Week 11 lecture and discussion questions

Attached Files:

Culture, Family, and Community.

Review the attached PowerPoint presentation.  Once done,

1.  Define Culture, Family, and Community and discuss how they are related.

2.  Mention and discuss what cultural concepts will you use to provide nursing care to families, communities and, aggregates.

3.  Mention and discuss potential health problems in refugees and immigrant populations.

4.  Mention and discuss interventions that are culturally sensitive and relevant to address the health concerns of a refugee population.

INSTRUCTIONS:

As stated in the syllabus present your assignment in an APA format word document, Arial 11 font attached to the forum in the discussion tab of the blackboard titled “Week 11 discussion questions” and the SafeAssign exercise in the assignment tab of the blackboard.   It is mandatory to post your assignment in the SafeAssign exercise.  If the assignment is not posted there, I will grade the assignment as 0.  A minimum of 2 evidence-based references besides the class textbook no older than 5 years must be used and quoted.

A minimum of 800 words is required.  Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.  Please review the rubric attached in lecture You must present the assignment according to how it is posted, answering the questions by number, essay-style assignments will not be accepted unless otherwise specified.

Case Study 3 & 4 (10 Points)

Students much 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 Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

Inflammatory Bowel Disease

Case Study

The patient is an 11-year-old girl who has been complaining of intermittent right lower quadrant pain and diarrhea for the past year. She is small for her age. Her physical examination indicates some mild right lower quadrant tenderness and fullness. Studies Results Hemoglobin (Hgb), 8.6 g/dL (normal: >12 g/dL) Hematocrit (Hct), 28% (normal: 31%-43%) Vitamin B12 level, 68 pg/mL (normal: 100-700 pg/mL) Meckel scan, No evidence of Meckel diverticulum D-Xylose absorption, 60 min: 8 mg/dL (normal: >15-20 mg/dL) 120 min: 6 mg/dL (normal: >20 mg/dL) Lactose tolerance, No change in glucose level (normal: >20 mg/dL rise in glucose) Small bowel series, Constriction of multiple segments of the small intestine Diagnostic Analysis The child’s small bowel series is compatible with Crohn disease of the small intestine. Intestinal absorption is diminished, as indicated by the abnormal D-xylose and lactose tolerance tests. Absorption is so bad that she cannot absorb vitamin B12. As a result, she has vitamin B12 deficiency anemia. She was placed on an aggressive immunosuppressive regimen, and her condition improved significantly. Unfortunately, 2 years later she experienced unremitting obstructive symptoms and required surgery. One year after surgery, her gastrointestinal function was normal, and her anemia had resolved. Her growth status matched her age group. Her absorption tests were normal, as were her B12 levels. Her immunosuppressive drugs were discontinued, and she is doing well.

Critical Thinking Questions

1. Why was this patient placed on immunosuppressive therapy?

2. Why was the Meckel scan ordered for this patient?

3. What are the clinical differences and treatment options for Ulcerative Colitis and Crohn’s Disease? (always on boards)

4. What is prognosis for patients with IBD and what are the follow up recommendations for managing disease?

Urinary Obstruction

Case Studies

The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft. Studies Results Routine laboratory studies Within normal limits (WNL) Intravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate Uroflowmetry with total voided flow of 225 mL 8 mL/sec (normal: >12 mL/sec) Cystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O) Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O) Electromyography of the pelvic sphincter muscle Normal resting bladder with a positive tonus limb Cystoscopy Benign prostatic hypertrophy (BPH) Prostatic acid phosphatase (PAP) 0.5 units/L (normal: 0.11-0.60 units/L) Prostate specific antigen (PSA) 1.0 ng/mL (normal: <4 ng/mL) Prostate ultrasound Diffusely enlarged prostate; no localized tumor Diagnostic Analysis Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems.

Critical Thinking Questions

1. Does BPH predispose this patient to cancer?

2. Why are patients with BPH at increased risk for urinary tract infections?

3. What would you expect the patient’s PSA level to be after surgery?

4. What is the recommended screening guidelines and treatment for BPH?

5. What are some alternative treatments / natural homeopathic options for treatment?

Assignment Details

Case Study: Prescribed Drugs with CAMs

A 35-year-old male, Mr. NX, presents to your clinic today with complaints of back pain and “just not feeling good.” Regarding his back, he states that his back pain is a chronic condition that he has suffered with for about the last 10 years. He has not suffered any specific injury to his back. He denies weakness of the lower extremities, denies bowel or bladder changes or dysfunction, and denies radiation of pain to the lower extremities and no numbness or tingling of the lower extremities. He describes the pain as a constant dull ache and tightness across the low back.

He states he started a workout program about 3 weeks ago. He states he is working out with a friend who is a body builder. He states his friend suggested taking Creatine to help build muscle and Coenzyme Q10 as an antioxidant so he started those medications at the same time he began working out. He states he also takes Kava Kava for his anxiety and garlic to help lower his blood pressure.

His historical diagnoses, currently under control, are:

Type II diabetes since age 27

High blood pressure

Recurrent DVTs

His prescribed medications include:

Glyburide 3 mg daily with breakfast

Lisinopril 20 mg daily

Coumadin 5 mg daily

Directions:

1. Present this Assignment as a PowerPoint presentation with at least 10 slides
2. Be sure to complete the assignment as the NP treating this family, not as a third party.
3. You will use the Narrative notes section of the presentation to include the majority of your evidentiary support of your treatment choices and education of family complete with in-text citations using APA formatting, remember if you use photos from outside sources, they must be cited below within the Power Point.

Due by Day 7 at 11:59 p.m. ET

Assignment Requirements:

Before finalizing your work, you should:

• be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and
• utilize spellingand grammar check to minimize errors.

Your writing Assignment should:

• follow the conventions of Standard English(correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 6th edition format

Review the video interview with Prof. Alondra Nelson about her research on genetic testing. Alondra Nelson’s interview on genetic testing and race explains the difficulties individuals encounter when trying to navigate the costs and benefits of finding out who they are and where they are from. In your discussion describe at least one way in which genetic testing is complicated for African Americans. Then reflect on how and in which ways the new research into genetics force us to reconsider the question of race as a social construct. Then consider Prof. Alondra’s discussion on the complexities of genetic testing in the African American community and think about how these complexities might apply, or not, to another ethic group. For instance, consider your own ethnic heritage and how you may or may not get accurate information from genetic testing.  Would you suggest that there be warning labels on commercially available genetic tests?

Responses are reflective writing in which you respond to question prompts. They should be at least 200 words long, written succinctly. Address all parts of the prompt question.