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In need of urgent and exact answers to all question!

In need of urgent and exact answers to all question!

https://www.Nurs.com/drug-biotechnology-pTugN

Healthcare workers who care for patients in their homes are among those at high risk in pandemics. Previous studies in the United States showed that the number of patients who were being cared for at home during a pandemic was nearly 3 times to the number being hospitalized. During the SARS epidemic in Hong Kong, the fall in hospitalizations for those with pre-existing chronic diseases was complemented with an increase for demand for community nursing services at patients' homes. Studies from the United Kingdom found that community HCWs expressed less willingness to work during a pandemic than their hospital counterparts. A similar study in the United States found that the intention to work with quarantine cases among community home health care services was lower (11%) than the willingness of healthcare workers who worked in the hospital (54%). Another study found that for HCWs working in New York City long-term facilities and outpatient centers, the most important barriers to willingness to work were fear and concern for family and self (31%). To the best of our knowledge, there is no other study exploring the willingness of, and factors associated with community nurses to work during the H1N1 pandemic. Thus, this study was conducted to explore the willingness of community nurses to continue to work during H1N1 influenza pandemic.

1)From molecular biology, _______ attaches to the _______ amino acid deposit for _______.

2) Vigor is a prerequisite for the Ubiquitin-proteasome dilapidation trail. Justify or falsify inference.

3)State whether the following is true or false/.

Children have a smaller thymus compared to adults.

4.Where do the lymphocytes mature in?

5. What substance secreted by the human brain is associated with skin coloration?

Identify the gland that secrets it.

6. What is associated with alterations in the concentration of oxygen, hydrogen ions

and glucose in the blood.

7. where does the sensation of touch, pressure and temperature happens in the?

8. State whether the statement below is true or false.

The spleen is situated in the lower right thoracic cavity, just above the diaphragm.

9. What does white pulp encompass majorly?

10. Provide an precise array for the length of the spleen."\

  From molecular biology, _______ attaches to the _______ amino acid deposit for _______.

• Answer: Ubiquitin attaches to the lysine amino acid residue for protein degradation.

  Vigor is a prerequisite for the Ubiquitin-proteasome dilapidation trail. Justify or falsify inference.

• Answer: Justify. Vigor is not a literal prerequisite but a metaphorical one. The ubiquitin-proteasome pathway is critical for protein degradation and requires cellular energy (ATP) to function efficiently. In this context, "vigor" could be interpreted as the necessary metabolic activity and energy for the process.

  State whether the following is true or false: Children have a smaller thymus compared to adults.

• Answer: False. Children have a larger thymus relative to body size compared to adults. The thymus is most active during childhood and gradually atrophies with age.

  Where do the lymphocytes mature?

• Answer: Lymphocytes mature in the thymus (T cells) and bone marrow (B cells).

  What substance secreted by the human brain is associated with skin coloration? Identify the gland that secretes it.

• Answer: Melatonin is the substance secreted by the pineal gland, which influences skin coloration indirectly by affecting circadian rhythms and overall health, though the primary role in pigmentation is not as significant.

  What is associated with alterations in the concentration of oxygen, hydrogen ions, and glucose in the blood?

• Answer: These alterations are associated with changes in respiratory rate and depth, as well as metabolic processes affecting blood pH and glucose levels.

  Where does the sensation of touch, pressure, and temperature happen?

• Answer: Sensation of touch, pressure, and temperature happens in the somatosensory cortex of the brain, which is located in the parietal lobe.

  State whether the statement below is true or false: The spleen is situated in the lower right thoracic cavity, just above the diaphragm.

• Answer: False. The spleen is located in the upper left abdominal cavity, not the right thoracic cavity.

  What does white pulp encompass majorly?

• Answer: White pulp in the spleen primarily encompasses lymphatic tissue and is involved in the immune response.

  Provide a precise array for the length of the spleen.

• Answer: The spleen typically measures approximately 12 to 14 cm in length in adults.

What is the difference between chronic stable angina pain and pain associated with myocardial infarction?

Chest pain of CSA vs pain due to Myocardial Infarction

 Chronic Stable Angina Pain:

 Onset: Is likely to happen systematically during the activities such as sports or exercises, whenever one is under stress or has other provoking causes.

 Duration: Usually of a few minutes’ duration, often settling with rest or nitroglycerin.

 Quality: Defined as chest discomfort that may be aching, tightness, or weight-like sensation. It may also be present in the neck, jaw, shoulder or the arm.

 Relief: The symptoms are improved either by resting or taking the nitroglycerin, meaning that pain results from temporary lack of blood supply.

 Pattern: Most commonly it appears in a given form, it manifests at a certain rate and has a certain level of intensity.

 Pain Associated with Myocardial Infarction (MI):Pain Associated with Myocardial Infarction (MI):

 Onset: Pleased might happen at any time when the person doesn’t have to be exerting himself or herself or stressed.

 Duration: Usually lasts more than angina, may last more than 20 minutes and is not relieved by rest or nitroglycerin.

 Quality: May be described as severe, crushing or burning in character. It may be associated with such symptoms as nausea, sweating, shortness of breath and, possibly, anxiety.

 Relief: This type of pain is not relieved by rest or nitroglycerin to suggest prolonged but severe ischemia.

 Pattern: The pain experience may be of higher degree, and is definitely not rhythmic, which in most cases signals a more critical condition.

Routes of Medications and their advantages and disadvantages. Give Examples for each routes

Routes of Medications: Opinion: Advantage and disadvantage

 Oral (PO)

 Examples: Cough, cold and fever drops, pills (e. g. Paracetamol, antibiotics such as Amoxicillin).

 Advantages:

 Convenience: It is relatively simple to perform given and the patients typically have a favourable response to the procedures.

 Cost-effective: As a rule, the drugs are cheaper to manufacture and dispense than the comparable biologics.

 Disadvantages:

 Variable Absorption: Absorption can be influenced by the presence of food or the pH of your stomach or by gastrointestinal disorders, for example.

 Delayed Onset: The effect of this route also takes a longer time to achieve therapeutic level as compared to other routes.

