What are the effects of controlling BP in people with diabetes?

Case Presentation:L.N. is a 49-year-old white woman with a history of type 2 diabetes, obesity, hypertension, and migraine headaches. The patient was diagnosed with type 2 diabetes 9 years ago when she presented with mild polyuria and polydipsia. L.N. is 5’4″ and has always been on the large side, with her weight fluctuating between 165 and 185 lb. Initial treatment for her diabetes consisted of an oral sulfonylurea with the rapid addition of metformin. Her diabetes has been under fair control with a most recent hemoglobin A1c of 7.4%.Hypertension was diagnosed 5 years ago when blood pressure (BP) measured in the office was noted to be consistently elevated in the range of 160/90 mmHg on three occasions. L.N. was initially treated with Lisinopril, starting at 10 mg daily and increasing to 20 mg daily, yet her BP control has fluctuated. One year ago, microalbuminuria was detected on an annual urine screen, with 1,943 mg/dl of micro-albumin identified on a spot urine sample. L.N. comes into the office today for her usual follow-up visit for diabetes and HTN.Subjective data reveals that she is experiencing increased exertional SOB. She expresses concern because when this happens it takes her awhile to get her breath back to normal. Denies any pain or dizziness with these episodes.Physical examination reveals an obese woman with a BP of 154/86 mmHg and a pulse of 78 bpm. Otherwise exam is unremarkable.CC: “I am more short of breath when walking up stairs than I used to be”.

Questions NEED TO BE ABOUT 3-4 SENTENCES BUT THOROUGH ANSWERS

1. What are the effects of controlling BP in people with diabetes?

2. What is the target BP for patients with diabetes and hypertension?

3. Which antihypertensive agents are recommended for patients with diabetes?

4 What testing does this woman need ordered due to her change in status both SHORTNESS OF BREATH and BLOOD PRESSURE? (USE CASE STUDY ABOVE FOR THIS QUESTION)

5. What is the significance of microalbuminuria in this woman? How does this affect her cardiovascular risk?

Write this case study up as a clinical note including all elements of plan of care regarding issues presented in the case.

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>Nursing homework help

The discussion assignment provides a forum for discussing relevant topics for this week on the basis of the course competencies covered. For this assignment, make sure you post your initial response to theDiscussion Area by the due date assigned and complete your participation for this assignment by Day 7. To support your work, use your course and text readings and also use resources from the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the South University Online Library. 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
TASK
Post your initial response to one of the two topics below.
Topic 1: Health Promotion

  • Using one of the health issues identified for your community, discuss health promotion areas at two of the three levels primary, secondary, or tertiary promotion.

Topic 2: Poverty and Community

  • What is the poverty level in your community?
  • How many people live below the poverty level in your community?
  • What does this mean for your community (what issues arise from the poverty level and the number of people below the poverty level)?
  • Justify your answers with resources.
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Jacob is an 87-year-old with bipolar I disorder. He came to the United States from Poland in 1937. He was institutionalized for 2 years in a large mental health facility; currently, he lives in a community mental health center (transitional housing).

Transcultural Perspectives in Mental Health Nursing

Read chapter 10 of the class textbook attached. 

Once done, develop and post an analysis of the following cases;

Case 1 :

1. Stephane, a 15-year-old Haitian refugee who is living at a center for children of refugees has a severe cough and fever. She is curled up in a corner of the community room wrapped in a towel. She looks like she has been crying.

How can the nurse ensure culturally competent care?

List three priorities for the nurse regarding the cultural values, beliefs, and possible practices that Stephane may have.

Case 2:

2. Jacob is an 87-year-old with bipolar I disorder. He came to the United States from Poland in 1937. He was institutionalized for 2 years in a large mental health facility; currently, he lives in a community mental health center (transitional housing).

a. Identify three questions that would be important to ask Jacob on your first encounter.

b. What is the main health issue for Jacob?

What structures are needed in a community to ensure that Jacob will get the care he needs?

APA format word document, Arial 12 

For grading and in Turnitin to verify originality. 

