Topic: Rheumatoid Arthritis

Give the Following:

• Definition
• Epidemiology
• Signs and Symptoms
• Treatment and Management
• Anatomy & Physiology

1. Why is getting adequate folate or folic acid so important before and during pregnancy? What could happen to the developing baby if the mom doesn't consume adequate folate or folic acid?

2. Why is getting adequate iron so important during pregnancy? What could happen to the developing baby or to the mom if the mom doesn't consume adequate iron during her pregnancy?

3. Why is excessive weight gain (gaining more than the recommended amount) during pregnancy potentially dangerous to the mom? To the developing baby?

4. Ideally, what should an infant be fed for the first 6 months of life? Why?

5. What are the benefits of breastfeeding to a baby? To the mom?

6. What are reason(s) some moms choose not to breastfeed their babies?

7. What are some things we could all do to support moms who want to breastfeed their babies?

8. What should older infants and young children aged 6–23 months consume? Should breastfeeding continue during this time?

9. Why is consuming iron-rich foods so important for older infants starting at age 6 months?

10. Why are nutritional needs for infants and young children higher (on a per kg or lb basis) than at any other time in the life cycle? Which nutrients in particular?

1. Describe the newest screening resources developed to address the mental health needs of nursing caring for COVID patients.
2. Identify steps to perform a reliable self-assessment.
3. Describe how to effectively deal with personal grief during COVID-19.
4. Discuss methods to effectively cope with other emotions that may be felt during the pandemic, i.e. anxiety, depression, anger, or fear.

Course Learning Outcomes-Covered
• Identify and analyze different perspectives on understanding problems for different situations. (3.1)
• Utilize different decision making tools to enhance problem solving and decision making approaches.   (4.3)
• Identify organized alternatives and select among possible alternative to evaluate business options. (2.10)
• Create a Decision Making and Problem Solving worksheet document. (4.5)

Critical Thinking Questions: (Marks 5)

Question 1: (1 Mark)
Suppose you are a member of a group asked to find ways to cut costs throughout your organization for the upcoming year. Sales have fallen sharply, and the company is in danger of going out of business. After gathering information, your group concludes that the company will save the most money by freezing pay for a year, despite a tradition of annual salary increases. How can you make sure this is a fair decision? How can you make sure that others in the organization will see it as a fair decision?

Question 2: Case Analysis
Care, a health consultancy company in Saudi Arabia, is studying the economic benefits of a program of preventative COVID-19 flu vaccinations. Care has to give advice to government for COVID-19 vaccination. If vaccinations are not introduced then the estimated cost to the government if flu strikes in the next year is SR.70m with probability 0.1, SR.100m with probability 0.3 and SR.150m with probability 0.6. It is estimated that such a program will cost SR.70m and that the probability of flu striking in the next year is 0.75.
One alternative open to the committee is to institute an "early-warning" monitoring scheme (costing SR.30m) which will enable it to detect an outbreak of flu early and hence institute a rush vaccination program (costing SR.100m because of the need to vaccinate quickly before the outbreak spreads).
    Question
• As a consultant of Care, Develop a decision tree for alternatives and make recommendation to Indian government that which alternative can maximize expected economic benefits?

Question 3: (1 Mark)
Decision support tools rely on objective, mathematical data. What part does ethics play in using decision support software?

Question 4: (1 Mark)
If you collect too much information for analyzing a decision, you can suffer from analysis paralysis, where you spend too much time thinking about a decision rather than making one. Recall a major financial decision you made recently, such as of a car or housing purchase or rental. Describe your process for making the decision. How could analysis paralysis have affected this process?

n Jacobson v. Massachusetts (1905), the United States Supreme Court upheld the right of states to enact compulsory vaccination laws—one of the most challenging constitutional dimensions of public health. It also provided the terms for what would eventually become a core question of public health ethics.

This case has become the precedent for many cases that have challenged vaccination laws. Both majority and dissenting opinions in numerous decisions have cited this case in reference to states’ authority to constrain individual behavior. These cases have involved issues ranging from fluoridation of municipal water supplies, to abortion, to the right to die. In Buck v. Bell (1927), the Supreme Court usedJacobson v. Massachusetts (1905) to uphold a forced-sterilization law using the reasoning that society must be protected from the burdens imposed by the offspring of “imbeciles.” Despite the troubling uses to which this decision has been put, public health law texts continue to cite the case as an example of the ways that public health practices must resolve the tensions between individual rights and the collective well-being.