 Contraindicated in patients who are unable to protect their airways, for example, unconscious patients or patients with swallowing problems.

 Intravenous (IV)

 Examples: Tablets or capsules (e. g. , vancomycin), injections (e. g. , morphine), and fluids (e. g. , saline).

 Advantages:

 Immediate Effect: Offers patient accessibility and initial action as well as allowing the patient precise control over the dosing.

 Complete Absorption: Does not go through the GI tract as it achieves 100% bioavailability.

 Disadvantages:

 Invasive: Involves an injection or placement of a catheter which may be painful or may lead to an infection.

 Costly: More costly as compared to normal surgical procedures arising from equipment and monitoring necessities.

 Potential for complications: Infiltration or air embolism as well as thrombophlebitis formation in the area where the infusion is produced.

 Intramuscular (IM)

 Examples: Inhalants, Vaccines (for instance influenza vaccines), Hormonal therapies …(for instance depot medroxyprogesterone acetate).

 Advantages:

 Moderate Absorption: More rapid than the peroral route yet less so than the intravenous one.

 When used for medication that has low circulation in the body after oral administration.

 Disadvantages:

 Pain and Discomfort: Can sometimes bring about pain or discomfort whenever the injection is being administered.

 Requires skill: There are also side effects, which can affect a patient in a negative way the most important of them being that injection site must be chosen carefully to avoid nerve damage.

 Contraindicated for daily dosing or dosing more than twice a week.

 Subcutaneous (SC)

 Examples: Insulin, anticoagulants including low molecular weight ones, for instance, enoxaparin.

 Advantages:

 Ease of Administration: It is usually less invasive as compared to IV or IM therapy.

 Suitable for Self-Administration: Usually employed when giving drugs that you can take on your own. Mobile Clinic 27 November 2015 at 17:53 Modern hospitals employ many types of clinics and clinics can be categorized in weekly clinics which are fixed; specialized clinics which are frequently rotating and; short clinics such as short stay, day and emergency. Luca 27 November 2015 at 18:03 Some of the common clinic classifications in modern hospitals include: Weekly clinics :

 Disadvantages:

 Slow Absorption: Onset is slower than that reached by IM or IV injection.

 Limited Volume: It is limited to small volumes (normally up to 1-2 mL) only.

 Potential for irritation: Can result in either irritation or formation of lumps at the point of injection.

 Topical

 Examples: Topical agents ( e. g. , hydrocortisone), skin patches (e. g. , nicotine skin patches).

 Advantages:

 Localized Effect: In that it can be used in local treatment with fewer repercussions in the rest of the body.

 Ease of Application: It has been found to be easy to use by most if the individuals and it is also easy to apply.

 Disadvantages:

 Limited Penetration: Created for acute or superficial skin conditions but not for systemic disease or for inflammation affecting deeper structures.

 Variable Absorption: Absorption is skin dependent, that is, it depends on some skin conditions and the site of application.

 Inhalational

 Examples: It includes short acting beta-agonists (e. g. , albuterol), Inhaled corticosteroids (e. g. fluticasone).

 Advantages:

 Direct Effect: Used in the treatment of respiratory ailments and offers localized manifestations of its action.

 Reduced Systemic Side Effects: Reduces overall risk of side effects as it goes directly to the lungs.

 Disadvantages:

 Technique Sensitive: Is usually invasive, and depends on the correct approach and cooperation from the patient in question.

 Potential for Local Irritation: May in some cases lead to throat inflammation or cough.

 Sublingual (SL)

 Examples: Tablets of nitroglycerin for angina, some hormone therapies.

 Advantages:

 Rapid Absorption: The fact is that the substances are absorbed rapidly through the mucous membranes under the tongue.

 Bypasses Digestive System: Exercises first-pass effect therefore does not undergo first-pass metabolism by the liver.

 Disadvantages:

 Limited to Certain Medications: No suitable for application in all types of drugs.

 Patient Sensitivity: Is taken with the patient unable to take any food or water during the time the medication dissolves.

Case Studies:

Case Studies:

A. Subjective (Jill)

1) You're working on a community team that responds to calls from the Edmonton Police Service (EPS). EPS received a call from Jill's mom, Cindy, who is concerned as there was a verbal altercation between Cindy and Jill. Jill is a 20 year old female who is living in Cindy's home. EPS member Cst. Vallee is on scene and you attend to assist them. Cst. Vallee asks that you assess Jill, but first, you speak with Cindy. Cindy describes Jill as being erratic. One minute she is fine and the next minute she will be screaming at her family that she hates them. She has not been able to hold down a job for the past two years, she always finds something wrong with her employer and feels that everyone turns against her. The fight tonight was triggered by Cindy talking to Jill about finding her own place to live and Jill became upset, feeling that her mother doesn't love her anymore. She recently broke up with her boyfriend of one year. Cindy isn't sure exactly why their relationship ended, but they did have a lot of fights, but then they would get along for a short time where they would make plans to move in together or get married.

You meet with Jill. She is calm and reports that her mother was trying to kick her out of the house with nowhere to go which is why she ""lost it."" She states that her mother only wants her out because her boyfriend doesn't like her. Jill endorses that she does think of suicide often. She identifies her nephew and her sister as a protective factor. She has no plan to kill herself and has not attempted suicide in the past. She does admit to cutting and shows you her arms which have numerous healed scars and some fresh superficial cuts that do not require medical attention. Jill wants to go stay with her sister for the night and will follow up with her psychiatrist in the morning. She agrees to a call from you tomorrow to ensure that she follows up with this plan and offer other supports if needed.

Please answer:

a. What is Jill's diagnosis?

b. What might be the differential diagnosis, if there is one?

2.. Cindy is concerned that Jill may be psychotic. She has seen a psychiatrist that she was referred to through her family doctor who prescribed her 25mg of Seroquel at night. Cindy doesn't know what diagnosis the psychiatrist gave her as Jill wouldn't allow Cindy to come to the appointments. Cindy did some research on the internet and discovered that Seroquel is an anti-psychotic medication. Jill hasn't taken it for the last month and Cindy is concerned that this is why Jill is acting in such an erratic fashion. During your interaction with Jill there is no evidence of psychotic symptoms or thought disorder.

