Fill out the NPW, please. This it the scenario: Traumatic hyphema
Astute triage leads to an evidence-based treatment plan.
By Aaron M. Sebach, PhD, DNP, MBA, AGACNP-BC, FNP-BC, CP-C, CLNC, CGNC, CNE, CNEcI, SFHM, FNAP, FAANP
BRIAN WRIGHT*, a 34-year-old man with a cein staining. Aside from a Grade Il hyphema, history of essential hypertension, is struck in the ophthalmologic examination is unremark-the right temple with a bat during a softball able with intraocular pressures 16 mmHg on game. Mr. Wright’s teammates drive him to the the left and 19 mmHg on the right.
emergency department (ED) for evaluation.
The ophthalmologist prescribes pred-
They wait 3 hours to be seen.
nisolone acetate 1% ophthalmic drops four times per day, for 7 days, and oxycodone, 5 mg
History and assessment
every 6 hours as needed, for severe pain. Mr.
Jane*, an experienced ED nurse, completes the
Wright is discharged home with daily outpa-
triage for Mr. Wright, who says he felt dizzy and tient ophthalmology follow-up and instruc-nauseous immediately after being hit by the bat.
tions to limit strenuous physical activity and to
Mr. Wright says he also experienced right eye
wear his right eye shield at all times.
pain (10/10), photophobia, and blured vision.
Mr. Wright’s vital signs are temperature 97.5° Education and follow up
F (36.4° C), HR 106 BPM, RR 18 breaths per
Traumatic hyphema is most common in men
minute, BP 142/78 mmHg, and Sao, 98% on and children with an incidence of 12/100,000 room air. While obtaining Mr. Wright’s vital individuals. Penetrating or blunt ocular trau-signs, Jane begins her triage assessment. She ma, which typically occurs as a result of athlet-notes the presence of blood in the anterior ic or recreational injuries, requires emergent chamber of his right eye and assigns an emer- evaluation to prevent vision loss. Patients fre-gency severity index score of 2 (out of 5) and quently experience vision loss, eye pain, photo-takes Mr. Wright directly to the trauma treat- phobia, nausea, or vomiting. Sickle cell disease, ment area for immediate evaluation.
anticoagulant use, and clotting disorders in-crease complications associated with hyphema.
Taking action
Diagnosis is primarily clinical, although globe
Jane assesses Mr. Wright’ visual acuity (left eye
rupture must be ruled out.
20/30, right eye 20/200, and both eyes 20/40).
Traumatic hyphema requires prompt identi-
Before notifying the attending ED physician
fication and ophthalmology evaluation. Indi-
about this traumatic injury, Jane elevates the viduals with a Grade II hyphema (less than 50% head of the stretcher to 45 degrees, applies a of the anterior chamber occupied by blood) can right eye shield, dims the examination room be managed as outpatients, with daily ophthal-lights, and instructs Mr. Wright to remain on mology evaluations to assess intraocular pres-the stretcher.
sures, administration of ocular glucocorticoids
The ED physician affirms the presence of a
to prevent rebleeding and control inflamma-
hyphema and consults with ophthalmology.
tion, limited physical activity, and eye shield-
She orders an I.V. and 4 mg of morphine sulfate
ing. Grade II hyphema typically resolves within
and 4 mg of ondansetron before transporting
7 days. In Mr. Wright’s case, Jane’s astute triage
Mr. Wright for a computed tomography scan
assessment facilitated timely implementation of
of the orbits and maxillofacial bones to rule
an evidence-based treatment plan.
AN
out fracture and globe rupture.
*Names are fictitious.
Outcome
Fortunately, Mr. Wright didnt sustain any maxillofacial or globe ruptures. He’s evaluated by ophthalmology in the ED with slit-lamp ex-amination of the anterior segment and fluores-
Access references at myamericannurse.com/?p=369784.
Aaron M. Sebach is dean of the College of Health Professions and Natural Sciences at Wilmington University, in New Castle, Delaware, and a nurse practitioner at TidalHealth Peninsula Regional, in Salisbury, Maryland.
LSU Discussion # 2
/0 Comments/in Economics /by bonniejecintaQuestion
This week we are learning about interest rates and valuation models for bonds and stocks. The underlying concept is all based on the time value of money: The “value” of a financial asset is the present value of all future cash flows. That present value is based on the “appropriate discount rate”, which is the required rate of return on the financial asset.
