Discuss two major challenges the nursing field faces today.
Discuss two major challenges the nursing field faces today. Elaborate on why you feel those specific challenges affect patient care in 2 pages.
Nursing is one of the most reputed professions in the health care delivery system due to the fact that it entails delivering patient care, health education and disease avoidance. However, the following areas of concern are seen by the nurses which hinders the provision of quality care. Among these challenges, two major issues stand out: For instance, there are issues to do with nurse staffing and burnout and mental health issues. These two challenges have a lot of impact on the care of the patients and the health care systems in general.
1. Nurse Staffing Shortages
Overview:
Deficiency of the required number of nurses in the healthcare organizations is an issue of concern across the globe. Some of the causes of this shortage are; retirement of the nurses, increased health care needs, and low turnover rate of the nurses. According to the American Nurses Association (ANA), the demand for nurses will rise in the future due to the growing incidences of ageing and patients with chronic diseases. The U. S. Bureau of Labor Statistics has predicted that the employment of registered nurses is expected to rise at a rate of 7 percent within the years 2019-2029 which is faster than the average rate of employment for all the occupations. However, the number of well trained nurses has not been increasing in the same ratio as the demand for these professionals.
Impact on Patient Care:
Staffing shortages directly affect patient care in several ways:The following is a discussion of how staffing shortages impact on patient care:
Increased Workload and Reduced Time for Each Patient: There is a stiff competition for patients in the society today and nurses are required to attend to many of them. This leads to the reduction in the amount of time that is spent on each patient, and this can lead to the quality of services being reduced, and the number of cases of mistakes being increased. For instance, the evidence shows that, more nurses per patient result in reduced mortality and adverse events.
Decreased Patient Satisfaction: As the population of patients rises, it may be difficult for the nurse to spend a lot of time to handle the patients and other matters which may affect the patient satisfaction. A research carried out in Health Affairs showed that lacking workforce is associated with low patient satisfaction and increased patients’ perceptions of unmet needs.
Compromised Patient Safety: Lack of workforce has been linked with high incidence of incidents for instance medication complications, patient fall, and hospital acquired infections. For instance, in the Journal of Nursing Administration, a research indicated that in facilities where there was one patient per nurse the rate of mortality within a month of admission was boosted by 7%.
Strategies for Addressing Staffing Shortages:Measures for Coping with Deficiency of Staff:
To mitigate the impact of staffing shortages, healthcare organizations can implement several strategies:Some of the measures that can be employed in order to reduce the effects of staffing deficits in healthcare organizations are:
Investing in Recruitment and Retention: Recommendations that may have been used in the past to improve the recruitment and retention of new and current nurses include increasing on the remunerations, promotion on the professional experience, and creation of a conducive working environment to reduce the effect of the nursing shortage.
Utilizing Technology: The use of new technologies such as the EHRs and telehealth can assist in making work easier and reduce the amount of paper work that the nurses have to do thus more time will be spent on the patients.
Optimizing Staffing Models: The patient load can be controlled in the following way as to alter the staffing pattern so as to include registered nurses, licensed practical nurses and nursing assistants.
2. Burnout and Mental Health
Overview:
Nursing burnout has been described to be increasing in the recent past and this has been of concern. It can be described as the state of affairs where one feels burned out, indifferent and unfulfilled at one’s workplace. The causes of burnout include; stress, long hours of work, emotions, and lack of support. A survey spear by American Nurses Foundation in 2021 showed that 30% of the nurses exhibited burnout and COVID-19 has only exacerbated such experiences.
Impact on Patient Care:
Burnout has several negative effects on patient care:The following are the various drawbacks of burnout in patient care:
Reduced Quality of Care: It can lead to the loss of focus, and poor judgment in decision making and thereby expose one to burn out. Burning out is a condition that hampers the attention and the memory of the nurses; this is quite risky for the quality of services delivered. A paper in The Lancet reveals that the levels of nurse burnout are associated with increased levels of medication and patient safety errors.