Please answer:

a. Why would the psychiatrist prescribe Seroquel for Jill?

b. How does this medication relate to Jill's diagnosis?

3. Cst. Vallee is concerned that based on what Cindy has said about the Seroquel that Jill may be psychotic and asks if you feel that Jill should be brought to the hospital under a form 10. Cindy feels that this is the best option.

Please answer:

a. What teaching do you provide to Cindy and Cst. Vallee?

b. What teaching would you give Jill about the medication?

B. Subjective: (Georgia)

1. Georgia is 13 and lives with her mum, Emma, her dad, Nick, and her younger brother Sam, aged 10. At a recent parents evening, Emma and Nick were concerned to hear that Georgia has been struggling with her schoolwork and has fallen significantly behind in some subjects. There have also been some difficulties in friendship groups and Georgia is often involved in arguments with friends. On a positive note, her teacher is pleased to report that she is doing exceptionally well at sport.

Emma and Nick have noticed that Georgia has become more and more disorganized over the past 18 months. She has lost many items of school equipment and is often late leaving the house for school and for social events, as it takes her so long to get ready. Georgia is often restless and finds it difficult to concentrate, even on things that she finds enjoyable; for example, it is unusual for her to be able to sit and watch a film through to its conclusion. Emma remembers that she was a lot like this when she was a child, and has not been particularly worried until now. Both she and Nick are concerned about the fact that Georgia is struggling academically but are more worried about the fact that she appears to be having problems making and keeping friends.

Please answer:

a. Describe what the possible differential diagnosis and please explain the rationale.

b. Identify some common interventions used for the chosen diagnosis.

c. What are some special considerations for use of medications in adolescents?

2. Georgia has been working hard at her behavioral management program and is currently on a drug holiday and things are starting to turn around for Georgia and she is having less difficult in relationships and in her ability to manage her school work. However, she has noticed that she has been having difficulty sleeping and she is worried that it will make it more difficult to navigate the previously identified challenges.

Please answer:

a. Discuss some of the nursing assessment questions you would use to identify issues related to Georgia's concerns.

b. What are some common medications used for troubles with sleeping?

c. What are some alternate, non-medication methods to manage poor sleep?

Please include references. Thank you."

Case Study: Jill

 1. Jill’s Diagnosis Self-View and Differential Diagnosis

 a. Diagnosis:

 Borderline Personality Disorder (BPD) may be the reason as to why Jill is presenting with these symptoms. Key features include:

 Emotional Instability: Emotive instability (fear one moment and be filled with love the next).

 Interpersonal Issues: Talking and arguing row often with her family and she switched boy friends very often.

 Self-Harm: Cutting behavior is present but not in a more significant way though it remains to be a sign that requires individuals experiencing it to be checked by their physicians.

 Impulsivity and Erratic Behavior: Employment instability and relationship instability.

 b. Differential Diagnosis:

 Bipolar Disorder: Also defined as episodes of depression with episodes of mania or hypomania, which is consistent with Jill’s symptoms. Nonetheless, bipolar disorder often comprises mood episodes that are necessarily different, whereas Jill’s symptoms are perennial and interactively twisted.

 Major Depressive Disorder (MDD) with Borderline Features: Could also explain the emotional distress and self-harm observed in BPD patients; however, does not account for the instability of relationships and the chronic pattern seen in BPD.

 2. Medication and Diagnosis

 a. Why Prescribed Seroquel:

 Seroquel is a second generation antipsychotic drug used in treatment of mood disorders, and may be used to prevent episodes of depressed mood. It is sometimes utilised off-label in cases of treating BPD due to impulsivity and elevated emotional response.

 b. Relation to Diagnosis:

 Seroquel may also contribute to the stabilization of mood and symptoms which are severe mood fluctuations or emotional impulsiveness. In contradiction to current lack of psychotic symptoms, the medication might have been prescribed to prevent severe mood or impulsivity related to BPD.

 3. Hospitalization and Teaching

 a. Teacher educating for Cindy and Cst. Vallee:

 Criteria for Hospitalization: Elaborate that the subject of Form 10 is made, usually, when there are impaired capacity and high risk of self or others’ harm. Therefore, Jill current management plan of staying with her sister and seeing her psychiatrist, together with no active suicide plan and more, may fail to meet the criterion.

 Support Options: In which you talk about resources available in the community, services in cases of mental health crisis, as well as the need for outpatient follow-up.

 Monitoring: Stress ongoing evaluation of the environment in which Jill functions as well as assessment of her mental condition.

 b. Teaching for Jill:

 Medication Purpose: Tell him that Seroquel is useful when it comes to mood and that is why it can help to stabilize ones emotions. For the management of symptoms and reduction of exacerbation, it is a vital aspect.

 Side Effects: Counsel about possible side effects and the need to adhere to the prescribed medication schedule.

 Case Study: Georgia

 1. Differential Diagnosis and Interventions

 a. Differential Diagnosis:

 Attention-Deficit/Hyperactivity Disorder (ADHD): It entails laxity, disarray and potentially wandering attention. That is why Georgia possesses the typical manifestations of ADHD: restlessness, excessive level of disorganization, and difficulties when it comes to concentration.

 Learning Disabilities: Could cause difficulties in school performance but wouldn’t generally explain the restlessness and disorderliness.

 Anxiety Disorders: Bar in impaired concentration and takeover social interactions though not often associated with such severity of restlessness as ADHD.

 b. Common Interventions for ADHD:b. Common Interventions for ADHD:

 Behavioral Therapy: I still find that it assists with any organizational skills and controlling impulses.

 Medication: Stimulants (for instance, methylphenidate, amphetamines) or non-stimulants (for instance, atomoxetine) may enhance attention and decrease hyperactive signs.

 Educational Support: Embraces all arrangements in school; it may be additional assistance in the completion of tasks or the ability to take a test in a quiet environment.

 c. Special Considerations for Medications in Adolescents:c. Special Considerations for Medications in Adolescents:

 Dosage Adjustments: The adolescent’s bodies also respond to drugs in a different manner and hence necessitate right dosages.

