Discuss how your concept of Community Health Nursing has changed from the beginning of   this course to now.

Discussion Forum #101. Discuss how your concept of Community Health Nursing has changed from the beginning of this course to now. 2. Identify at least 2 ways that you have changed.3. Identify 2 strategies that you may use in your future practice to impact positive change in the community.4. Discuss three of the most interesting ideas or lessons that you will take away from this class?

What was the cause of this patient’s iron-deficiency anemia?

case 1 Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition Iron-Deficiency Anemia Case Study A 72-year-old man developed chest pain whenever he was physically active. The pain ceased on stopping his activity. He has no history of heart or lung disease. His physical examination was normal except for notable pallor. Studies Result Electrocardiogram (EKG), p. 485 Ischemia noted in anterior leads Chest x-ray study, p. 956 No active disease Complete blood count (CBC), p. 156 Red blood cell (RBC) count, p. 396 2.1 million/mm (normal: 4.7–6.1 million/mm) RBC indices, p. 399 Mean corpuscular volume (MCV) 72 mm3 (normal: 80–95 mm3 ) Mean corpuscular hemoglobin (MCH) 22 pg (normal: 27–31 pg) Mean corpuscular hemoglobin concentration (MCHC) 21 pg (normal: 27–31 pg) Red blood cell distribution width (RDW) 9% (normal: 11%–14.5%) Hemoglobin (Hgb), p. 251 5.4 g/dL (normal: 14–18 g/dL) Hematocrit (Hct), p. 248 18% (normal: 42%–52%) White blood cell (WBC) count, p. 466 7800/mm3 (normal: 4,500–10,000/mcL) WBC differential count, p. 466 Normal differential Platelet count (thrombocyte count), p. 362 Within normal limits (WNL) (normal: 150,000– 400,000/mm3 ) Half-life of RBC 26–30 days (normal) Liver/spleen ratio, p. 750 1:1 (normal) Spleen/pericardium ratio <2:1 (normal) Reticulocyte count, p. 407 3.0% (normal: 0.5%–2.0%) Haptoglobin, p. 245 122 mg/dL (normal: 100–150 mg/dL) Blood typing, p. 114 O+ Iron level studies, p. 287 Iron 42 (normal: 65–175 mcg/dL) Total iron-binding capacity (TIBC) 500 (normal: 250–420 mcg/dL) Transferrin (siderophilin) 200 mg/dL (normal: 215–365 mg/dL) Transferrin saturation 15% (normal: 20%–50%) Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 Ferritin, p. 211 8 ng/mL (normal: 12–300 ng/mL) Vitamin B12, p. 460 140 pg/mL (normal: 100–700 pg/mL) Folic acid, p. 218 12 mg/mL (normal: 5–20 mg/mL or 14–34 mmol/L) Diagnostic Analysis The patient was found to be significantly anemic. His angina was related to his anemia. His normal RBC survival studies and normal haptoglobin eliminated the possibility of hemolysis.. His RBCs were small and hypochromic. His iron studies were compatible with iron deficiency. His marrow was inadequate for the degree of anemia because his iron level was reduced. On transfusion of O-positive blood, his angina disappeared. While receiving his third unit of packed RBCs, he developed an elevated temperature to 38.5°C, muscle aches, and back pain. The transfusion was stopped, and the following studies were performed: Studies Results Hgb, p. 251 7.6 g/dL Hct, p. 248 24% Direct Coombs test, p. 157 Positive; agglutination (normal: negative) Platelet count, p. 362 85,000/mm3 Platelet antibody, p. 360 Positive (normal: negative) Haptoglobin, p. 245 78 mg/dL Diagnostic Analysis The patient was experiencing a blood transfusion incompatibility reaction. His direct Coombs test and haptoglobin studies indicated some hemolysis because of the reaction. His platelet count dropped because of antiplatelet antibodies, probably the same ABO antibodies that caused the RBC reaction. He was given iron orally over the next 3 weeks, and his Hgb level improved. A rectal examination indicated that his stool was positive for occult blood. Colonoscopy indicated a rightside colon cancer, which was removed 4 weeks after his initial presentation. He tolerated the surgery well. Critical Thinking Questions 1. What was the cause of this patient’s iron-deficiency anemia?2. Explain the relationship between anemia and angina. 3. Would your recommend B12 and Folic Acid to this patient? Explain your rationale for the answer 4. What other questions would you ask to this patient and what would be your rationale for them Case 2 Studies The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months. Physical examination revealed right-sided pneumonitis. The following studies were performed: Studies Results Complete blood cell count (CBC), p. 156 Hemoglobin (Hgb), p. 251 12 g/dL (normal: 14–18 g/dL) Hematocrit (Hct), p. 248 36% (normal: 42%–52%) Chest x-ray, p. 956 Right-sided consolidation affecting the posterior lower lung Bronchoscopy, p. 526 No tumor seen Lung biopsy, p. 688 Pneumocystis jiroveci pneumonia (PCP) Stool culture, p. 797 Cryptosporidium muris Acquired immunodeficiency syndrome (AIDS) serology, p. 265 p24 antigen Positive Enzyme-linked immunosorbent assay (ELISA) Positive Western blot Positive Lymphocyte immunophenotyping, p. 274 Total CD4 280 (normal: 600–1500 cells/L) CD4% 18% (normal: 60%–75%) CD4/CD8 ratio 0.58 (normal: >1.0) Human immune deficiency virus (HIV) viral load, p. 265 75,000 copies/mL Diagnostic Analysis The detection of Pneumocystis jiroveci pneumonia (PCP) supports the diagnosis of AIDS. PCP is an opportunistic infection occurring only in immunocompromised patients and is the most common infection in persons with AIDS. The patient’s diarrhea was caused by Cryptosporidium muris, an enteric pathogen, which occurs frequently with AIDS and can be identified on a stool culture. The AIDS serology tests made the diagnoses. His viral load is significant, and his prognosis is poor. The patient was hospitalized for a short time for treatment of PCP. Several months after he was discharged, he developed Kaposi sarcoma. He developed psychoneurologic problems eventually and died 18 months after the AIDS diagnosis. Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. Critical Thinking Questions 1. What is the relationship between levels of CD4 lymphocytes and the likelihood of clinical complications from AIDS? 2. Why does the United States Public Health Service recommend monitoring CD4 counts every 3–6 months in patients infected with HIV? 3. This is patient seems to be unaware of his diagnosis of HIV/AIDS. How would you approach to your patient to inform about his diagnosis? 4. Is this a reportable disease in Florida? If yes. What is your responsibility a provider Students must 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 topics change every semester. Topic TBDThe answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use past students’ work as all files submitted in this course are registered and saved in turn it in the program.Answers must be scholarly and be 3-4 sentences in length with rationale and explanation. No Straight forward / Simple answer will be accepted. Turn it in Score must be less than 25 % 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 25 %. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.All answers to case studies must have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites) per case Study