Increased Absenteeism and Turnover: Burnout raises the levels of absenteeism and turnover in nurses, which aggravates the deficiency of personnel and affects the continuity of care. According to the American Nurses Association conducted a poll whereby revealed that about one in every three nurses is planning to leave the current job in the next one year due to stress.
Negative Effects on Patient-Nurse Relationships: Nursing profession is not an exception and burnout is one of the most frequent outcomes which affect the emotions of the staff and therefore the interactions between the patients and the nurses. This can be rather disadvantageous when it comes to the patient satisfaction and the patient experience.
Strategies for Addressing Burnout:
To address burnout and support nurse mental health, healthcare organizations can:Preventing and handling burnout and supporting the mental health of nurses can be done by the following:
Implement Support Programs: Listing counseling services and support groups also can help the nurses to relieve stress and therefore prevent burnout.
Foster a Positive Work Environment: Thus, to avoid the occurrence of burnout, the work environment of the nurses should be enhanced to the best of its capacity. Some are; availability of communication channels for some training and development, and the provision of adequate time for work and personal life.
Enhance Work Conditions: This also prevent burnout since there is less paperwork, more staffs, and enough time is given for rest and support.
Conclusion
Among the most significant problems that affect the nursing practice in the current society include the shortage of nurses and burnout. These two problems therefore directly impact on patient care and, as such, solutions need to be sought in order to address these two problems. The healthcare organizations can improve the performance of the nurse, and hence the patient by improving the recruitment and retention of the nurse, improving the staffing model and the mental health of the nurse. To achieve this there is need to know how these challenges can be best managed so as to enhance the quality and safety of care given.
Only attempt when you are 100% sure and for any incorrect answer i will rate unhelpful
Given the rapid, evolving nature of this pandemic, there is a need for information about COVID-19, specifically how populations from low and middle income countries (LMICs) are preparing and dealing with it. The objective of this study is to conduct a mix of formative research activities from families, healthcare workers, and healthcare administrators across India to understand COVID-19 perspectives to inform message and content creation. Among families, the study aims at understanding the current COVID-19 knowledge, attitude, prevention behaviors, health seeking behaviors, attitude, and sources of information among the general population. This will help to design customised messages as per population needs. For healthcare workers and hospital administrators, understanding of their current preparation for COVID-19 and treatment and the current challenges will help policy makers and other researchers in India and other LMICS to help plan their response to this pandemic
1. As per the case study above why did the USA government jailed Mc Jonathan.
2. Is it true to conclude that Mc Jonathan was entitiled to the apartment being discussed in the case study provided together with the link below.
https://pubmed.ncbi.nlm.nih.gov/7548209ksbgs687be45fg77
3. . Determine whether the inference below is true or false.
Fixing of minute fragments to enzymes results in response reticence.
4. Basically, _______ constriction is an instance of _______ regulation, where a restriction fragment _______ to a spot on an enzyme that is discrete from the _______ spot. What does the fixing of such inhibiting fragments modify?
5. . Determine whether the deduction below is valid or invalid concerning
6. Falsify the following.
The constriction polypeptides attach to the enzymes with covalent connections.
7. Identify and describe polypeptides whose events are regulated by covalent alterations.
8. To which side series do polypeptide kinases relocate phosphate units? Describe the entire mechanism.
9. The entire family of phosphatases are class specific in form as it is for kinases. Justify or falsify.
10. Falsify the following concerning amino acids, must be sourced from gene regulation.
Nitrosylation of arginine deposit.
11. Determine the count of subgroups present in cAMP-dependent protein kinase.Describe broadly cAMP-dependent protein kinase.
12.How many phases are involved in controlling enzyme activity? Describe the entire mechanism."
1. From the case study above, what do you think led to the incarnation of Mc Jonathan by the USA government?
There is no specific person referred to as Mc Jonathan in this particular case study and there is no information that will make one to understand why this person would be jailed by the US government. It is impossible to give the right answer to this question as it is depends on the particularities of the given case. The link that have been provided in the query does not seem to be working or is misplaced somewhere.