 Side Effects: Youth are more vulnerable to the side effects such as alteration in appetite, sleep disorders and aggressive behavior.

 Monitoring: Routine follow-ups in order to evaluate its effectiveness and adverse effects is very important .

 2. Addressing Sleep Concerns

 a. Nursing Assessment Questions:

 Sleep History: For how long now has she has been facing a problem of poor sleep quality? Said another way, is it ‘getting to sleep’, ‘staying asleep’, or ‘waking up too early’.

 Sleep Environment: What does she sleep in and where does she sleep? What do you make of this location with regard to it’s suitability to produce restful sleep ?

 Daily Routines: What does she do daily and how does she expend her time with reference to her sleeping pattern?

 Current Medications: has she on any medications that will disturb her sleep or that needs to be taken at night?

 b. Common Medications for Sleep:b. Common Medications for Sleep:

 Melatonin: A hormone of the body that is believed to assist in regulation of sleep in individuals.

 Non-Benzodiazepine Hypnotics: For short-term sleep disorders it is possible to take medicines such as zolpidem (Ambien) or eszopiclone (Lunesta).

 Antidepressants: Selective serotonin reuptake inhibitors such as fluoxetine or paroxetine, and others including trazodone can also be used for sleep disorders off label.

 c. Non-Medication Methods:

 Cognitive Behavioral Therapy for Insomnia (CBT-I): Supports to deal with the distorted attitude towards sleep and to cultivate favorable perceptions and behaviours.

 Sleep Hygiene Practices: The three approaches include: adherence to a sleep schedule, following a regular sleep-wake routine, and preparingSleep environment.

 Relaxation Techniques: Activities like listening to music, going for a walk, taking warm bath, having a cup of tea or coffee, doing gentle stretching exercises like yoga, practicing deep breathing, taking a nap, having a pet, doing something creative, reading, having a bad temper, shouting at someone, destruction of objects, screaming, hitting the wall, or pounding on a pillow.

 References:

 American Psychiatric Association. (2013). DSM-5- Diagnostic and Statistical Manual of Mental Disorders (5th edition). Arlington, VA: Published by American Psychiatric Publishing.

 Joint as the National Institute of Health and Clinical Excellence (NICE) shortened its name to the National Institute for Health and Care Excellence in October 2013. (2018). Attention deficit hyperactivity disorder: diagnosis and management was unique and the intervention SPECFIX was more effective than a “regular” cardiac rehab program. Retrieved from NICE.

 Terman, Malcolm & Terman Judith (2001). Chronobiology: Biology Clock and Its Discos. Cambridge University Press

Noninvasive Positive Pressure Ventilation (NIPPV) is bilevel ventilation that provides inspiratory and expiratory support.

Noninvasive Positive Pressure Ventilation (NIPPV) is bilevel ventilation that provides inspiratory and expiratory support. Using the low to high approach to initiate NIPPV, what are the initial settings that should be ordered?

A.  IPAP 10, EPAP 5, FIO2 100%

B.  Respiratory Rate 12, Vt 500, PEEP 5, FIO2 100%

C.  IPAP 25, EPAP 5, FIO2 100%

D.  Respiratory Rate 20, PEEP 5, FIO2 100%"

Bilevel NIPPV entails the identification of starting values that need to be set in order to regulate the IPAP and EPAP though which support the patients inhaled and exhaled volumes. The settings are typically prescribed at the base and are titrable depending upon the response of the patient and the clinical scenario.

 For the low-to-high approach, the initial settings should generally be:The initial settings for low-to-high approach should be generally as following:

 PERIPHERAL: C. IPAP 25, EPAP 5, FIO2 100%

 Explanation:

 IPAP (Inspiratory Positive Airway Pressure): This is set higher in order to deliver adequate inspiratory assistance. A starting level of the pressure support of 25 cm H₂O is hence quite standard in patients who need quite a lot of help with inspiring.

 EPAP (Expiratory Positive Airway Pressure): This is set lower initially for the use of enough pressure to give support for expiration and to retain alveoli recruitment, it is set at 5 cm of H₂O.

 FIO2 (Fraction of Inspired Oxygen): It may first be given at FIO2 of 100 % and finally be reduced, needed for the most important or serious hypoxic conditions.

What is an appropriate priority nursing diagnosis and expected outcomes with rationale for bells palsy

What is an appropriate priority nursing diagnosis and expected outcomes with rationale for bells palsy

Sources of MN Ng as priority nursing diagnosis and expected outcomes; for Bell’s palsy

 Nursing Diagnosis:

 This problem may be termed as Impaired Facial Tissue Perfusion which results from Bell’s Palsy affecting the facial nerve.

 Rationale:

 Bell’s Palsy is an acute onset of unilateral facial nerve palsy, which leads to muscle weakness and alteration of facial feelings and sensation; it also compromises blood supply to tissue of the face. The condition can cause problems like weakness or paralysis of the face, facial asymmetry or imbalance, and potentially increased risk for bruising or injury on the side of the face because of loss of reflex ‘guarding’ mechanism.

 Expected Outcomes:

 Patient will express increased strength and control and the cranial face muscles as the patient will be able to perform various face muscle contractions (for instance raising or lowering eyebrows, closing eyes tightly, smiling) in the next 4-6 weeks.

 Rationale: The prognosis for Bell’s Palsy is usually favourable; particular healing takes a period between several weeks and several months. Recovery henceforth is measured by improvement in the strength and function of the facial muscles. By taking 4-6 weeks to complete the timeframe of the activities corresponds to the expected period of recovery after the disease.

 Patient will be able to recount measures to prevent contact of the side of the face within a week.

 Rationale: The patient may not be properly aware of dangers of facial protection so it is important for proper education in order to avoid corneal abrasion or other facial trauma as this patient might have decreased sensation and motor abilities on the left side of the face.

 Patient will exhibit adequate intake of nutrition and proper hydration with no problems associated with facial weakness in 2weeks duration.

 Rationale: Muscle weakness around the face muscles especially those around the mouth, facilitates chewing and swallowing. The eight right related to the plan of care involves assessing and monitoring of the patient’s ability to meet nutritional needs.