What would you do first prior to prescribing any medication?

Howard is a 24 year-old male who presents to the clinic with his wife for what he states is severe lower back pain. He states the pain is so bad that he rates it as a “50 out of 10.” He also tells you that due to a past medical history of an ulcer, he cannot take any medications “like Motrin.” He states that the pain is from a car accident in 2012, and that it flairs up and he needs pain medications. He also tells you that he has a high pain tolerance, and that when he gets pain meds he requires the higher doses.Discussion 1What would you do first prior to prescribing any medication?What are the various schedules of medications for controlled substances?Would you prescribe a long or short acting narcotic? Why or why not?Discussion 2What other non narcotic medication options can you offer to this patient?What patient education is needed with them?What would you do if the patient and his wife tell you that none of them work for him?

Develop a drawing/network topology of your home network that includes computers, switches, routers, Internet Service Provider, and any security or firewall protection.

Using Appendix M in your textbook on page 275. Develop an interconnection agreement based on utilizing your home computer system as your home business system. The movement, protection, and reliability of your interconnection is important to your business so provide sufficient depth and scope of your interconnection agreement to ensure your business is protected and remains available. Develop a drawing/network topology of your home network that includes computers, switches, routers, Internet Service Provider, and any security or firewall protection.

How did the simulated experience of Henry Williams’s case make you feel?

Henry Williams, Part 1Guided Reflection QuestionsOpening QuestionsHow did the simulated experience of Henry Williams’s case make you feel?What nursing actions did you feel were appropriate within this scenario? Scenario Analysis Questions*What priority problem did you identify for Henry Williams?What is the rationale for recognizing Henry Williams’s shortness of breath and for initiating actions in a timely manner?What is the rationale for recognizing Henry Williams’s anxiety and concern for his wife and for initiating actions in a timely manner?What teaching strategies and information should be included during Henry Williams’s visit to the clinic?What appropriate assessments were made to help you decide what interventions Henry Williams needed?What was the relevance of the nursing communication with Henry Williams’s daughter-in-law, Betty?What health care team members and services may play a role in Henry Williams’s care and why?What actions should take place to improve Henry Williams’s quality of care?How do you think Henry and Ertha Williams will be coping 1 month after the scenario? Concluding QuestionsReflecting on Henry Williams’s case, were there any actions you would do differently? If so, what were these actions, and why would you have done them differently?How would you apply the knowledge and skills that you obtained in Henry Williams’s case to an actual patient care situation?

What are some of the qualitative factors that must be considered when selecting a company in which to invest?