2. Was Mc Jonathan entitled to the apartment under consideration in the case study here and the link below?
Once again, given the fact that the content of the link posted by Mc Jonathan is unknown it is not possible to determine if he was entitled to an apartment or not. The link you have shared is apparently a link to a PubMed article and it may not be actually about the housing entitlements. To find out whether that article has any relation to the case in the given instance – Mc Jonathan, it has to be read through.
3. Determine whether the inference below is true or false: This is because when fragments are attached to enzymes, the response is not as high as when they are free.
True. The binding or affiliation of small molecules which may include inhibitors or regulatory molecules to enzymes can lead to a decrease in the activity or what may be referred to as ‘response dampening’.
4. In essence, _______ constriction is a form of _______ control in which an indicates molecule binds to a site on an enzyme that is distinct from the definite site. What does the fixing of such inhibiting fragments change?
Answer: Allosteric constrictions is a subcategory of allosteric regulation whereby a fragment of DNA will bind to an enzyme at site which is not the active site of the particular enzyme in question.
Explanation: Allosteric regulation is form of regulation that involves binding of molecules to enzyme in a site different from the enzyme’s active site and which is referred to as allosteric site. This binding can lead to changes in the orientation of active site of the enzyme which may either increase or decrease the activity of the enzyme.
5. Determine whether the deduction below is valid or invalid concerning:Establish the validity or otherwise of the following deduction concerning:
Therefore, without specific deduction provided one cannot be in a position to determine whether it is valid or invalid. May I have a deduction of the evaluation?
6. Falsify the following: The constriction polypeptides are linked to the enzyme with the help of covalent bond.
False. Constriction or inhibition polypeptides (these are often allosteric inhibitors) typically bind to enzymes in a non-covalent way; this may be through hydrogen bonding, electrostatic interactions or van der Waals’ forces. Phosphorylation and other covalent modifications are frequently employed in the control or alteration of enzymes, but not in the basic inhibition.
7. Enumerate and describe some of the polypeptides that have events regulated by covalent modifications.
Answer: Some of the polypeptides which are regulated by covalent modifications are include:
Protein Kinases: These enzymes are controlled by the action of phosphate groups in a process known as phosphorylation in which phosphate groups are added to the enzyme. It is a covalent modification of the kinase and can either enhance or reduce the enzymatic activity of the kinase.
Phosphatases: These enzymes have the function of dephosphorylation, they remove phosphate groups from proteins and as it is known phosphorylation and dephosphorylation is one of the most essential mechanisms for regulation of proteins activity.
Explanation: Post-translational modifications consist of covalent modifications such as phosphorylation and acetylation, which alter the function, half-life or compartmentalisation of the protein.
8. In which side series of polypeptide kinases do the phosphate groups transfer? Describe the entire mechanism.
Answer: Polypeptide kinases are enzymes that catalyse the transfer of phosphate groups to the hydroxyl groups of serine, threonine or tyrosine of the target proteins.
Mechanism:
Activation: This enzyme is a kinase enzyme that comes into contact with its target protein.
Phosphorylation: The kinase catalyses the transfer of a phosphate group from ATP to the hydroxyl group of serine or threonine or tyrosine of the substrate protein.
Conformational Change: When a protein is phosphorylated, it undergoes conformational change which enables the protein to function or not function as initial.
Termination: Phosphorylation can be removed by the action of phosphatases which cleave the phosphate group from the protein.
9. The whole family of phosphatases is also form specific as is the case with kinases. Justify or falsify.
False. The family of phosphatases is not as form-specific for class as kinases are. Despite the fact that kinases are classified into subfamilies according to their substrate preference (kinases of serine and/or threonine vs. kinases of tyrosine), phosphatases are somewhat different. Phosphatases can be classified into a number of types (for example, serine/threonine phosphatases, tyrosine phosphatases) that have different three-dimensional structures and mechanisms of action.
10. Falsify the following concerning amino acids, must be sourced from gene regulation: The reduction of nitrosylated arginine.
False. Nitrosylation is a PTM in which a nitroso group is added to cysteine residue and not to arginine. This modification changes the protein and can be reversible, and can be regulated by cellular processes but does not include or affect the changes in gene expression.