 Patient will state that he has less anxiety and stress from the condition and would demonstrate through expressive words and participation in support activities in 2 weeks.

 Rationale: It can be disconcerting to the mental health of the individual and is referred to as Bell’s Palsy. Which psychological aspects should be addressed and what kind of an assistance should be given to enhance overall recovery and quality of life?

 Nursing Interventions:

 Monitor Facial Function: This should be done frequently to measure the patient’s physical evolution and to contrast it with the symptoms for worsening.

 Facial Protection: Explain to the patient that they should avoid rubbing or exposing the affected eye to any kind of dryness or injury. Carol do eye patches or artificial tears as maybe necessary.

 Pain Management: Offer anesthetic which may be acupuncture or making a warm compress as the case may be.

 Nutrition Support: Help in other ways pertaining to diet in order to make meal taking easy and comfortable for the patient. For those that have problems with chewing, foods that are soft or in a liquid consistency should be taken.

 Emotional Support: Comfort the patient and provide a psychology session where they should be recommended to attend support groups.

Membrane proteins that export antibiotics from the cell and maintain their low-intracellular concentrations are called efflux pumps.

Membrane proteins that export antibiotics from the cell and maintain their low-intracellular concentrations are called efflux pumps.[4] At the same speed, where these antimicrobials are entering the cell, efflux mechanisms are pumping them out again, before they reach their target.[9] These pumps are present in the cytoplasmic membrane, unlike porins which are present in OM. Antibiotics of all classes except polymyxin are susceptible to the activation of efflux systems.[13] Efflux pumps can be specific to antibiotics. Most of them are multidrug transporters that are capable to pump a wide range of unrelated antibiotics - macrolides, tetracyclines, and FQ - and thus significantly contribute to multidrug resistant organisms.

1. Demonstrate the value of  F1 = 4.5 to 9 to replicate the value of Froude number

2.link the ratio of 2:1 to 5:1 to the slopes of the glacis

3. The length of the jump is how times the height of the jump? Explain

4.why is the Sloping Glacis considered les and the s to the dissipation of surface energy

5.categorise the Froude number groups the jumps

6.describe the assumption that render the derivation of momentum formula realistic

7.falsify; For the value of Froude number 9 the jump is said to be strong jump.

8.propose the range interval of the jump and the  limits of Froude number,

9.what information justifies the change in depth of the direct jump

10.explain on the Undular Jump to the parameter of its small depth and its name"

1. Explain how F1 which stands for Force one can be of great value. 5 to 9 to replicate the value of Froude number:5 to 9 to replicate the value of Froude number:

 Froude number (Fr) is a type of non-dimensionalized rate at which formation happens, making use of inertial and gravity forces. It is defined as:

 Fr

 =

 𝑉

 𝑔

 𝐿

 Fr=

 gL

 ​

 V

 ​

 where:

 𝑉

 V = flow velocity,

 𝑔

 g = acceleration due to gravity;

 𝐿

 L = characteristic length.

 In order to set achieve the Froude number of 4 for replication. If one needs a flow velocity (V) between 5 and 9, gravity (g) and characteristic length (L) are also tuned to the chosen range of the flow velocity. For instance to attain a Froude number of 4. 5:

 4. 5

 =

 𝑉

 𝑔

 𝐿

 4. 5=

 gL

 ​

 V

 ​

 If gravity

 𝑔

 g is

 9. 81

 m/s

 2

 9. 81m/s

 2

 and characteristic length

 𝐿

 L is

 1

 m

 1m, then:

 𝑉

 =

 4. 5

 ×

 9. 81

 ×

 1

 ≈

 14

 m/s

 V=4. 5×

 9. 81×1

 ​

 ≈14m/s

 To achieve further the Froude numbers 4 in the middle range, the following specifications of the model were made: 5 to 9, adjust

 𝑉

 V from about 14m/s up to 27m/s.

 2. Link the ratio of 2:1 to 5:1 to the slopes of the glacis:Link the ratio of 2:1 to 5:1 to the slopes of the glacis:

 The ratio of 2:1 and 5:1 typically refers to the slope of glacis in hydraulic engineering:The ratio of 2:1 and 5:1 typically refers to the slope of glacis in hydraulic engineering:

 2:1 Slope: Slope that measures more steeply, that is, for each 2 units on the horizontal axis, 1 unit vertically.

 5:1 Slope: Fair slope, generally for every five thousand horizontally, a variation of one thousand vertically is made.

 The above ratios determine either the stability of the jump or the type of hydraulic jump which forms at the downstream region. A steeper number such as a 2H/1V slope will cause such as flow to change rapidly through space and has more energy loss as compared to a gentler slope such as the 5H/1V.

 3. How many of the height of the jump are contained in the length of the jump? Explain:

 The ratio of the length of the hydraulic jump to its height can be approximated depending on the Froude number:The ratio of the length of the hydraulic jump to its height can be approximated depending on the Froude number:

 In a weak jump, distance at which the athletes jump covers a height of 2-4 times the height made by the jump.

 For a superb jump, the length can be as much as, or one to 2 occasions the height.

 The length to height ratio depends with the Froude’s number and flow conditions with higher Froude’s number causing shorter yet more potent jumps.

 4. Why does Christison regard the Sloping Glacis to be inferior in the dispersion of surface energy?

 The sloping glacis (or sloping weir) is considered less effective in dissipating surface energy compared to a vertical drop or a steep slope because:The sloping glacis (or sloping weir) is considered less effective in dissipating surface energy compared to a vertical drop or a steep slope because:

 Reduced Energy Dissipation: The gradual slope to a channel also goes down with a less steep slope to result in reduced energy release instantaneously.

 Gradual Transition: Where the slope is involved, the transition from supercritical to subcritical flow makes it possible to dissipate energy over a longer range, and not at a specific locality.

 5. Categorize the Froude number groups of the jumps:Categorize the Froude number groups of the jumps:

 Subcritical Flow (Fr < 1): Lack of jumps in movement, the movement is more or less continuous; It is streaming like water and has more regard to gravity than momentum or velocity.

 Critical Flow (Fr = 1): Flow is on the limit between sub- and super critical flows where gravity and inertial forces are in a very special relation.