Changes in value of financial assets, and bonds in particular, is the topic for this discussion. The US Federal Reserve Board (the Fed) has increased interest rates, specifically the federal funds rate (the rate banks charge other banks, usually for overnight loans).
Fed interest rate today 2022-present: The Fed’s latest moves in an era of soaring inflation
Rate hikes 2022-present
Meeting date
Rate change
Target range
March 15-16, 2022
+25 basis points
0.25-0.5 percent
May 3-4, 2022
+50 basis points
0.75-1 percent
June 14-15, 2022
+75 basis points
1.50-1.75 percent
July 26-27, 2022
+75 basis points
2.25-2.5 percent
Sept. 20-21, 2022
+75 basis points
3-3.25 percent
Nov. 1-2, 2022
+75 basis points
3.75-4 percent
Dec. 13-14, 2022
+50 basis points
4.25-4.5 percent
Jan. 31-Feb. 1, 2023
+25 basis points
4.5-4.75 percent
March 21-22, 2023
+25 basis points
4.75-5 percent
May 2-3, 2023
+25 basis points
5-5.25 percent
July 25-26, 2023
+25 basis points
5.25-5.5 percent
Source: Fed’s board of governors
As you can see from the data above, interest rates increased by 5% between March 2022 and July 2023. With these changes, there was a ripple effect felt across the economy. The value of bond portfolios held by banks as well as individual investors dropped, the “cost” of borrowing money increased across the board from car loans to mortgage loans as well as business loans.
For your discussion this week, I’d like for you to pick a sector or topic and discuss the impact of the interest rate increases. Below are examples of directions you could take:
Personally (Never put personal info in the post that you are uncomfortable with!! Speak in generalities if you prefer, the point is to apply the interest rate change impacts to your post.
How have the interest rate changes impacted on your purchase decisions maybe it is to delay a major purchase (car or house maybe).
What about the buy vs. rent decision? There have been articles on how the relative economics have changed recently.
Have you modified investment allocations in your portfolio or IRA/401K investments?
Banking sector:
Pick a bank that has failed or was purchased by another bank because of problems with their bond portfolio or similar situation. What was the underlying problem at the bank? What was the outcome? Yes, a deeper discussion of SVB is acceptable here as long as you cite an additional outside credible source. The number of troubled banks is limited.
Corporate sector:
Pick a company that may have had to change their plans on raising funds because of required higher coupon rates. Maybe the company has experienced changes in its sales because consumers are holding off on spending.
Maybe discuss a firm that has had a hard time getting loans because of high rates.
There are a lot of different directions you can go with your post, but no matter what you choose (even personal) you MUST have at least one credible outside source (remember that Investopedia and Wikipedia are not considered reliable). As with any discussion, be sure to reread the grading rubric before posting.
Bottom line:
What aspect are you discussing? What changed, and why? How did decisions or outcomes change from what would have been expected without the interest rate increases? The “so what” is where I’m looking for. Go beyond “interest rates went up, bond prices went down”.
post a discussion to agree or disagree on nursing informatics
/0 Comments/in Health Medical /by bonniejecintaQUESTION
Main Post
Nursing informatics is a key player in what makes a healthcare organization run efficiently, safely, and cost effective. According to the American Nurses Association (ANA) nursing informatics is “the specialty that transforms data into needed information and leverages technologies to improve health and health care equity, safety, quality, and outcomes,” this specialty has become increasingly more important as healthcare has continued to grow in advance in both technology and the patient care experience (2021). I currently work as a bedside nurse in a hospital, and while we do not ever see the people who collect and analyze all of the data it is known they are there just by acknowledging and seeing all of the important changes that are made to our and the patients experience everyday.
Data specialists interact with other professions in the hospital daily, they promote and encourage interdisciplinary care just by doing their jobs. Interdisciplinary care is a key factor in allowing the hospital to run effectively and efficiently, it also allows for our natural leaders in each department o step forward and help to make the necessary changes needed to improve patient care (Victoria Department of Health, 2021). I feel that data specialists play a large role in facilitating this because they are on of the few jobs that get to actively participate with all employees of the hospital frequently. They are consistently observing and collecting data from each aspect that makes up the interdisciplinary team (Sweeney, 2019). For example the specialist could speak to the doctors about nurse to doctor communication and where there would be room for improvements, they could then go back to the nurses and ask the same questions and find out where each discipline could meet in the middle to improve the overall communication of doctors and nurses.