11. In order to determine the number of subgroups present in cAMP-dependent protein kinase. What is cAMP-dependent protein kinase?
Answer: cAMP dependent protein kinase (Protein Kinase A or PKA) is a four subunit enzyme of which two are regulatory subunits and the other two are catalytic subunits. The above subunits are organized in a tetrameric form.
Description:
Structure: The R subunits have cAMP which on binding leads to the exit of the inactive C subunits.
Function: When they are released, the C subunits phosphorylate serine and threonine residue of the target protein and involve in many cellular processes such as metabolism, gene expression, cell growth, etc.
12. What are the levels of control of enzyme activity? Describe the entire mechanism.
Answer: There are two major ways of the regulation of enzyme activity:
Allosteric Regulation: Here, the enzymes are regulated by molecules that bind to the sites that are not the active sites of the enzymes and this is referred as allosteric effectors. This binding results in the altering of the shape of the enzyme and can result in an increase or a decrease in the rate of the catalytic activity of the enzyme.
Covalent Modification: It involves the attachment or the stripping off of chemical groups through the formation of covalent bonds for example phosphorylation or acetylation. These modifications alter the enzyme in a manner that it alters its shape or its flexibility.
Mechanism:
Allosteric Regulation: Allosteric effectors are those that cause a change in the conformation of the enzyme and hence the substrate and catalytic sites.
Covalent Modification: Other enzymes modify enzymes by phosphorylation or dephosphorylation among other modifications. These changes can either act as an on or off switch to the enzymes and thus change the working of the enzyme.
The hardest part of the nursing process AAPIE (ADPIE) as a novice nurse and/or nursing student?
The hardest part of the nursing process AAPIE (ADPIE) as a novice nurse and/or nursing student?
1, Why do you think planning is the hardest part of the nursing process ADPIE ( AAPIE) as a novice nurse and/or nursing student?
2, which nursing process is the easiest for nursing students and why?"
1. Why planning is often the hardest part of the nursing process (ADPIE) for novice nurses or nursing students:
Complexity and Individualization: Planning requires formulation of care plan from the assessment data which mean that a lot of information has to be processed. Fresh and new nurses often struggle to rank and tailor the care plans as they are still getting acquainted with how to apply the knowledge they obtained from the academic into practice.
Resource and Time Management: New companions may fail to manage resources efficiently for instance time and the right interventions to employ. Sometimes they have to prioritize several patients and their demands and tools, and it can be quite a challenge.
Critical Thinking and Prioritization: As for the need of developing and prioritizing the interventions according to the patient’s needs, the critical thinking skills are essential. New to the profession, the novice nurses may not know which of the planned interventions are most crucial or which adverse events to expect.
Confidence in Decision-Making: New nurses may have low self- efficacy in decision making in the process of nursing care. It may be attributed to inexperience or simply lack of confidence that can be as a result of fear of making mistakes.
Integration of Evidence-Based Practice: The use of guidelines in formulation of care plans is vital although this may be cumbersome for the newbie. Some of them could require more guidance to appreciate and apply the current research findings to their planning.
2. The easiest part of the nursing process for nursing students and why:The easiest part of the nursing process for nursing students and why:
Assessment: Assessment is generally considered to be the easiest by many nursing students. This phase consists of fact-gathering processes such as observation, interviewing the patient, and physical examination; these are non-ambiguous than the subsequent phases.
Reasons for Ease:
Structured Guidelines: Assessment has certain protocols and checklists that one has to follow and it may be convenient for the beginners to understand and implement.
Direct Observation: Data collected from observation and regular record yields precise information that is easy to understand and implement than data analysis and strategizing.
Learning Focus: The assessment phase commits most of its time to establish a foundation that will be used in the development of skills.