 Supercritical Flow (Fr > 1): Velocity is also high and erosive; hydraulic jumps are formed when flow regime is changed for subcritical one.

 6. Describe the assumptions that render the derivation of the momentum formula realistic:Describe the assumptions that render the derivation of the momentum formula realistic:

 To derive the momentum formula for hydraulic jumps, the following assumptions are made:To derive the momentum formula for hydraulic jumps, the following assumptions are made:

 Steady Flow: Flow conditions are independent of the flow time or any time for that matter.

 Incompressible Flow: In the same case, the fluid density is also fixed.

 Uniform Flow: Flow properties exhibited by the cross-section are uniform.

 Negligible Viscosity: Concerning the influences of fluids’ viscosity, they are not very significant.

 These assumption allow for simplification of the calculations in a way that makes derivation of the momentum equations possible.

 7. Falsify: In the case of Froude number that equals 9 a strong jump is reported.

 In real flow conditions, a Froude number of 9 means just not a strong jump, but very strong jump. This Froude number is very high and this precipitates a large difference between supercritical and subcritical flow and therefore leading to a steeper and sharper hydraulic jump. Thus, the statement is true.

 8. Propose the range interval of the jump and the limits of the Froude number:Propose the range interval of the jump and the limits of the Froude number:

 Weak Jump: Froude number of the order of 1. 5 to 2. 5.

 Moderate Jump: Froude number all around 2. 5 to 4.

 Strong Jump: The froude number above 4.

 These intervals aid in the classification of the kind and magnitude of hydraulic jumps.

 9. That knowledge supports the alteration of depth of the direct jump?

 The change in depth of the direct jump is justified by:The change in depth of the direct jump is justified by:

 Flow Velocity: The values of flow velocities in super critical flow are high and hence, a greater reduction in depth during the jump.

 Energy Dissipation: Hydraulic jump is a phenomenon that is used in managing excess flow energy in super critical flow regime and where there is always an increase in depth as the energy is converted to turbulence and heat.

 Froude Number: The depth change can be computed ratio initial Froude number to the final Froude number following the shift from supercritical to subcritical flow regime.

 10. Explain the Undular Jump in terms of its small depth and its name:Explain the Undular Jump in terms of its small depth and its name:

 An undular jump is different from the hydraulic jump in that instead of a jump of water there is a series of waves or ridges and troughs. The key features include:

 Small Depth Change: The alteration of depth in an undular jump is considerably less as compared to the rest of the varieties of jumps.

 Wave Formation: The jump seems as series of waves that surfs upstream from the position of the jump.

 The term ‘undular’ may be derived from the Latin word ‘undula’ which means ‘little wave’ referring to the wave like flow pattern. One of these sorts of jumps usually takes place at a lower Froude number and entails lesser energy expenditure than in other jumps.

 References:

 Chow, V. T. (1959). Open-Channel Hydraulics. McGraw-Hill.

 Hager, W. H. (1992). Hydraulic Models. Birkhäuser

Altered cell wall precursors:

Altered cell wall precursors: Cell wall synthesis in Gram-positive bacteria can be inhibited by glycopeptides, e.g., vancomycin or teicoplanin, by their binding to D-alanyl-D-alanine residues of peptidoglycan precursors. D-alanyl-alanine is changed to D-alanyl-lactate as a result of which glycopeptides do not cross link with them, hence resistance to them develops.[4,5] E. faecium and Enterococcus faecalis strains have high resistance to vancomycin and teicoplanin (Van A-type resistance). Van B and Van C type resistance show resistance to vancomycin but is sensitive to teicoplanin

1.relate the inhibiting factors to the cell shrinking away during Plasmolysis

2.describe your fine understanding of the turgor pressure as initiated by the outward pressure

3.explain the relevance of the Tonicity subject to the osmotic pressure gradient of solutions separated by a semipermeable membrane

4. Name the term which is given for the movement of water through a semipermeable membrane?

5.elaborate on Nonpolar molecule as illustrated by the property of water

6. Cohesion of water molecules is due to?explain

7.what is your core understanding of Ascent of sap in regard to the movement of water against gravitational force

8.Which pathway is used to transport water from the epidermis to a tracheary element of root?

9.interconnect the Permanent wilting to the wilt beyond recovery

10.what are the contribution of the  field capacity to the Water holding capacity of soil"

1. Relate the inhibiting factors to the cell shrinking away during Plasmolysis:Relate the inhibiting factors to the cell shrinking away during Plasmolysis:

 Plasmolysis is the process through which a cell shrinks as a result of losing its water content to the environment, usually as a result of the cell being placed in a hypertonic solutions which has higher concentration of solutes than the interior of the cell. This makes the cell membrane to pull away from the cell wall since water is moving out of the burger. In Gram-positive bacteria, the action of glycopeptides like vancomycin is to inhibit cell wall synthesis, and that would change the cell wall precursors, for example D-alanyl-D-alanine residues are replaced with D-alanyl-lactate thereby weakening the cell wall and may be more vulnerable to plasmolysis if exposed to hypertonic solutions.

 2. Describe your understanding of turgor pressure as initiated by the outward pressure:Describe your understanding of turgor pressure as initiated by the outward pressure:

 Turgor pressure is the hydrostatic pressure which the cell sap exerts on the cell wall of a plant cell. This is derived from the passive transport of water into the cell, a process that generates outward pressure and forces the protoplasm against the cell-wall. They exert this pressure for maintaining the rigidity and structural support of the cells. In a hypotonic solution the external concentration of solute ions will be lower and this will cause the movement of water into the cell thus raising turgor pressure. In hypertonic solutions, on the other hand, water movement is out of the cell, thus lowering turgor pressure.

 3. Explain the relevance of Tonicity subject to the osmotic pressure gradient of solutions separated by a semipermeable membrane:Explain the relevance of Tonicity subject to the osmotic pressure gradient of solutions separated by a semipermeable membrane:

 Tonicity is all about relative solute concentration of solutions that are separated by membranes which are usually selectively permeable to water. It determines the direction of water flow based on osmotic pressure gradients:It determines the direction of water flow based on osmotic pressure gradients:

 Isotonic Solution: There are the same amount of solute concentration on each side of the membrane and no flow of water takes place.