In 3-6 pages, complete a ratio analysis using a provided balance sheet and income statement, specify how you would analyze a potential investment, and describe how you would forecast a company’s potential success.IntroductionAn investment analysis has two fundamental components: 1) A financial analysis, such as reviewing current financial ratios within the company, and 2) a non-financial analysis, which is reviewing a company’s strategic vision, employee satisfaction, et cetera. The first two parts of your assessment provide an opportunity for you to demonstrate both of these types of analyses.The goal of forecasting the performance of a company is to estimate the financial performance of a company over a selected period of years. When forecasting a company’s performance, similar to an investment analysis, you look at both financial and non-financial factors. This is the focus of the last part of your assessment.InstructionsPart 1: Ratio Analysis (1–2 pages)Using the XYZ Balance Sheet and Income Statement [DOC] and the table provided below, complete the following for XYZ Inc.:Calculate the indicated ratios for XYZ.Construct the DuPont equation for both XYZ and the industry.Use your analysis to outline XYZ’s strengths and weaknesses.Say XYZ had doubled its sales as well as its inventories and common equity during 2013. Do you think this would this affect the validity of your ratio analysis? No calculations are necessary.RatioXYZ Inc.Industry AverageCurrent 2.0xQuick 1.3xDays sales outstanding 35 daysInventory turnover 6.7xTotal assets turnover 3.0xProfit margin 1.2%ROA 3.6%ROE 9.0%Part 2: Investment Analysis (1–2 pages)For this part of the assessment, imagine that you are looking into investing in a manufacturing company, such as a car company or a steel company. Your goal is to create a plan for determining the potential strength of an investment in the company (investment analysis) and determining how the company might perform over a selected period of years (forecast).After considering a potential investment in this manufacturing company, address the following:What are some of the qualitative factors that must be considered when selecting a company in which to invest?What financial ratios would you examine, and why?What non-financial factors would you examine, and why?Use research from at least two references to support your ideas.Part 3: Forecast (1–2 pages)Using the same hypothetical manufacturing company described above, address the following questions related to forecasting the performance of the company:How would you forecast revenue, profitability, and asset management, such as inventory control and accounts receivable, for a hypothetical manufacturing company?What ratios would you analyze?What techniques would you use? Why?What non-financial factors would be important in your analysis?Use research from at least two references to support your ideas.Additional RequirementsLength: Your document should include 3–6 typed, double-spaced pages to cover all of the parts of the assessment. In addition, include a title page and references page.Written communication: Written communication should be free of errors that detract from the overall message.Style and Formatting: Apply APA style and formatting to cite your references.Resources: You must use at least four references, at least two references supporting Part 2 and two references supporting Part 3.Font and font size: Times New Roman, 12 point.Competencies MeasuredBy successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:Competency 2: Evaluate the financial health of the firmConstruct a ratio analysis for a company.Describe how to forecast revenue, profitability, and asset management.Evaluate techniques for forecasting financial statements.Choose ratios to include in the forecasting analysis.Choose non-financial factors to include in the forecasting analysis.Competency 5: Apply evaluation principles of various financial instruments.Articulate qualitative factors to consider when selecting an investment.Determine financial ratios to consider when selecting an investment.Determine non-financial factors to consider when selecting an investment.

Outline a 2- to-3-page security policy in which your team Defines application security policies

Your organization’s chief information security officer (CISO) wants to improve the application security controls throughout the company since it must protect the confidential and personally identifiable information of its customers.Outline a 2- to-3-page security policy in which your team:Defines application security policiesDefines user login and password policiesDefines secure coding policies and tests for internally created softwareIncludes 2 other standards or guidelines of your team’s choiceCite any references Format according to APA guidelines.

Outline a changing set of facts and circumstances which would make this an offense of capital murder, voluntary manslaughter, involuntary manslaughter, and negligent homicide.

Susie leaves school and, while driving home, hits and kills her criminal law professor. Outline a changing set of facts and circumstances which would make this an offense of capital murder, voluntary manslaughter, involuntary manslaughter, and negligent homicide.

Describe how you would address a company needing to decide about in-person or hybrid work over the next 6 months (i.e., should they stay remote, move to in-person, or go with a hybrid approach?

Describe how you would address a company needing to decide about in-person or hybrid work over the next 6 months (i.e., should they stay remote, move to in-person, or go with a hybrid approach?

What would you do to transform the culture in one of these organizations?

Assume you are in charge of one of the major professional sports organization (i.e., National Football League, Major League Baseball, National Basketball Association, FIFA, US Gymnastics). The issues of domestic violence & sexual assault have existed for some time but meaningful change has not yet occurred (e.g., NFL has taken some actions but baseball is far behind in addressing the issue; US Gymnastics recently settled some cases but there are questions about whether they’ve done enough). What would you do to transform the culture in one of these organizations? In answering this, you should consider 2 different stakeholders, how you would address them, & what risks/consequences would result from your changes. NOTE: if you choose FIFA, you can discuss the issue of corruption that has plagued that group over the years (e.g., awarding the World Cup to Qatar).

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