Case study 1 - Screening Adolescent for Heart Risk
Case study 1 - Screening Adolescent for Heart Risk
Patient Name: Chris Brooker, Age 15, male
Height 5' 11"" Weight 178 BP: 115/78 P: 78 RR: 15/min
Chief complaint/reason for office visit: Pre-participation sports examination for basketball season
PMH: (Bulleted format)
� Mild, intermittent asthma since age 8; uses Albuterol as needed for wheezing and before playing sports. 2 puffs before start of exercise
� sometimes get short of breath with exercise, but not more than his teammates
� once felt like he was going to pass out when exercising, but thinks it was due to
dehydration and fatigue because it was during the Hot summer
He wants to play on the city league team. Has been playing on the team since grade school. He has mild, intermittent asthma and uses his Albuterol as needed for wheezing and before playing sports. On history he reports that he sometimes get short of breath with exercise, but not more than his teammates. He also says he once felt like he was going to pass out when exercising, but because it was during the hot summer, he thinks it was due to dehydration and fatigue. He is otherwise well
Family History
� negative for unexplained sudden deaths in anyone under 50 years
� Family Hx: DM - MGM; Pat GF: HTN; Pat GM: Breast CA
ROS
� Not documented - no pertinent positives or negatives
� HEENT - normal - wears glasses for distance vision since age 5; wears contacts
since age 12
� Card/Resp - no complaints
� GI - nausea occasional after
� GU - deny dysuria, frequency
� Surgeries: Tonsillectomy age 7
� NKDA
� Meds: None
Physical examination
� normal findings for all systems, except:
� Cardiac: new soft systolic ejection murmur [never heard before and it is not been documented elsewhere by others in the electronic medical record.
� What is the best way to screen adolescents to exclude those at risk of sudden cardiac death from athletic participation?
� In the U.S., the American Heart Association has not recommended the use of the 12- lead EKGs as a screening tool for athletic pre-participation. This is in contrast to other countries, such as Italy and Japan, which have been screening with EKGs for more than 20 years and report data that suggest a decrease in mortality rates from SCD in athletes as a result. Recently, the International Olympic Committee and European Society of Cardiology have recommended the use of the 12-lead EKG as a screen for athletic participation. The AHA has expressed concern about the high false-positive rate of mass EKG screening , as well as the practical implementation and cost-effectiveness of a mass EKG screening program.
In practice, what should the clinician do?
Certain locales, whether as part of a research protocol or through advocacy work, have been able to implement mass-participation EKG screening and place AEDs in high- school athletic venues.
Pay attention to the AHA 12-point screening recommendations and any concerns that arise should prompt further cardiac evaluation."
First case: Screening adolescent for heart risk
Patient Profile:
Name: Chris Brooker
Age: 15
Height: 5' 11"
Weight: 178 lbs
BP: 115/78 mmHg
P: 78 bpm
RR: 15/min
Chief Complaint: Examination for pre participation in basketball for the next season
Past Medical History (PMH):
Mild, episodic asthma (only uses Albuterol inhaler on an as needed basis).
Dyspnoea on exertion (as with teammates)
A history of near-syncope in hot weather, which is ascribed to dehydration and fatigue.
Family History:
Nonsignificant for unexplained sudden death in persons below fifty years.
Diabetes Mellitus (maternal grandmother)
Hypertension (paternal grandfather)
Breast Cancer (paternal grandmother)
Review of Systems (ROS):
HEENT: None; has eyesight and wears glasses as well as contact lenses.
Cardiovascular/Respiratory: No complaints
Gastrointestinal: Occasional nausea
Genitourinary: The patient does not complaint of having dysuria or frequency
Surgical History: Adenoidectomy at age 5 and Tonsillectomy at age 7
Medications: None
Allergies: NKDA
Physical Examination Findings:
Otherwise the physical examination was entirely normal apart from a new softer systolic ejection murmur.
Questions and Recommendations:
1. Best Way to Screen Adolescents to Exclude Those at Risk of Sudden Cardiac Death (SCD):Best Way to Screen Adolescents to Exclude Those at Risk of Sudden Cardiac Death (SCD):
The best way to screen adolescents for SCD risk is by taking a detailed history and examination of the patient, as well as the family history, and if necessary, more diagnostic procedures. The American Heart Association (AHA) recommends a 12-point screening approach, which includes:The American Heart Association (AHA) recommends a 12-point screening approach, which includes:
History of the patient and the family history
Cooled emphasis on the cardiovascular and respiratory systems
Recommendation of fuher cardiac examination if any abnormalities are detected.