 Hypertonic Solution: In this solution, solute concentration is high than in the cell, therefore water shifts out of the cell thus giving a shrunken cell.

 Hypotonic Solution: The external solution has lower solute concentration, and this means that water will flow in the cell to form a condition such as cell swelling or even rupture.

 4. Name the term given for the movement of water through a semipermeable membrane:Name the term given for the movement of water through a semipermeable membrane:

 The term used is osmotic diffusion or in short osmosis. Osmosis on the other hand is the movement of water across a semipermeable membrane from a region of low solute concentration to the region of high solute concentration.

 5. Elaborate on Nonpolar molecules as illustrated by the property of water:Elaborate on Nonpolar molecules as illustrated by the property of water:

 Nonpolar molecules do not have globally fixed charges and so there is no dipole-dipole interactions. But, water has a polar covalent bond where oxygen was slightly negatively charged and hydrogen atoms are slightly positively charged. Oils and fats, for example, are nonpolar substances and cannot mix with water, with which water molecules are comfortable only with polar or ionized particles. This leads to the accomplishment of the process of separation of various nonpolar compounds from respective aqueous solutions.

 6. What causes water molecules to cohesives? Explain:

 In the case of water, the principle of cohesion is explained by the use of hydrogen bonding. Within a crystal if you had a water molecule it can engage in hydrogen bonding up to and inclusive of four other water molecules. This is so because the valence shell of oxygen, being partially negative attracts the partially positive hydrogen atoms of nearest water molecules. These chemical bonds lead to great cohesion between water molecules which leads to high surface tension and capability to from droplets.

 7. What is your core understanding of the Ascent of Sap in regard to the movement of water against gravitational force:What is your core understanding of the Ascent of Sap in regard to the movement of water against gravitational force:

 Ascent of sap – process of transportation of water and soluble nutrients from roots towards the aerial parts of the plant. This process occurs against gravity through a combination of:This process occurs against gravity through a combination of:

 Root Pressure: resulting from osmotic pressure of water soluble nutrients in the soil.

 Transpiration Pull: Water is transported through the vascular bundle called xylem in the plants through the process which the water evaporates through the microscopic small mouth like openings on the surface of the leaves known as stomata.

 Capillary Action: The molecules of water cohere collectively and they also adhere to the walls and sides of xylem that enables the water to move more upwards.

 8. In which of the following pathway is water transported from the epidermis to the tracheary element of the root?

 The apoplast pathway is also employed in the movement of water from the epidermis towards the tracheary elements (xylem vessels) of the root. In this pathway the water does not enter the cytoplasm phase of the cell but it goes through the cell walls and the tissues spaces.

 9. Interconnect Permanent wilting to the wilt beyond recovery:Interconnect Permanent wilting to the wilt beyond recovery:

 Permanent wilting is the mark of a plant that has suffered chronic water deficit; it cannot replenish the lost water from other sources or from the reserve soil water that is below a survival level. At these periods of time, water deficiency greatly exceeds water absorption by the plant and the plant dries up severely. However, if the soil moisture content reduces to below the PWP, the physical and biochemical processes of the plant are damaged and cannot be restored even when water is a plenty.

 10. That raises the question of the role of field capacity in the holding capacity of soil in regard to water.

 Field capacity describes the extent of water which is held in the soil when it is in a state where further drainage of water is not possible at least within the first 24-48 hours after it has been soaked. In terms of water the capacity shows the maximum amount of water in the soil that could be retained against the force of gravity. Field capacity is crucial because:Field capacity is crucial because:

 Water Availability: It expresses the quantity of water that is in a form that it can easily be absorbed by plants.

 Soil Moisture Management: They help in monitoring of irrigation practices and knowledge of how much water soils can hold.

 Plant Health: Facilitates that plants receive enough water for their growth minimizing on Water logging or drought stress.

 References:

 Taiz, Taiz L. , Zeiger E. , Introduction to the cell, In: introductory plant physiology. Plant Physiology. Sinauer Associates.

 W. J. Davies and J. Zhang, [year unknown] The investigation of close relationships between England and China As can be. Root Growth and Water Uptake Selected through IAA and IBA Introduction IAA and IBA are two important hormones which aid in the plant growth and development process, more particularly in root growth and water uptake process. Journal of Experimental Botany.

 Alberts B. , et al. Molecular Biology of the Cell Fourth edition, 2002. Published by with the title of Molecular Biology of the Cell. Garland Science.

Discussing your progress in achieving presence and praxis in nursing?

Discussing your progress in achieving presence and praxis in nursing?

Presence and praxis in nursing is therefore the bridging of the gap between theory and practice in order to cultivate a more comprehensive approach of patient care. Here’s a structured discussion on progress in achieving these aspects:Here’s a structured discussion on progress in achieving these aspects:

 Presence in Nursing

 Such relates to being fully attentive to patients, and being able to show empathy and develop therapeutic relationships. Achieving presence involves:

 Active Listening: As J and R proposed, this comes to the extent of concentrating solely on the signals offered by the patient, both verbally and in a more figurative sense. It can be used in sensing their concern’s to generate trust.

 Progress: Being specific, active listening can be improved through more frequent exercising during interactions with patients as well as paying attention to the feedback received from other people, including peers and supervisors.

 Empathy: Inclusion of the patient’s perception of the situation and no criticism of their emotions. As one of the vital therapeutic communication skills, it contributes to the formation of positive relationship with the clients.

 Progress: Self-practice of being reflective and asking for feed-back in empathetic responses can help in enhancing them.

 Mindfulness: Possessing the ability to focus on the patient and the current situation without any form of interruption.

 Progress: Mindfulness practices can be inserted in to practice schedules in form of deep breathing or even short have been practices.

 Praxis in Nursing

 Praxis may refer to the use of nursing theories that are used in actual situations such as in decision making, use of the nursing skills and linking of facts when solving real-life problems. Achieving praxis involves:

 Applying Theoretical Knowledge: Adapting elements of nursing theories in the patient care, for example, patient involvement approach and other best practices.

