Complete a 7 page, single spaced paper on Cardiovascular disease health disparities within the United States. Include section headings and subheadings (when appropriate) within the paper. Cite all referenced articles using APA 6TH edition format. NO PLAGARISM! The paper should be written in your own words, DO NOT SIMPLY COPY AND PASTE information from online.
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SBI241 Assessment 2: A 49-year-old male farmer presents to the emergency department with intractable nausea and vomiting, dyspnoea on exertion, and dizziness. The nausea began about two weeks prior to admission. There is no history of medication or toxin exposure. He has lost some weight recently and his current body weight is 52 kg. His past medical history is positive for hypertension diagnosed 4 years ago with no follow-up. He has smoked 1 packet per day for 20 years. The attending nurse in the emergency department reports his blood pressure to be 160/120 mmHg, temperature 36.7°C, pulse 93/min. His skin is pale with numerous areas of spontaneous bruising. Chest x-ray shows increased pulmonary vascular markings and hazy obliteration of the lower lung bases. Abdominal ultrasound examination shows a right kidney size of 7 cm and a left kidney size of 6.8 cm (normal kidney size approx. 10 cm). Laboratory evaluation reveals: Urinalysis Protein 1+ Blood 1+ Glucose Neg Casts Neg Bacteria Blood report Reference range WBC 10.7 x 109/L 4.5-11 x 109/L Platelets 245 x 109/L 150-400 x 109/L Haematocrit 0.31 0.40-0.54 (adult male) Creatinine 540 umol/L 60-110 umol/L (adult male) Urea 35.2 mmol/L 3.0-8.0 mmol/L (adult) Calcium 1.75 mmol/L 2.10-2.60 mmol/L Uric Acid 0.68 mmol/L 0.20-0.45 mmol/L (male) He’s admitted to the nephrology ward for further evaluation and management of his condition. Please answer the following TWO questions: QI. What is the pathophysiological basis of hypertension in a patient with chronic kidney disease? (350-400 words) Q2. Based on the clinical picture and laboratory investigations provided, what stage of chronic kidney disease this patient is in and what will be the main management approach at this stage? (100-150 words) Support your answers with appropriate evidence (references). This assignment tests your ability to search scientific literature and present your answer in a scientific language. CDU library has heaps of resources to support you. Please make full use of these helpful resources: Tips on academic/scientific writing: General Guidelines on how to write your assignment .. The word limit for this assignment is 450 to 550 words, this does not include references. Please stick to word limit, failing to do so will result in losing marks. :• Only word and pdf formats are acceptable. Do not copy the case study questions in your file, just write QI, Q2 and provide your answer. . This assignment must be submitted via Safe Assign/Turitin on Learnline. No other form of submission is acceptable including email, hand delivery or post. . It is advised to have a foot note on your assessment containing your name, student number and unit code. No COVER PAGE REQUIRED. Please note there is NO DRAFT SUBMISSION for this assignment. Once you upload your file and click submit, it will be submitted for grading. All the information about the assignment is available on Learnline; please take time to locate the necessary documents prior to sending an email to me enquiring about the assignment details.
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Health Promotion: Prevention of Disease Case Study Module 12 Instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA format. Deadline: Due by Sunday at 23:59 p.m.
CASE STUDY: Caregiver Role Strain: Ms. Sandra A.
Sandra, a 47-year-old divorced woman, received a diagnosis of stage 3 ovarian cancer 4 years ago, for which she had a total hysterectomy, bilateral salpingo- oophorectomy, omentectomy, lymphadenectomy, and tumor debulking followed by chemotherapy, consisting of cisplatin (Platinol), paclitaxel (Taxol), and doxorubicin (Adriamycin). She did well for 2 years and then moved back to her hometown near her family and underwent three more rounds of second- line chemotherapy. She accepted a less stressful job, bought a house, renewed old friendships, and became more involved with her two sisters and their families. Sandra developed several complications, including metastasis to the lungs. Then she could no longer work, drive, or care for herself. She had been told by her oncologist that there was nothing else that could be done and that she should consider entering a hospice. She met her attorney and prepared an advance directive and completed her will. She decided to have hospice care at home and, with the help of her family, set up her first floor as a living and sleeping area. She was cared for by family members around the clock for approximately 3 days. Sandra observed that she was tiring everyone out so much that they could not really enjoy each other’s company. At this time, she contacted the Visiting Nurse Association (VNA) to seek assistance. Her plan was to try to enjoy her family and friend’s visits. After assessment, the VNA nurse prioritized her problems to include fatigue and caregiver role strain. Other potential problem areas that may need to be incorporated into the care plan include anticipatory grieving and impaired comfort. Reflective Questions
1. What are some of the stresses on Sandra’s middle-aged sisters and their families? 2. What resources are available to manage these stresses and support the sisters while
caring for their dying sister Sandra? 3. Describe Sandra’s feelings about dependency and loss of autonomy because she is
unable to do her own activities of daily living any longer
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Assignment details: Construct an epidemiological triad for an infectious disease. Define its common agent, reservoir, portal of exit, means of transmission, portal of entry, and host (the chain of infection). How long is its incubation period? Does it have a common source of outbreak? Does the CDC have active surveillance on this infectious disease? Does herd immunity apply? Is it pandemic? Do this over influenza
Common agent: influenza has common antiviral agents
Reservoir: The common reservoir of influenza virus A are the wild birds mostly shorebirds, ducks, and geese.