2. In practice, what should the clinician do?
Follow AHA Recommendations: Begin with history and physical examination as outlined by the AHA. See if the new systolic ejection murmur needs any more evaluation.
Evaluate Further: However, since Chris has a new murmur and has had some near syncope he may need further assessments. The only concern that the AHA has with mass screening is that it is expensive and are prone to false positives; thus, it is only recommendable in localized or high risk areas. If there are any questions regarding the possible presence of pre-existing cardiac conditions it is best to consult a cardiologist.
Consider Local Practices: In the areas where the mass EKG screening and AED installations are provided, follow the recommendations if possible. In research contexts, or with particular programmes, further assessment can be useful.
Rationale:
1. Cardiac Evaluation: New onset systolic ejection murmur and history of near syncope are signs that require follow up due to possibility of having some cardiac origin. While many ejection murmurs in adolescents are innocent, a new finding should be further assessed to exclude more important disease.
2. Utilization of EKGs: The AHA opines that mass EKG screening is not advisable because of high false-positive results; however, it is recommended that guidelines and protocols of the local region be followed when they are evidence-based and proven to work. Such measures can be fairly useful in the high risk or research environments.
References:
American Heart Association. (n. d. ). Recommendations for Preparticipation Screening. [Link]
International Olympic Committee. (n. d. ). Cardiovascular Screening in Athletes. [Link]
European Society of Cardiology. (n. d. ). Guidelines on Cardiovascular Screening. [Link]
A summary on a career path that a new nurse can take to get involved in international health care.
A summary on a career path that a new nurse can take to get involved in international health care.
Include a discussion of the knowledge, skills, and attitudes necessary for success in this field.
What other safety or support issues may be important?"
Below is the career path for new nurses wishing to get involved in international health care.
1. Career Path Overview
A new nurse who wants to work in the international health care can use the following steps to achieve the desired goal. Here’s a summary of key steps and stages in this career path:Here’s a summary of key steps and stages in this career path:
Educational Foundation: Start with the basics of a good grounding in nursing education. A Bachelor of Science in Nursing (BSN) is commonly acceptable. Further qualifications include obtaining a Master’s degree in Public Health (MPH) or International Health.
Clinical Experience: The following is a list of goals and objectives to be achieved by the nurse practitioner: Acquire practical experience in different facilities. Previous experience in the field of emergency, infections or public health may be helpful. The opportunity to work in a variety of conditions will assist in the development of a large amount of professional skills.
Specialized Training: Take more training in international health care for instance global health, epidemiology or tropical disease training. Some of the certifications include the Certified in Public Health (CPH) or taking specific courses in global health.
Language Skills: It is often beneficial to learn a second language especially if one is to work in an area where the particular language is used. Knowledge of other languages for instance Spanish, French or Arabic can help in communication and management in the international environment.
Volunteering and Internships: The following are some of the ways that one can get involved with international health organizations: This offers ‘real life’ experience and potential contacts.
Networking and Professional Associations: Adhere to the societies like the Global Health Council or the International Council of Nurses among others. Interaction with other professionals in the same field can help one get information and leads on international jobs.
Job Opportunities: International organizations, non-profit and NGOs working in the sphere of global health are a good place to search for a job. It may also be possible to find jobs at governmental or non-governmental organizations, or at research institutions that are involved in the implementation of international projects.
2. The Skills, Knowledge and Attitudes That Are Helpful in Succeeding in This Line of Business
Knowledge:
Global Health Issues: Identifying the key issues in the field of global health including infectious diseases, malnutrition, and health inequalities.
Cultural Competency: Culture, customs, and healthcare systems of other people.
Public Health Principles: Knowledge on epidemiology, public health measures and the promotion of health.
Skills:
Clinical Skills: The knowledge of the different clinical procedures in the care of clients and the flexibility in handling and accommodating different medical situations and systems.