Working in the hospital a large suggestion I would make to improve the strategies between the specialists and staff would be to integrate the specialists into the staffs daily lives more. While we know they are doing a ton of important work behind the scenes in order to create policies and plans that keep everyone safe and happy it would be nice to put a face to the people working so hard for us. I think this would not only encourage compliance for the changes they decide to make but would make the staff more comfortable to come to them with their own ideas on how to improve quality in both patient care and the staffs work environments.
Nursing informatics will not be going anywhere anytime soon. It continues to play in an important role in the hospitals and all other healthcare facilities. I think as technology grows and more science develops nursing informatics and the positions that go along with them will only continue to expand and become more complex that it will require a change among the professional interactions in order to collect and analyze adequate data. Specialists will also be needed to help introduce new policy and guidelines for all of the new advancements that we will see in healthcare over the next 20 years. Nursing informatics will most likely become one of the largest healthcare fields that we have at that point in time.
The scope of Nursing Informatics Practice. American Nurses Association . (2021). https://www.nursingworld.org/~49c602/globalassets/…
State Government of Victoria, Australia. (2021, October 24). An interdisciplinary approach to caring. Department of Health. Victoria, Australia. https://www.health.vic.gov.au/patient-care/an-inte…
ADW AND AEW
/0 Comments/in Business & Finance /by bonniejecintaQUESTION
Adw 1 reply to discussion
The Cardiovascular System Quiz to Start Us Off
I am thinking that at the beginning of each section, we could start off with a quiz and see where the discussion takes us. Ok, here we go and remember, all of the questions will be either true or false and you MUST include an explanation to earn full credit:
Adw 2 reply to discussion
Lymphatic System Quiz to Start Us Off
I am thinking that at the beginning of each section, we could start off with a quiz and see where the discussion takes us. Ok, here we go and remember, all of the questions will be either true or false and you MUST include an explanation to earn full credit:
AEW 3
https://accounts.mheducation.com/login?app=connect…
COMPLETE WEEK 3, ONLY COMPLETE WHAT COUNTS TOWARD A GRADE
Log into McGraw Hill
Albertewilliams24@gmail.com
Snow@2018
AEW 4
https://www.starbucks.com/
Using the Starbucks website and Robbins et al. (2017), go to the Starbucks website
Links to an external site.. locate the “For Business” section, and access the “Suppliers” link. Evaluate how the requirements and standards to become a Starbucks’ supplier.
Using the transformation process (Ferrell et al., Chapter 8), explain how Starbucks serves its customers, from inputs to outputs. Conduct additional research as needed.
AEW 5 REPLY TO DISCUSSION
From what I gather, Starbucks utilizes a set of standards for its suppliers and its operations in order to ensure proper service to their customers. The transformation process used to ensure this service starts with standards which range from supplier code of conduct, to supply chain security standards, to responsible sourcing standards, and operational standards to name a few.
The inputs in this process would be coffee beans, other food items that are needed to produce pastries sold by Starbucks, the needed finances to operate the organization, as well as the human capital necessary.
The transformation begins as the raw materials such as coffee beans are ground for use or for sale in packaging at Starbucks physical locations. The locations themselves are an integral part of the process because of the equipment used for preparing the products to be sold, as well as the ambiance it provides as a comfortable place for coffee and conversation.
The output of these processes ultimately are the teas, coffees, cakes and other pastries served to the customers on a daily basis.
Starbucks could not be as successful as they are without the standards they set forth for themselves and their suppliers in my opinion.
Nursing Process Worksheet
/0 Comments/in Writing /by bonniejecintaQUESTION
Fill out the NPW, please. This it the scenario: Traumatic hyphema
Astute triage leads to an evidence-based treatment plan.
By Aaron M. Sebach, PhD, DNP, MBA, AGACNP-BC, FNP-BC, CP-C, CLNC, CGNC, CNE, CNEcI, SFHM, FNAP, FAANP
BRIAN WRIGHT*, a 34-year-old man with a cein staining. Aside from a Grade Il hyphema, history of essential hypertension, is struck in the ophthalmologic examination is unremark-the right temple with a bat during a softball able with intraocular pressures 16 mmHg on game. Mr. Wright’s teammates drive him to the the left and 19 mmHg on the right.
emergency department (ED) for evaluation.