Portal of exit: influenza infectious agent uses a similar portal to get into and out of the host. It mostly uses the respiratory tract of the host and gets into the respiratory tract of the new host. It exits the respiratory tract by means of coughing and sneezing
Means of transmission: the influenza virus mode of transmission are the hands, surfaces, and droplets where they use it to gains entry.
Portal of entry: it refers to the way the pathogen gets admission into a susceptible host, for instance, the pathogen exits the respiratory tract of its source and gets into the respiratory tract of the new host.
Host (the chain of infection): during the circulation of the pathogen in humans, the virus usually gets accumulated into points of mutation in HA and NA which gives provision of it to escape the host immunity.
Incubation period: the incubation period of flu is generally between one and for days though it usually varies from one individual to the other. Therefore, the average incubation period for influenza is for two days.
Common sources of the outbreak: influenza virus usually have a common source epidemic where the period of exposure is relative, not long and in many instances occur within one incubation period.
CDC active surveillance: the influenza virus infections cannot be identified as a CDC agent as it is not nationally notifiable though it is reported in some countries. The local health institutions are required to follow strict guidelines on reporting its outbreaks.
Application of herd immunity: herd immunity applies to influenza as its notion is that when many people get the influenza vaccine, it assists in protecting the entire population. This is due to the reason that there are fewer infected people to transmit this contagious infection.
Is it epidemic: an influenza pandemic can be referred to as an epidemic of an influenza virus which generally spreads globally on a broader scale. The virus,…………………………………………………………………………………………………………………………………………………………………………………………………………………………………,………………………………………………………………………………………………………………………………………………………………………………………………………………………………… epidemiological triad for an infectious disease
Research paper: Choose a disease process with extensive public health implications (e.g. heart failure, dementia, kidney disease). Research its impact upon both the national and international community, using such resources as the World Health Organization. Review the goals of Healthy People 2020 regarding this disease process. What inequities exist? Give examples of policies that shape the public nursing response to the disease process. Apply one of the theories of health maintenance and promotion to the aggregate. How does systems theory influence policy design?
Studies have showed that cardiovascular disease is the leading cause of mortality in developed countries. Heart failure is one of the chronic diseases that disrupt everyday life of the patient, their families and the wider community. The patients and their families spend enormous resources to attempt to seek out the most effective strategies, support and information to manage the disease and minimize interruptions(Mainar, et al., 2015). The prevalence of heart failure in developed countries especially the United States, Australian and United Kingdom is high. Some of the common symptoms associated with heart failure include fatigue, peripheral oedema and breathlessness, which causes multiple interaction with daily life. Depending with the severity of the attack, the patient may develop multiple chronic co-morbidities which may require complex treatment regime.
World Health Organization has made the education of a patient to monitor their own health and being able to recognize illness severity as well as self-management of multiple chronic diseases as the current health care policy. Research have showed that symptom unpredictability leaves the patients to feel helpless and completely dependent on those around them, hence leading to lack of control on the illness and increasing the burden on the health care system and on the family(Fry, et al., 2016). In most circumstance, the responsibility for care shifts from the patient to the caregivers, spouses or immediate family. Under these conditions, the patient typically adopt to the ‘sick role’ thus depending on their families to provide support with their illness as well as in the previous responsibilities. During this time, a patient with greater levels of family support tend to build strong…..………………………………………………………………………………………………
Construct an epidemiologic triad for a noninfectious disease process. Give examples of primary, secondary, and tertiary preventions for the chosen disease process. List risk factors, prevalence rates, and mortality rates. Define if your prevalence rates are period prevalence or point prevalence. Summarize the current state of the disease process in the U.S.
Make sure you read about Epidemiologic triad for a noninfectious disease process
This is a triangle which consist of an external agent, a host and an environment. The host and agent are brought together, thus causing the illness to occur in the host. In this paper, epidemiologic triad for non-infectious disease was constructed(Harkness & DeMarco, 2016). Cardiovascular disease was chosen and epidemiologic triad was constructed using smoking as one of the main causes of the heart diseases(Heath, et al., 2008). When an individual smoke, he/she inhales carcinogen which is found in cigarette and it causes the disease. The vectors are those individuals who manufacture, sell and distribute the cigarettes. They bring the disease-causing agents to the susceptible host as shown in the figure below.
The epidemiologic triad above contain some potential interventions that may help minimize the prevalence of cardiovascular disease in the population(The Pennsylvania State University, 2018). For example, clean indoor air legislation, advertising potential harm from smoking as well as establishing workplace smoking cessation program leads to the change of the environment and reduces the exposure of host to agent. Contrary to these interventions, increasing the number of vendors, increasing advertisement and increasing the manufacturing of cigarette would increase exposure of host to agent.