Communication: The ability to communicate verbally and in writing to work with people and organizations from a range of cultural backgrounds and to work in an international team.
Adaptability: General skills that include; the ability to work in varying environments and deliver services in spite of adverse conditions of work including limited resource.
Problem-Solving: The ability to reason and solve problems in order to identify and solve health related problems in different situations.
Attitudes:
Cultural Sensitivity: Tolerance people’s values and behaviors, their beliefs and traditions.
Flexibility and Resilience: The willingness to work in conditions that are difficult and may be volatile and the capacity to cope with stress.
Commitment to Global Health: A great concern in enhancing the health of people across the globe and an interest in social justice for health.
3. Safety and Support Issues
Safety Considerations:
Personal Safety: Compliance with the standard precautions in areas of turbulence. This entails knowing the threats likely to happen in the area and having preparations to make in case of occurrence.
Health Precautions: Maintaining the current vaccination schedules and precautions regarding diseases peculiar to the area of the work.
Support Issues:
Emotional Support: Mental health support because of the stressful working conditions that are apparent in the line of duty.
Training and Orientation: Pre-departure and on-going training to increases awareness of the cultural, political and health systems in the area.
Logistical Support: The following is significant in the welfare and productivity of international health workers: logistic support, shelter, transport, and communication requirements.
Kindly answer the following challenge questions with precision.
Nurses have critical roles and responsibilities during the COVID-19 pandemic. They will continue to be at the front line of patient care in hospitals and actively involved with evaluation and monitoring in the community. Nurses have to ensure that all patients acquire personalized, high-quality services irrespective of their infectious condition. They will also engage in planning for anticipated COVID-19-related outbreaks, which increase the demand for nursing and healthcare services that might overload systems.1 Moreover, nurses must maintain effective supply and usage of sanitation materials and personal protective equipment and offer screening information, confinement guidelines, and triage protocols based on the latest guidance. A global pandemic needs strong nursing staff engagement in clinical management, awareness and knowledge exchange, and public safety. The American Nurses Association's Code of Ethics for Nurses (2015) is the definitive professional conduct norm for the nursing field. Clause 2 of the code specifies that ""the sole responsibility of the nurse is toward the patient."" Clause 5 of the code notes that the nurse has the same obligation to themselves and to others. During outbreaks, these equitable responsibilities can clash as nurses have to constantly care for contagious patients, especially in pressing situations with scarce or unavailable resources and unrestrained contagion. Nurses and their co-workers will have to determine how much care they could give to others in times of pandemics, while still taking care of themselves.
1.Sourcing from contained outlines in chains, profiles are located by executing the global
_____ of a set of chains and then eliminating the _____ sections within the configuration
into a trivial _____.
2. Given numerous __________ sites for an enzyme in a particular __________, digestion
is performed in __________ phases. State how the preliminary digestion ought to be. Why
is the digestion in that nature?
3.Where does the posttranslational alteration of numerous polypeptides commence in?
4. What does the DISC composite entail?
5. Identify whether the following conclusion is true or false and explain your response.
An outline from an MSA can be generated by the program profile maker.
6. Essentially, ________ can be yielded at a constraint spot via cutting and degrading the
single-stranded terminals with an ________.
7. Determine the count of signal transducers in existence.
8. The ion trail Acetylcholine receptor ion is an instance of?
9. The h of the Bcl-2 family protein can caspase 8 act on?
10.Through which means can Epstein Barr virus can trigger cancer?"
1. The contained outlines in the chains are used in the following way: to find the profile one performs the global __________ of a set of chains and then __________ the __________ parts of the configuration to get a trivial one.
Answer: First of all, the set of chains on the global level and second, reduction of the configuration to the minimal one, that is the trivial one.
2. There are several __________ sites for an enzyme in a particular __________; thus, digestion runs in __________ stages. The preliminary digestion should be done in the following manner. What causes the digestion to take such a form?
Answer: When there are multiple sites on a substrate that can be cleaved by one enzyme then it is done in the order. The preliminary digestion stage is important in that it should only require partial digestion of the sample to enable the other stages of digestion to be done. This makes the enzyme to bind to all the possible sites thus giving a better over all cutting of the substrate.