The ophthalmologist prescribes pred-
They wait 3 hours to be seen.
nisolone acetate 1% ophthalmic drops four times per day, for 7 days, and oxycodone, 5 mg
History and assessment
every 6 hours as needed, for severe pain. Mr.
Jane*, an experienced ED nurse, completes the
Wright is discharged home with daily outpa-
triage for Mr. Wright, who says he felt dizzy and tient ophthalmology follow-up and instruc-nauseous immediately after being hit by the bat.
tions to limit strenuous physical activity and to
Mr. Wright says he also experienced right eye
wear his right eye shield at all times.
pain (10/10), photophobia, and blured vision.
Mr. Wright’s vital signs are temperature 97.5° Education and follow up
F (36.4° C), HR 106 BPM, RR 18 breaths per
Traumatic hyphema is most common in men
minute, BP 142/78 mmHg, and Sao, 98% on and children with an incidence of 12/100,000 room air. While obtaining Mr. Wright’s vital individuals. Penetrating or blunt ocular trau-signs, Jane begins her triage assessment. She ma, which typically occurs as a result of athlet-notes the presence of blood in the anterior ic or recreational injuries, requires emergent chamber of his right eye and assigns an emer- evaluation to prevent vision loss. Patients fre-gency severity index score of 2 (out of 5) and quently experience vision loss, eye pain, photo-takes Mr. Wright directly to the trauma treat- phobia, nausea, or vomiting. Sickle cell disease, ment area for immediate evaluation.
anticoagulant use, and clotting disorders in-crease complications associated with hyphema.
Taking action
Diagnosis is primarily clinical, although globe
Jane assesses Mr. Wright’ visual acuity (left eye
rupture must be ruled out.
20/30, right eye 20/200, and both eyes 20/40).
Traumatic hyphema requires prompt identi-
Before notifying the attending ED physician
fication and ophthalmology evaluation. Indi-
about this traumatic injury, Jane elevates the viduals with a Grade II hyphema (less than 50% head of the stretcher to 45 degrees, applies a of the anterior chamber occupied by blood) can right eye shield, dims the examination room be managed as outpatients, with daily ophthal-lights, and instructs Mr. Wright to remain on mology evaluations to assess intraocular pres-the stretcher.
sures, administration of ocular glucocorticoids
The ED physician affirms the presence of a
to prevent rebleeding and control inflamma-
hyphema and consults with ophthalmology.
tion, limited physical activity, and eye shield-
She orders an I.V. and 4 mg of morphine sulfate
ing. Grade II hyphema typically resolves within
and 4 mg of ondansetron before transporting
7 days. In Mr. Wright’s case, Jane’s astute triage
Mr. Wright for a computed tomography scan
assessment facilitated timely implementation of
of the orbits and maxillofacial bones to rule
an evidence-based treatment plan.
AN
out fracture and globe rupture.
*Names are fictitious.
Outcome
Fortunately, Mr. Wright didnt sustain any maxillofacial or globe ruptures. He’s evaluated by ophthalmology in the ED with slit-lamp ex-amination of the anterior segment and fluores-
Access references at myamericannurse.com/?p=369784.
Aaron M. Sebach is dean of the College of Health Professions and Natural Sciences at Wilmington University, in New Castle, Delaware, and a nurse practitioner at TidalHealth Peninsula Regional, in Salisbury, Maryland.
AIIB to world bank
/0 Comments/in Business & Finance /by bonniejecintaQUESTION – QUESTION
respond to these statements
1. I think you’re correct in suggesting that the impact of the AIIB on U.S. businesses will be complex. The opportunities for U.S. businesses to leverage AIIB-funded projects for revenue is clear, given that the U.S. is a technological leader, including sustainable technologies. For businesses that were seeking an entry point to Asian markets, the AIIB would appear to be a resources to help bridge that process. Conversely, domestic activity in the U.S. as it relates to infrastructure development, will likely have greater competition as the AIIB invests almost exclusively in Asia. The U.S. is already a global leader in green technology development and implementation, as reflected through the negotiation and involvement in the Paris Agreement to reduce greenhouse emissions. If U.S. companies can engage in projects funded by the AIIB, perhaps this could also provide valuable experience for projects that could be replicated domestically in the U.S. by those same infrastructure companies who completed work abroad in Asia.