A minimum of 3 evidence-based references besides the class textbook must be used. 

Textbook title

Transcultural Concepts in Nursing Care

Author

Joyceen   S. Boyle; Margaret M. Andrews

A minimum of 700 words is required. Please make sure to follow the instructions as given.

Due Friday July 5th midnight.

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Security Assessment and Testing

The paper instructions are hereby attached.

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Looking Ahead—Subscribing to a Newsletter

Question Description

To prepare:

  • Access the Fierce Healthcare website.
  • Enter your e-mail address into the “sign up for our newsletter” section of the website. You will receive a confirmation e-mail shortly after signing up. Copy and paste this confirmation into a Word document. If you are having trouble copying the e-mail in its entirety, you may also utilize the “print screen” button on your keyboard and then paste the copy of your screen into your Word document. Save this confirmation document, as you will submit this with your final paper.
  • Over the next weeks, make time to regularly browse the newsletters that you receive, selecting two informatics articles that are of particular interest to you. Each of the articles that you select must come from a different newsletter.

To complete:

Submit a 2- to 3-page paper that addresses the following:

  • Summarize the key points of each article you have selected. In your summary, include how the informatics topic, trend, initiative, etc. is impacting nursing practice and/or health care settings. In addition, explain how nursing practices, the needs of patient populations, and society in general are influencing the informatics topics being discussed.
  • Explain how (or if) you found the Fierce Healthcare newsletters to be beneficial to your studies and/or your professional growth as a scholar practitioner. In your explanation, include whether or not you intend to continue your subscription and whether or not you are considering signing up for any other digital communications from professional organizations. Explain your rationale.
  • Provide a copy of your confirmation e-mail at the end of your paper. (Note that this does not contribute towards your page count.)

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.

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Quality Improvement Milestones

Throughout history, major events have influenced quality improvement efforts in health care. For example, the Institute of Medicine’s report To Err is Human: Building a Safer Health System revealed statistics about errors in patient safety that result in thousands of deaths annually. Health care providers must be cognizant of the purpose and philosophy of quality improvement efforts as they lead the charge for improving health outcomes and patient safety. This Discussion is intended to help you understand how various developments have shaped contemporary perspectives and approaches to promoting health care quality.

By tomorrow 11/28/17, write a minimum of 550 words essay in APA format with 3 references from the list below which addresses the level one headings as numbered below:

Post a cohesive scholarly response that addresses the following:

When “To Err is Human” was published in 1999, it marked an important milestone in Quality Improvement Science.

1) Analyze how this milestone has influenced the health care delivery system and nursing practice.

2) Provide an example from your own work history and experience as to how the patient safety movement has affected your practice. 

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

  • Chapter      1: “Healthcare Quality and the Patient”
  • Chapter      2: “Basic Concepts of Healthcare Quality”

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press. 

Executive summary: Released in 1999, this groundbreaking report provides the rationale for implementing comprehensive improvements in patient safety, an important subset of health care quality. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Institute of Medicine, Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. 

Executive summary: This report was published by the Institute of Medicine in 2001 to highlight the significant gap between the state of health care quality and where it should be. The report draws attention to the need to improve the U.S. health care delivery system as a whole, and identifies six areas for improvement: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Wachter, R. M. (2010). Patient safety at ten: Unmistakable progress, troubling gaps. Health Affairs, 29(1), 165–173.

This article presents an analysis of progress in patient safety since the publication of the IOM report, To Err is Human. As you read this article, evaluate the author’s critique, and consider recent developments that continue to shape patient safety efforts in health care.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Concepts of quality and patient safety. Baltimore: Author. 

This video examines the recent history of the quality improvement movement, including two pivotal IOM reports, To Err is Human and Crossing the Quality Chasm. Dr. Donald Berwick introduces six dimensions of quality: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Other topics addressed include transparency, the prevention of adverse events, and the usefulness of international comparisons for quality assessment and improvement.

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compare and contrast the health status of the minority group you have selected to the national average.