 Progress: Reflecting on both theoretical content and practice on a frequent basis as well as finding the ways to become involved into evidence based practice can improve this integration.

 Clinical Skills: Explanation of effective clinical techniques and application of them according to the patient’s requirements.

 Progress: The skill development is done through practicing fail and non successful attempts, by technical rehearsal through simulations, workshops, and even clinical practices.

 Critical Thinking: Journaling & documenting: criteria/ practice: Analyze the situation by distinguishing between the What, Who, Where, When, Why, and How of the circumstance; Assess by making the proper decision based on the analysis of the situation; and Reflect by learning…

  1. Illinois State Board of Education – College and Career Readiness

  2. Warcraft – Destructive Products of the Technological Advancement

  3. Management

 Progress: One can enhance critical thinking through case works, discussions with mentors, and analysis of clinical scenarios.

 Continuous Learning: Updating themselves with the current findings, practices, and possible developments in nursing.

 Progress: Continuing education courses, recent journals, and professional development activities are some of the ways of continuing learning.

 The Approaches that may be adopted for the purpose of taking Presence and Praxis to another level.

 Self-Reflection: Some of the patients’ interactions and the aspects of clinical decisions can be reviewed and will be useful to identify the aspects that require enhancement and, on the other hand, the aspects that should be emphasized due to their efficiency.

 Feedback: It can be useful to expostulate with peers and supervisors as well as to ask patients about their experience concerning the presence and praxis.

 Mentorship: This could mean engaging with senior nurses so as to be informed and receive direction as to the methods to achieving both presence and praxis.

 Practice: Participation in simulation, role play, and other clinical activities serves the purpose of skill development and in the practical application of such knowledge.

 Balance: Since work and personal life should not interfere, the mental and emotional status of a person should always be in check so as to create an effective presence and praxis.

 Conclusion

 Presence and praxis in nursing mean that one has to engage in a long process of enhancement of his/her self, reflection, and theoretical and practical realization. The elements such as active listening, empathy, mindfulness, using the knowledge from the nursing theories one can improve the quality of care. Even here, there is self-checking, feedback and learning that are continuous as part of this process.

What are some of the obstacles or barriers to implementing EBP in nursing?

What are some of the obstacles or barriers to implementing EBP in nursing? Provide a rationale for your answer. Since there are numerous topics on the issue, it is not appropriate to repeat one that has already been mentioned unless providing new information."

1. limited access to research evidence.

 Rationale: Nurses may not be able to afford journals or even databases which they use in updating their knowledge base. This reduces the possibility of practicing in accordance with the latest evidence.

 Example: If a hospital does not take a subscription to some basic medical databases, then a nurse will be lacking some of the newer studies that can help in practicing.

 2. Lack of Time

 Rationale: Most nurses are working under tight schedules carrying heavy work loads, whereby there is little time to devote in re-visit of literature and incorporation of identified research findings.

 Example: In clinical practice environments, a nurse might fail to undertake the time-consuming activity of scrutinising and assimilating research findings into practice due to the flurry of obligations for his/her patients.

 3. Insufficient Training in EBP

 Rationale: Because of this, nurses may be deprived of adequate formal education or training in EBP methodologies which will make it hard to make sense of the research literature.

 Example: Without research knowledge a nurse is very likely to find it difficult in the appreciation of study quality, or synthesis of the findings to practice.

 4. Resistance to Change

 Rationale: Certain practitioners of HCPs may not be willing to adopt newer models or principles of practice or even guidelines which have been produced from current research.

 Example: A unit may stick to the previous concepts because of their past practices or due to questioning of new findings.

 5. Inadequate Support from Leadership

 Rationale: Leadership support or resource providing and encouragement is usually expected to contribute to the success of EBP implementation. Again the process may be hampered in the absence of support.

 Example: A lack of support for EBP from the hospital’s administration or a lack of resources for EBP will lead to inefficiency of the effort made by the nurses to take change the practices.

 6. Limited Collaboration and Communication

 Rationale: EBP is a process that involves a number of members of the health care fraternity. For example, if there are misunderstandings between employees on what exactly needs to be done or if there is little or no cooperation to achieve intended objectives, it will hinder the change.

 Example: However, when there is no proper coordination between the nurses and the physicians implementing EBG to the patient care may be difficult.

 7. Cultural and Organizational Barriers

 Rationale: This is due to barriers of organizational culture and practice which may go against the recommended guidelines or embrace them slowly due to a number of reasons.

 Example: Credence-belief culture: An organisation that relies heavily on its staff’s experience will have a challenge in embracing EBP.

 8. Financial Constraints

 Rationale: Applying evidence to practice changes may involve a cost implication of training, additional personnel or technology acquisition which is often a limitation.

 Example: Implementing the new technologies or buying effective tools may be expensive hence challenging.

 9. Complexity of Evidence

 Rationale: Most of the time the findings of a research may be complicated, and one may need to have some understanding of research so as to be in a position to apprehend it appropriately.

 Example: Such translation of results of statistical analyses to more doable interventional approaches that can be implemented by the nursing profession may be tasking especially if the researchers lack other supports or resources.

 10. Lack of Standardized Guidelines

 Rationale: Some of the challenges of accessing EBP include: The standards for implementing EBP may not be properly developed or are not well outlined; because of this, nurses may find it hard to put EBP into practice in various health-care facilities.

 Example: The guidelines of different institutions are usually not set at the same level; this causes disparity in the way that evidence-based interventions are practiced.

 References:

 Melnyk, B. M. , & Fineout-Overholt, E. The Role of Evidence-Based Practice in Comprising the Next Generation of Quality and Safety Leaders Journal of Orthopaedic Nursing , 22(1) , 3–5. Evidence-Based Practice in Nursing & Healthcare: The establishment of the benchmark for effective practices is therefore documented as A Guide to Best Practices. Wolters Kluwer.

 In their paper, Melynk, B. M & Fineout-Overholt, E (2011) Evidence-Based Practice in Nursing & Healthcare: , popularly referred to as OCR (Optical Character Recognition): A Guide to Best Practices. Lippincott Williams & Wilkins.