2. The missions of both institutions, the AIIB and the World Bank are commendable as they strive towards the betterment of humanity and the planet. However, as we move forward, global poverty and pollution remain the most pressing concerns. China, being the largest contributor to pollution, needs to take significant steps towards sustainability to tackle the environmental crisis. The AIIB, along with political leaders in the region, must encourage large organizations to restructure their infrastructure for sustainable development. This will not only help reduce the carbon footprint but also pave the way for a cleaner and healthier future.
It is crucial for both the AIIB and the World Bank to collaborate with major corporations to uplift the economies of underdeveloped nations. By investing in sustainable infrastructure and renewable energy sources, these institutions can help create job opportunities and increase economic growth in these countries.
However, to ensure outside support, poor countries need to take a stand against corrupt leadership and reclaim their countries for progress. It is important to promote transparency and accountability in governance and create a conducive environment for private investment. Together, the AIIB, the World Bank, and the political leaders of these countries can work towards achieving sustainable development goals and improving the lives of millions of people around the world.
3. Great post! You provided good insight of the Asian infrastructure investment bank and the potential impact on US based businesses. The Asian infrastructure investment bank does serve adjacent to the world bank, specifically focusing on infrastructure in Asia. Your emphasis on the infrastructure and its development was appreciated. With these projects, the potential for increased demand is present from the US. Secondly, these projects can lead to expanded markets leading to more international trade. This is good for the consumer because the goods and services diversify leaving two new products on the market as well as new investment opportunities. With these new investment opportunities, it poses collaboration and competition challenges among the two organizations. It’s crucial to understand these regulations, cultural differences, and economic landscape to further push negotiation and other types of projects. Overall, I appreciated your insight on the impact the AIIB would have on businesses stationed in the United States. However, it’s important to understand the both potential negatives and positives of if we cooperate on the infrastructure and development of Asia and the rest of the world.
PCOS – Peer Response
/0 Comments/in Health Medical /by bonniejecintaQUESTION
Peer Responses – Pratiksha
Citations: At least two high-level scholarly reference in APA per post from within the last 5 years
Globally Polycystic Ovary Syndrome (PCOS) affects around 8% to 20% of women during their years according to diagnostic criteria (Singh et al., 2023). The prevalence varies across populations due, to environmental factors.
Pathophysiology
The underlying mechanisms of PCOS involve metabolic disruptions mainly characterized by levels of androgens and insulin. Increased androgen levels originating from the ovaries and adrenal glands result in symptoms such as hair growth (hirsutism) and acne while disturbing ovarian function (Witchel et al., 2019). Imbalances in the ovarian axis worsen excess androgen production, influenced by genetic factors affecting steroid production. Additionally, insulin resistance contributes to insulin levels, which in turn stimulate androgen production and lower sex hormone binding globulin levels intensifying the effects of androgens.
Clinical Presentation
Common symptoms include cycles, hirsutism, acne, weight gain and difficulty conceiving. Long term implications involve metabolic issues, like diabetes, abnormal lipid levels and cardiovascular problems (Bulsara et al., 2021).
Diagnostic Criteria
To diagnose syndrome (PCOS) healthcare providers consider various criteria outlined by the Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group in 2004. These criteria involve the presence of two out of three key features; hyperandrogenism (HA) ovulatory dysfunction (OD) and polycystic ovarian morphology (PCOM) observable on ultrasound scans. The Androgen Excess and PCOS Society (AE PCOS) criteria also consider hyperandrogenism and ovarian dysfunction for diagnosis. Anti Mullerian hormone (AMH) plays a role as an indicator in PCOS reflecting the maturation and development of ovarian follicles. Elevated levels of AMH can hinder development contributing to the dysfunction commonly seen in PCOS cases.
Non-Drug Treatment Approaches
For women with PCOS lifestyle modifications are fundamental in managing the condition alongside medication. Engaging in activity is vital as it improves insulin sensitivity and overall metabolic health. Including both aerobic exercise and resistance training in routines has been shown to enhance insulin sensitivity and regulate androgen levels. Following glycemic index (LGI) diets that’re high in fiber and plant-based fats can provide metabolic benefits by helping to regulate glucose levels and hormones that control appetite.
It’s important to steer diets that’re high in calories, sugar and saturated fats to help reduce inflammation and insulin resistance linked to PCOS (Singh et al., 2023).