Based on these Supreme Court decisions, respond to the following:

• Do you believe health departments should be able to enter your house without a warrant from a judge?
• Should health departments be able to isolate or quarantine you without a trial? Why or why not?

List Complication that may occur related to a stroke, L side Hemiplegia, procedure, and comorbidities.

What nursing or medical interventions may prevent the above alert or complications?

Review ears, eyes, nose, mouth, throat system

Review how to assess the thyroid gland, hearing, eyes,

Review types of hearing loss

Review abnormalities of the mouth

Review 12 cranial nerves and how to assess each of them

On tests you will need to know RDAs and ULs for all groups - remember that you can refer to the tables inside the text if you have a hard copy or use the scanned RDA/UL tables.

There may not be RDAs or ULs on the tables for every mineral - be sure to check the textbook for all information!

type and storage

indicate if it is a major or trace mineral

include whether/where in the body excess is stored

symptoms of deficiency

summarize the effects on the body if you don't have enough

include the names of any specific diseases or syndromes

symptoms of toxicity

summarize the effects on the body if you get too much

indicate how toxicity could occur (hint - in most cases the risk is from over-supplementation not from food sources)

for some minerals this is rare and/or there is no known toxicity - if that's the case say so

any additional info that you think is important or is emphasized in lecture slides

For this written assignment, select one recent (within the past two years) evidence-based article from a peer reviewed nursing journal that describes a "best practice" in an area of nursing you are interested in. For example, if you would like to be a pediatric nurse, select an article that discusses a best practice in pediatric care.

Cite the article and provide a brief overview of how the results or findings were obtained. Then describe the "best practice." Conclude your discussion by explaining whether you thought the research findings supported the conclusions and the best practice.

please explain The Effect of Kangaroo Care on Maternal Attachment in Preterm Infants.

1. Describe a business situation where you felt uncomfortable or ill at ease
2. What would you do differently to handle the situation?
3. What can you do to maintain composure in even the most difficult or stressful business situation?

Mr. Gennaro is a 61-year-old Spanish-speaking man who presents to emergency room with his wife Dolores. Mr. Gennaro is also Spanish-speaking, but understand some English. Mr. Gennaro complains of nausea and vomiting for two days and symptoms of confusion. His blood glucose is 796 mg/dL. Intravenous regular insulin is prescribed and he is admitted for further evaluation. He will require teaching regarding his newly diagnosed diabetes.

He is a past medical history of coronary artery disease (CAD) and hypertension (HTN). Smokes one pack of cigarettes per day; tobacco use for 35 years. He also takes jerbero, and curandera.

Mr. Gennaro is newly diagnosed with diabetes. His hemoglobin A1c is 10.3%. Mr. Gennaro is slightly overweight. He is 5’10” tall and weighs 174 pounds. He reports no form of regular exercise. He does not follow a special diet at home. He states, “I eat whatever Dolores puts in front of me. She is a good cook.” Neither can recall how long it has been since these changes are Mr. Gennaro began. Dolores states, “it has been quite a while now. It just seems to be getting worse and worse.”

1. The nurse does not speak Spanish. Discuss what the nurse should keep in mind to facilitate effective communication using an interpreter. What is the difference between the role of a medical “interpreter” and that of a medical “translator”?

2. Describe the following serum glucose tests used to help confirm the diagnosis of diabetes mellitus: casual, fasting, postprandial, and oral glucose tolerance test.

3. When evaluating Mr. Gennaro’s postprandial results, what is important to consider regarding his age and tobacco use?

4. Explain what hemoglobin A1c lab test tells the healthcare provider.

5. How might the nurse briefly explain what diabetes is in lay terms to Mr. and Mrs. Gennaro?

Mr. Gennaro is a 61-year-old Spanish-speaking man who presents to emergency room with his wife Dolores. Mr. Gennaro is also Spanish-speaking, but understand some English. Mr. Gennaro complains of nausea and vomiting for two days and symptoms of confusion. His blood glucose is 796 mg/dL. Intravenous regular insulin is prescribed and he is admitted for further evaluation. He will require teaching regarding his newly diagnosed diabetes.