Analyze the health status of a specific minority group. Select a minority group that is represented in the United States (examples include: American Indian/Alaskan Native, Asian American, Black or African American, Hispanic or Latino, Native Hawaiian, or Pacific Islander.)

In an essay of 750-1,000 words, compare and contrast the health status of the minority group you have selected to the national average. Consider the cultural, socioeconomic, and sociopolitical barriers to health. How do race, ethnicity, socioeconomic status, and education influence health for the minority group you have selected? Address the following in your essay:

What is the current health status of this minority group? How is health promotion defined by the group? What health disparities exist for this group? Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice. Cite a minimum of three references in the paper.

You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:

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

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center. 

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Applied Sciences homework help

 For your signature assignment, you will develop an original extension of previous research. Part of the paper you will write is the methods section. One sub-section of your methods is the dependent variable, or the behavior you will be measuring and how you will measure it. For this assignment, you will describe your dependent variable and measurement system in detail. Be sure to covering at least the following points:  For each dependent measure State the name of your dependent variable(s). Operationally define your dependent variable(s). Describe how you will collect data on your dependent variable(s). Include any calculations needed. Describe how you will establish the reliability of your dependent measure(s). Include reliability formula. Another sub-section of your methods is the independent variable, or the procedures which will be implemented. For this assignment, you will describe how your independent variable is implemented and how baseline (or control) procedures are implemented. Be sure to covering at least the following points: For the procedures section: Explain any aspects that will consistent across baseline and independent variable sessions (length of sessions, where you will be in relation to the participant, etc.). You may include the type of design being used in this paragraph. Explain the procedures for baseline in detail. State the name of your independent variable(s). Explain the procedures for your independent variable in detail – not including data collection procedures (those were in your DV assignment). Describe how you will establish the reliability of your independent variable implementation (treatment integrity). Include calculation to obtain percentage
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Analyze the health status of a specific minority group. Select a minority group that is represented in the United States (examples include American Indian/Alaskan Native, Asian American, Black or African American, Hispanic or Latino, Native Hawaiian, or Pacific Islander).  In an essay of 750-1,000 words, compare and contrast the health status of the minority group you have selected to the national average. Consider the cultural, socioeconomic, and sociopolitical barriers to health. How do race, ethnicity, socioeconomic status, and education influence health for the minority group you have selected? Address the following in your essay: 1.What is the current health status of this minority group? 2.How is health promotion defined by this group? 3.What health disparities exist for this group? 4.Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.  Cite a minimum of three references in the paper.  You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links: 1.Minority Health: http://www.cdc.gov/minorityhealth/index.html 2.Racial and Ethnic Approaches to Community Health (REACH): http://www.cdc.gov/chronicdisease/resources/publications/aag/reach.htm 3.Racial and Ethnic Minority Populations: http://www.samhsa.gov/specific-populations/racial-ethnic-minority  Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.  This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.  You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

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>Financial markets homework help

Answer the Two study cases.

  1. Company Euronappy sells disposable diapers in Europe. It would like to expand into the Middle East. After some preliminary market research, four countries were put on the short list: Bahrain, Kuwait, Saudi Arabia, and the United Arab Emirates (UAE). Given its limited resources, the company can only enter two of these countries. Your assignment is to come up with a market size estimate for each one of them so that Euronappy can decide which one to enter. You decide to run a regression using data from Euronappy’s European market. Three variables are presumed to predict the sales of disposable diapers: population size, per capita GDP, and the birth rate. Data were collected on all three variables for the 19 European countries where Euronappy operates. However, the birth rate did not seem to be a factor. The estimated regression model is:

Y = –630.6 + 0.015 X1 + 47.15 X2
Y = annual sales of diapers in millions of units
X1 = population in thousands
X2 = per capita Gross Domestic Product (GDP–Purchasing Power Parity Basis) in thousands US$

  1. Collect data on the population and per capita GDP for the four countries on the list (Bahrain, Kuwait, Saudi Arabia, and the UAE).
  2. Now use the estimated regression model to predict the yearly sales of disposable diapers for these four countries. Which of these two would you choose?
  • attachment

    Casesch16.pdf
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