What is the cardinal sign of Lyme disease?

Lyme Disease Case Study 1

A 38-year-old male had a 3-week history of fatigue and lethargy with intermittent complaints of headache, fever, chills, myalgia, and arthralgia. According to the history, the patient’s symptoms began shortly after a camping vacation. He recalled a bug bite and rash on his thigh immediately after the trip. The following studies were ordered:

Critical Thinking Questions 

1. What is the cardinal sign of Lyme disease? (always on the boards)

2. At what stages of Lyme disease are the IgG and IgM antibodies elevated?

3. Why was the ESR elevated?

4. What is the Therapeutic goal for Lyme Disease and what is the recommended treatment.

Peripheral Vascular Disease Case Study 2

A 52-year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except for decreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibial pulses were markedly decreased compared with those of his left leg.

Diagnostic Analysis

With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography to document the location of the vascular occlusion. The patient underwent a bypass from the proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.

Critical Thinking

Questions 

1. What was the cause of this patient’s pain and cramping?

2. Why was there decreased hair on the patient’s right leg?

3. What would be the strategic physical assessments after surgery to determine the adequacy of the patient’s circulation?

4. What would be the treatment of intermittent Claudication for non-occlusion?

Review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

Case Study 1 & 2 Lyme Disease and Peripheral Vascular Disease

The answers must be in your own words with reference to journal or book where you found the evidence to your answer

develop a process for advocating about an issue as a nurse

Reaching out a Solution

In a Microsoft Word document of 4-5 pages formatted in APA style, you will develop a process for advocating about an issue as a nurse, from identifying a problem that needs to be solved through articulating a process for doing so.

This assignment consists of answering each of the questions listed below from the “Political Analysis and Strategies” chapter of your course textbook. Write each question as a new topic area; then follow with a paragraph or two to answer the question.

Let us assume that you are a school nurse in a high school. At a recent school athletic event, a spectator suffered a cardiac arrest in the stands. A coach of the home team went into the high school to fetch the automatic emergency defibrillator (AED) only to find out that it was not readily available. In the meantime, an emergency squad arrived and resuscitated the spectator. On Monday morning, you learn of the absence of the AED only to find out that it had been locked in the custodian’s closet. Reflect on the following questions outlined in the “Political Analysis and Strategies” chapter

  • What is the issue?
  • Is it my issue, and can I solve it?
  • Is this the real issue or merely a symptom of a larger one?
  • Does it need an immediate solution, or can it wait?
  • Is it likely to go away by itself?
  • Can I risk ignoring it?
  • What are the possible solutions? Are there risks to these solutions?
  • What steps would you need to take in order to solve the issue?
  • Does anyone else at the school need to be involved in the solution?
  • Where is the power leverage in the school to reach the preferred solution?
    • Reaching a solution requires the use of power vested in the nurse. Review Box 9-1 (Sources of Power) and determine which type(s) of power the school nurse has in this situation. State your reasons for your answer.

On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.
• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

Please note that the title and reference pages should not be included in the total page count of your paper.

develop a written implementation plan.

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.( cardiac , respiratory and renal related)

The assignment will be used to develop a written implementation plan.

For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

proposed capstone project topic.

In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

Write a 500-750 word description of your proposed capstone project topic. Include the following:

1-The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.

2-The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.

3-A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.

4-Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.

5-Significance of the topic and its implications for nursing practice.

6-A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.

You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

impact on genetics on disease is becoming a part of how we practice.

Based on what you have studied and heard in class, the impact on genetics on disease is becoming a part of how we practice.  If you watch television, you might have seen the advertisements for genetic testing and you often see people very excited about “finally” having detailed information about their heritage.  I want to start a discussion on the pros and cons of genetic testing. By genetic testing, I do not mean heritage, but instead the effects of genetics on ones’ health.  Currently, patients can be tested for several issues, like hemophilia or sickle cell disease, but the horizon is full of possible testing, including looking at the risk of cancers and problems with the fetus.   This is a personal opinion and you can bring in resources if you like, but I’d like you to discuss genetic testing because, as a nurse, people will ask your opinion and you cannot give an honest response until you explore it.  Answer the questions below in your initial post with an expected 300 – 500-word essay.

  • Should genetic testing be mandatory?
  • Should doctors, insurance companies, hospitals, employers require it of everyone they see, insure, hire, treat?
  • What are the benefits of genetic testing?
  • What are the potential problems with genetic testing?
  • If it was offered to you today, would you do it?

 

Your reply post should be meaningful and responses respectful and substantive.  “Nice post” is neither. The reply post should be 250-350  words in length.

You must reference your initial discussion post rationale make sure to use APA formatting for your reference and in-text citations. You do not need to reference your reply posting.

develop a change proposal for a new technology that will contribute to a safer patient environment.

develop a change proposal for a new technology that will contribute to a safer patient environment.

Change Proposal

  • In a Microsoft Word document of 4-5 pages formatted in APA style, develop a change proposal for a new technology that will contribute to a safer patient environment.
    In your paper address each of the following criteria:
  • Describe how the change proposal for the new technology will:
    • impact patient safety.
    • be measured to assess the impact of your change.
    • be communicated to staff and implemented.
  • Examine human factors related to change and resistance to change.

Read more

Explain the etiology of the hematologic disorder

  1. Explain the etiology of the hematologic disorder

Module 09 Content

  1. Using the concept map, select a hematologic disorder and complete the fields included on the map.
    1. Include the pathophysiology of the hematologic disorder
    2. Explain the etiology of the hematologic disorder
    3. Describe the clinical manifestations of the hematologic disorder
    4. Provide the treatment for the hematologic disorder
    5. Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.

please follow the  Concept Map Template

spread of communicable diseases paper

spread of communicable diseases paper

Develop your position about the individual rights to control the spread of communicable diseases for the good of society.