Pharmacological Management
Oral contraceptives (OCPs), including both progesterone-only pills and combined estrogen-progesterone pills, serve as first-line therapy for menstrual irregularities and ovulation suppression (Bulsara et al., 2021). Antiandrogens such as spironolactone, flutamide, and cyproterone acetate are preferred for managing hirsutism. Insulin sensitizers like metformin improve insulin resistance and restore menstrual regularity, while thiazolidinediones (TZDs) offer additional benefits in improving ovulation and reducing androgen levels (Bulsara et al., 2021).
Education
Patient education on lifestyle modifications, contraception, and long-term health risks is crucial. Encourage adherence to treatment and regular follow-ups.
Follow-up
Regular monitoring of menstrual cycles, androgen levels, and metabolic parameters is essential. Adjust management strategies based on patient response and goals.
PURPOSEFUL SAMPLING AND SATURATION
/0 Comments/in Writing /by bonniejecintaQUESTION
What is a good sample in qualitative research? It is NOT about size or generalizability.
The answer lies in how clearly you articulate the criteria for selecting data sources; (b) your ability to purposefully select cases; and (c) the extent to which those cases are “information-rich… for in-depth study” (Patton, 2015, p. 264) with respect to the purpose of the study.
As you prepare for this week’s Discussion, consider turning your attention to the variety of purposeful sampling strategies you may consider in developing your research plan. Also consider that qualitative researchers seek a threshold or cut-off point for when to stop collecting data. There is no magic number (although there are guidelines). Rather, saturation occurs as an interface between the researcher and the data and (b) between data collection and data analysis to determine when enough is enough.
For this Discussion, you will critique a sampling strategy used in a research article.Prepare a critique of the sampling strategy used by Yob and Brewer (n.d.). Include the following your critique:
Be sure to support your main post and response post with reference to the week’s Learning Resources and other scholarly evidence in APA style.
Crisis Intervention w/ Children Who Experience Grief and Trauma Due to the Loss of a Parent
/0 Comments/in Humanities /by bonniejecintaQUESTION
RESEARCHPROJECTSERIES:REASEARCHPAPERASSIGNMENTINSTRUCTIONS
OVERVIEW
As part of the Research Project Series, you will write a literature review research paper that
synthesizes the major points of your findings. Your paper must focus on your selected topic and
the field of mental health crisis intervention. Your paper must relate your research findings to the
content of this course, your academic research, your interview findings, cultural concerns, and
biblical perspectives on crisis counseling.
INSTRUCTIONS
? The body of your paper (not counting the cover page, abstract, or reference pages) must
be between 12-15 pages. Any submissions less than 12 pages will be prorated and heavily
penalized. There is no need to go over to impress as succinct writing is highly valued in
crisis work.
? Current APA or Turabian formatting is required. Focus on the cover page, headers, Level
1 and Level 2 headings, citations, references in particular.
? Your paper must contain a formal introduction and a formal conclusion. Conclusions in
literature review papers must contain a paragraph related to “ideas for future research”.
You just read the literature so you are in a positive to advise what seems to be missing.
This tells future researchers what to focus on.
? Spiritual application is required in the paper including specific Bible verses/passages.
? You must incorporate some key points from your interview in this paper. This is where
you share your interview findings. There is no need for a specific section but rather
weave in the interview data like you do other academic sources.
? Avoid personal experience or personal opinions in these papers. This is a literature
review paper so only academic sources are utilized.
? At least 15 scholarly sources must be used to support your findings and research. At least
10 of your sources must be published within the last 5 years. It is fine to use an older
study only if it is considered a “classic study” in the field.
? Be sure to review the rubric for additional requirements before submitting your paper and
use the rubric as a checklist to ensure that no requirements are missed.
? Proofread your paper carefully before submission. Consider this a major assignment and
submit your best work.
Here is a basic outline of the main sections that your paper must include:
1. An APA or Turabian cover page.
2. An Abstract. (An Abstract and Introduction are often confused but they are different in
both formatting and content. Be sure you know the difference.)
3. Body of the report which includes all of the areas listed below:
a. Introduction –in APA or Turabian Form. Use this section to orient your reader
and grab their interest. Why does this topic matter? What interesting background
information can you share?
b. Mental health symptoms / relationship dynamics common in your population-of-
interest How can new interventionists identify this population? What type of
CRIS 606
Page 2 of 2
mental health issues typically arise? What type of relationship issues typically
occur?
c. Best practices in crisis intervention (how can we best help them?). NOTE: avoid
any discussion of long-term counseling or psychotherapy. This is a crisis course
so be sure you know the difference.
d. Spiritual applications/interventions (What does Scripture say about your topic
area that is relevant?)
e. Cultural considerations What cultural concerns/considerations must we attend to
when working with this population?
f. Conclusion Wrap up your paper discussing key themes and findings that you
uncovered. Note: The conclusion of literature review papers must include at least
a paragraph on “ideas for future research.” You just read the literature on your
topic area so you are conversant in the research. What seems to be missing? What
should future researchers focus on?