Three types of prevention mechanism
There are three types of prevention mechanism that prevent and reduces the impacts of cardiovascular disease: primary, secondary and tertiary prevention.Primary prevention: These are step taken by………………………………………………………………………………………………
Chapter 24 Drugs Used in Treating Infectious Disease
Nick is a 16 year old who presents to the clinic with a sore throat, enlarged cervical lymph nodes, and a fever of 102°F. His rapid strep test is positive.
Treatment Plan for Nick, 16-Year Old with Sore Throat
Name of Student
University Affiliation
Treatment Plan for Nick, 16-Year Old with Sore Throat
Acute pharyngitis is one of the leading causes of hospital visits in the United States. According to Luo et al. (2019) the most common cause of acute pharyngitis is Streptococcus pyogenes, estimated to cause about 5-10% of sore throat infections in adults and 20-30% of sore throat infections among the children. The authors assert that though the infection can heal on their own, over 60% of the cases are treated with antibiotics so as to prevent some complications. Sore throat is diagnosed through rapid antigen detection test (RADT).
The diagnosis for Nick turned out positive for sore throat, which should be treated with antibiotic. The available antibiotics for treatment for sore throat are penicillin and amoxillin. The dosage are Penicillin 500 mg PO bid × 10 days or Amoxicillin 1,000 mg PO daily × 10 days. The prescription should be discussed with the patient in order to determine if there are any reactions towards the specific type of antibiotic. The medication is readily available and is not expensive, making it affordable for the patient. Sore throat can be uncomfortable and a lack of effective treatment may lead to other complications such acute rheumatic fever, post-streptococcal glomerulonephritis, and rheumatic heart disease (Luo et al., 2019). The parent of Nick should be advised on these dangers of sore throat and recommended to follow the dosage directions to ensure effective treatment. In addition, Nick will be contagious within the first 24 hours upon antibiotic treatment. Any symptoms of rush and hypersensitivity upon the start of antibiotic…………………………………………………………………………………………………
As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.
Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.
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When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.
To Prepare
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history in your case study.
By Day 3 of Week 1
Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples Pharmacology is the study of the interactions between drugs and the body. The two broad divisions of pharmacokinetics refers to the movement of drugs through the body, whereas pharmacodynamics refers to the body’s biological response to drugs. Pharmacokinetics describes the drug’s exposure by characterizing absorption, distribution, bioavailability, metabolism, and excretion as a function of time, while pharmacodynamics describes drug response in terms of biochemical or molecular interactions (Arcangelo et al., 2017). The focus of this discussion will be in the process of warfarin in term of pharmacokinetics and pharmacodynamics of it in the body. Ms. J.J. ‘s Health issue: I was in charge of Ms. J. care couple years ago, a 85 year old African American women who was diagnosed with dementia cerebral infarction due to unspecified occlusion of cerebral artery, arthropathy, major depressive disorder, atrial fibrillation with a history of long-term use of anticoagulants, contracture of muscle, constipation, hypertension and GERD. She is currently on coumadin for the atrial fibrillation and the blood levels are monitoring every week in order to control the drugs therapeutic levels and avoid any adverse reactions. Pharmacodynamics versus pharmacokinetics of this anticoagulant: Many statistics from the stroke prevention in atrial fibrillation (SPAF) trial suggest that safety of anticoagulant in the elderly can be maximized through a careful monitoring and maintenance of the INR which is between 2 and 3. Ms. J’s therapeutic window for warfarin 2 to 3 which is the normal range for coumadin therapeutic level. Her weekly dosage is adjusted to her current blood levels. Bleeding is the most related complication of anticoagulant. Amy INR that increasing to 3.4 or 4.0 from Ms. J will result in nose bleeding, decreasing the coumadin or stop it for one or two days will be the only option (Horton & Bushwick, 1999). Factors influencing Ms. J’s drugs therapy: Multiple factors may affect the absorption of her medication. For example, the presence or the absence of flood in the stomach, blood flow to the area for absorption, and the dosage form of the drug. In Ms. J’s case, the most critical factor. Influencing her absorption of coumadin is gastric motility due to the history of constipation that she has, while a routine laxative dose and stools softens are administered daily for bowel movement. Patient-centered care plan for management of constipation: A non-pharmacologic care plan management can be introduced for the constipation in order to reduce the frequency and the quantity of laxative and stool. Softens doses that Ms. J is getting and ultimately gain a net decrease in gastrointestinal absorption of coumadin. Increasing a dietary fiber in her menu, encourage fluid and prune juice can have a significant impact on her bowel movement (Portalatin & Winstead, 2012). Portalatin, M., Winstead, N. (2012). Medical Management of Constipation. Clinic in Colon and Rectal Surgery. Doi: 10.1055/s-0032-1301754. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348737/ Horton, J. D., Bushwick, B. M. (1999). Warfarin Therapy: Evolving Strategies in Anticoagulation American Family Physician. 59(3):635-646. Retrieved from https://www.aafp.org/afp/1999/0201/p635.html Arcangelo, V. P., Peterson, A. M., Wilburg, V., Reinhold, J. A. (2017). Pharmacotherapeutics for Advanced Practice: A Practical Approach. (4th Ed.). Wolters Kluwer Lippincott Williams