He is a past medical history of coronary artery disease (CAD) and hypertension (HTN). Smokes one pack of cigarettes per day; tobacco use for 35 years. He also takes jerbero, and curandera.

Mr. Gennaro is newly diagnosed with diabetes. His hemoglobin A1c is 10.3%. Mr. Gennaro is slightly overweight. He is 5’10” tall and weighs 174 pounds. He reports no form of regular exercise. He does not follow a special diet at home. He states, “I eat whatever Dolores puts in front of me. She is a good cook.” Neither can recall how long it has been since these changes are Mr. Gennaro began. Dolores states, “it has been quite a while now. It just seems to be getting worse and worse.”

1. Explain the difference between type I diabetes type II diabetes and who is at increased risk for developing each type. Based on this understanding, which type of diabetes does Mr. Gennaro have?

2. Discuss the prevalence of diabetes and the potential long-term complications of diabetes.

3. List five nursing diagnosis appropriate to consider for Mr. Genaro.

4. Discuss Mr. and Mrs. Gennaro’s learning needs. Consider the communication preferences of Mexican Americans.

5. Discuss the dietary recommendations for diabetics based on the diabetic food pyramid.

Mr. Gennaro is a 61-year-old Spanish-speaking man who presents to emergency room with his wife Dolores. Mr. Gennaro is also Spanish-speaking, but understand some English. Mr. Gennaro complains of nausea and vomiting for two days and symptoms of confusion. His blood glucose is 796 mg/dL. Intravenous regular insulin is prescribed and he is admitted for further evaluation. He will require teaching regarding his newly diagnosed diabetes.

He is a past medical history of coronary artery disease (CAD) and hypertension (HTN). Smokes one pack of cigarettes per day; tobacco use for 35 years. He also takes jerbero, and curandera.

Mr. Gennaro is newly diagnosed with diabetes. His hemoglobin A1c is 10.3%. Mr. Gennaro is slightly overweight. He is 5’10” tall and weighs 174 pounds. He reports no form of regular exercise. He does not follow a special diet at home. He states, “I eat whatever Dolores puts in front of me. She is a good cook.” Neither can recall how long it has been since these changes are Mr. Gennaro began. Dolores states, “it has been quite a while now. It just seems to be getting worse and worse.”

1. Discuss how culture may influence Mr. Gennaro’s diabetes management interpreting food choices diet and exercise and use of an alternative healthcare provider.

2. Discuss what Mr. Gennaro should be taught about how to manage his diabetes on days that he is ill.

3. Mr. Gennaro meets his friends at a local bar once a week for beer or two. What impact does alcohol have on diabetes? Should he discontinue the social activity?

You have a preceptee assigned to work with you for 6 weeks. She has been a nurse for two years and has been working in an ICU. Her name is Elissa and she is approximately 25 years old. You work on a busy med-surg unit where several nursing assistants have been employed 15 years or more. After 3 weeks you notice she never delegates any tasks to the nursing assistants and she cannot complete all of her work by the end of the shift.

What are some possible reasons for Mindi’s behavior?

How should you as the preceptor guide Mindi in delegating to the nursing assistants?

Using the 5 rights of delegation, develop a plan of action with Mindi.

Your preceptee, Melody, is 40ish. She graduated from a local nursing program 3 months ago and she is now an RN. She has been working with your for 2 weeks. You began her patient load with one patient and she did a great job although she seemed to stay busy with this assignment. She is very thorough in everything she does. Her technical skills are excellent. You have been progressively moving up her patient assignments. This morning you assigned her three patients. She completed and charted her morning assessments. The charge nurse and the unit secretary are away from the floor. Now at 11:00 a.m. she was getting ready to go to lunch and the following things happen?

Mr. Price who was admitted yesterday with DVT complains of acute shortness of breath.

Mrs. Manning’s accucheck is due at 11:00, her IV is infiltrated, and she has a 12:00 antibiotic.

Dr. Lovell is standing at the desk demanding LOUDLY that an old chart be requested to the unit STAT for Mr. Clark who was admitted with pneumonia two days ago and is stable.

How is Melody as a novice or advanced beginner likely to feel in this situation?

What can you as the preceptor do to help?

How would you direct Melody in managing this situation?