Develop your position about the individual rights to control the spread of communicable diseases for the good of society.

· Survey the role of boards of health in your community and state (Florida) to determine how communicable diseases are prevented and controlled.

·150-word minimum/250-word maximum without the reference(s).

·  Minimum of one reference, APA format.

Investigate the role and responsibilities of the ethics committee at a clinical institution.

Investigate the role and responsibilities of the ethics committee at a clinical institution.

Legal and Ethical Issues of Advanced Practice Nursing – Week 2 Practice Experience

Ethics Committee Roles and Responsibilities – The Telephone Interview

Investigate the role and responsibilities of the ethics committee at a clinical institution. Conduct a phone interview one of the members of the ethics committee to determine the ethical decision-making process that the ethics committee goes through.

1.  Develop 3 open-ended questions to ask during the interview.

2.  Conduct the phone interview.

3.  Use the questions and answers to write a paper that summarizes your interview.

4.  Choose one question-answer dyad. What inference can you make regarding the importance of the ethics committee on patient rights based on this question-answer dyad?

This assignment will be 3 page, APA formatted, paper and include a minimum of 2 references from peer-reviewed nursing articles that address health care ethics and were published within the last five years.

Explain the pathophysiology behind the signs and symptoms of COPD. 

Explain the pathophysiology behind the signs and symptoms of COPD. 

Chronic Obstructive Pulmonary Disease (COPD) is just as it sounds, a chronic obstruction in the pulmonary function that causes disease. This disease is comprised of two major phenotypes, of which are bronchitis (hypersecretion of mucus and chronic productive cough that occurs consecutively for at least two years with at least a consecutive three-month period each year) (McCance & Huether, 2019) and emphysema (an abnormal permanent enlargement of gas-exchange airways or acini, accompanied by destruction of the alveolar walls without obvious fibrosis (McCance & Huether, 2019). The leading cause of COPD is that of smoking. However, there is another factor that contributes to COPD and that is an inherited mutation in the a1-antitrypsin gene. The development of COPD results from this gene, even in those who do not participate in the consumption of smoke inhalation4. Both emphysema and chronic bronchitis affect ventilation-perfusion mismatch with hypoxemia; however, in chronic bronchitis, bronchial edema is caused by the inspiration of irritants that increases the number and size of mucus glands and goblet cells of the airway (McCance & Huether, 2019). This produces an environment in which mucus cannot be cleared of the airway due to narrowing. Eventually, the continuous production of copious amounts of secretions and narrowed airways lead to an obstruction. In Emphysema, the increases in neutrophils of the airway release protease and elastase that cleave structural collagen and promote tissue breakdown (McCance & Huether, 2019). The introduction of macrophages is also present, which contribute to reduction of surface area regarding gas exchange and loss of cellular apoptosis. When it comes to COPD, the difficulty of expiration is due to the accumulation of copious mucus membranes, loss of elastic recoil (from expansion), and epithelial edema. According to the Centers for Disease Control (CDC), as of 2014, COPD has accounted for 39.1 percent of 100,000 deaths in the United States (CDC, 2018). The CDC also states that, the prevalence of COPD varied amongst states, with Colorado, Hawaii, and Utah exhibiting <4% of cases; Tennesse, West Virginia, Alabama, and Kentucky exhibiting >9%, and states along the lower Mississippi rivers and Ohio exhibit the highest prevalence of COPD (CDC, 2018).

What relationship do you see with Mr. Brown’s vital signs – 26 RR, 91% oxygen saturation, temp: 37.8, HR: 93 BP: 150/70 

When observing Mr. Brown’s vital signs, his respiration rates are increased at 26. Eupnea (normal breathing) is 8 to 16 beats per minute according to our text (McCance & Huether, 2019). Due to this patients’ history of COPD for 10 years, it is safe to say that this patient is breathing heavier due to lack of perfused oxygen. His lungs are working harder at this point to keep him oxygenized. HIs oxygen saturation of 91% exhibits hypoxemia and possibly ‘air trapping’, which can be correlated to the reduction of oxygenation of tissue cells. You must be careful when increasing oxygenation to these patients by nasal cannula, as these patients tend to not be receptive of oxygen outside of airways in increased amounts and may develop hypercapnia. The patient is also running a fever of 100.04 degrees Fahrenheit. This could be a resultant of an infection. The patients’ blood pressure is also elevated. From our last discussion, we discussed risks of constriction due to narrowing of vessels when dealing with increased blood pressures or hypertension.

Describe the goals of care for Mr. Brown. Make sure to use the COPD gold standards of care( https://goldcopd.org/wp-content/uploads/2018/02/WMS-GOLD-2018-Feb-Final-to-print-v2.pdf (Links to an external site.) (Links to an external site.)) for your plan.

As Mr. Brown has not been noted to be an unstable patient of COPD, I will assume for this lesson that he is stable. In saying this, I will address the stable COPD patients’ goals according to the COPD gold standards of care. Smoking cessation is highly encouraged if the patient is a smoker. As there is no cure, maintenance of the disease is highly profitable to the patient in regards of symptoms and exacerbation risks in the future. These patients are asked to identify and reduce irritant exposure. Continuation of prescribed medications such as bronchodilators, corticosteroids, oxygen therapy, and macrolides, to reduce the symptoms experienced by this patient is also reinforced.

How would you follow up on your proposed plan of care? 

Routine follow-up visits are required of this individual, as well as, blood gases, chest x-rays, and pulmonary function test. If not definitive, the introduction of high-resolution CT scanning may be indicated. As COPD is not a curative disease, it is however, a manageable one. Maintaining a functional oxygenation level and exhibiting the abilities to continue to perform activities of daily living (ADL’s) is the end goal of these types of patients.