediatric CAP.
3. Evaluate the risk of antibiotic resistance and the importance of antibiotic stewardship in this case.
4. Monitor: Define what clinical signs/symptoms and laboratory findings should be monitored to ensure the therapy is effective.
5. Adjust: Outline any considerations if the patient fails to respond to first-line therapy or develops adverse effects.
6. Counsel: Provide key teaching points for parents on the correct use of antibiotics, potential side effects, and the importance of completing the prescribed course.