Deaf Clients in Canada
/0 Comments/in Humanities /by bonniejecintaQuestion
Counselling Deaf Clients in Canada.
A. Socio-cultural and demographic background – In this section, include descriptive information about the specific cultural group that you have researched, such as demographics, history, social and cultural customs, traditions, belief systems and values, as well as epidemiological data on the prevalence of certain conditions, if such data exist. Make sure to be as specific as possible in your Question. For example, if you write about youth in a particular group, make sure to define what age range you mean and what researchers have noted. Include at least two (2) recent (last seven years), peer-reviewed sources and any required peer-reviewed course readings you cite. Write about 400 words for this section.
week 5 disc 1 reply to Yosef L
/0 Comments/in Writing /by bonniejecintaQuestion
Q1. Which classes of diabetes medications are either weight neutral or cause weight loss? Please give one (1) example of a drug’s generic and trade name in that class.
A1: A class of diabetes medication that also helps with weight loss are Glucagon-like peptide 1 agonists. An example of this class is the generic drug exenatide, with the brand name Byetta (Van Gorp et al., 2020).
Q2. Based on the current guidelines of the ADA, it would be appropriate to treat her with monotherapy since the patient is hesitant to take any injections. What agent would you recommend? Please provide the trade name, generic name, the dose you would start the patient with frequency, and route.
A2: Based on this patient’s medical history of obesity and hyperlipidemia, her reluctance to injections and the ADA guidelines, I would suggest Jardiance, generic name empagliflozin, a type of SGLT2 inhibitor. This medication not only helps against type II diabetes, but also has some medium level efficacy against obesity as well as decreasing the possibility of Major Adverse Cardiac Events (MACE) (“Standards of Care in Diabetes—2023 Abridged for Primary Care Providers,” 2022). This medication, however, can be expensive, depending on her insurance. Depending on how obese she versus how much her insurance covers would be the deciding factor. The recommended dose for Jardiance is 10mg, once daily in the morning (Ingelheim, 2023)
Q3. What are the contraindications of your selected diabetic therapy?
A3: Contraindications for Jardiance include: pregnancy, renal insufficiency, bariatric surgery and any surgery in general (Empagliflozin: Drug Information – UpToDate, n.d.).
Q4. What lab workup should you obtain? What sort of results will you see in patients who have hypothyroidism and hyperthyroidism?
A4: to assess for either hypo or hyperthyroidism, I would obtain a TSH lab with an additional free thyroid hormone T-4 one. If the TSH is high and T4 is low then the patient would be diagnosed with hypothyroidism. If it is reversed, with TSH being low and T4 high, then we would diagnose hyperthyroidism (American Thyroid Association, 2020).
Q5. What is the treatment of choice for hypothyroidism? What is the mechanism of action? Please provide the initial dose, trade, and generic name of the drug, route, and frequency.
A5: Choice of treatment for hypothyroidism is Synthroid, a type of levothyroxine medication. It works because it is a synthetic form of thyroxine, the endogenous hormone in the body. Dosing for Synthroid depends on patients medical history, TSH and free T4 levels as well as patient’s weight. So the initial starting dose would be 1.6 mcg/kg/day (patient’s weight is unknown) and increase the dose by 12.5-25mcg every 3-6 weeks based on lab results. She should take it once a day, early in the morning, without food (Dosing & Administration – SYNTHROID®, n.d.)
Q6. What are the adverse effects, and what important teaching will you provide this patient on thyroid replacement therapy?
A6: Adverse reactions of Synthroid are symptoms of hyperthyroidism. This includes: increased BP, dyspnea, diarrhea, weight loss, sweating, vomiting, anxiety and headache, to name a few. Teaching for this medication include: not crushing the medication, taking it on an empty stomach, early in the morning and not within four hours of any calcium- or iron-containing products or bile acid sequestrants. It should be stored at room temp and that she should tell her provider if she plans or becomes pregnant (Levothyroxine: Drug Information – UpToDate, n.d.)