3. Where does the initiation of the posttranslational modification of a very large number of polypeptides take place in the cell?
Answer: Many of the polypeptides are post translational modifications that occur in the co and post endoplasmic reticulum upto the golgi apparatus.
4. What do we find in the DISC composite?
Answer: The DISC is a behaviour type tool that sorts people depending on the power they exercise, their ability to persuade others, their level of patience and their detail orientation. It is applied in the assessment of individual and group conduct, with a view of enhancing relations between people.
5. Determine if the conclusion made is valid or not, for the given argument. From the MSA, an outline can be produced by the software known as ‘profile maker’.
Answer: False. To get an outline from a Multiple Sequence Alignment (MSA), one cannot usually use a program profile maker. Profile makers are the tools that are used in the process of generating profile databases from the given sequence alignments while MSA tools are the ones that are used in the alignment of the sequences so as to come up with the alignment matrix.
6. In fact, in a constraint site, ________ may be obtained by shearing and depolymerizing the single-stranded ends with an ________.
Answer: In essence, fragments can be created at a constraint site through cutting and the eroding the single-stranded overhangs with exonuclease.
7. It’s important to know how many signal transducers are in the world.
Answer: The number of signal transducers is not clearly known as it depends with the context and the system in use. Signal transducers can come in many forms such as receptor proteins, G-proteins and other intracellular signaling molecules; the number of these may depend on the specific context as to their use.
8. Which of the following is example of ion trail? Acetylcholine receptor ion
Answer: Ach receptor ion is one of the examples of the ligand-gated ion channels which is ion trail.
9. The h of the Bcl-2 family protein can caspase 8 act on ?
Answer: Caspase 8 is capable of cleaving the Bid protein of the Bcl-2 protein family that is engaged in apoptosis.
10. By which mechanism does Epstein Barr virus cause cancer?
Answer: EBV causes cancer in the following ways; firstly through the ability of EBV to activate the latent phase and transformation of the infected B-cells to lymphoproliferative disorders include but not limited to Burkitt’s lymphoma, Hodgkin’s lymphoma and Nasopharyngeal carcinoma. EBN can also support cell cycle progression and the survival of B-cells and, therefore, oncogenesis.
The most important functions within the nervous system and explain these functions
The nervous system is a complex structure which plays and essential role in controlling and regulating functions and activities. Its primary functions can be categorized into several key areas:
1. Sensory Function
Description:
Sensory function of the nervous system is with regard to the capacity of the system for perceiving stimuli from the environment as well as the internal milieu of the body. Receptors in the sensory organs of the body capture stimuli from light, sound, touch, heat and chemical among others.
How It Works:
Receptors: Some cells or structures are specialized to detect specific type of stimulus (for instance photoreceptor cells in the eye or the mechanoreceptors in the skin).
Sensory Neurons: Conduct impulses from the receptors of the body to the central nervous system through the afferent pathways.
Processing: The CNS combines this information and presents perception of sensations which is the perception of sensations.
Examples:
Vision: The light which is incident on the photoreceptors in the retina is sent to the visual cortex to create the images that are perceived.
Touch: Among the skin receptors which are known to be responsive to pressure and thermal changes are the tactile receptors which yield touch and texture sensations.
2. Motor Function
Description:
Motor function means the beginning and regulation of the voluntary and the involuntary movements. It is involved in the activation of muscle and gland through the signals which are relayed from the CNS.
How It Works:
Motor Neurons: It transmits signals from the CNS to muscles and glands in order to enable movement and other actions within the body.
Efferent Pathways: This pathways transmit motor signal from the CNS to the peripheral nervous system (PNS).
Effectors: Thus, muscles and glands execute these signals through contraction of muscles or secretion of some substance.
Examples:
Voluntary Movements: The activities are walking, writing or even the act of speaking and all these activities use the skeletal muscles.
Involuntary Movements: Automatic responses such as the stretch reflex such as the patella reflex or the capacity to control the rate of the heart during stress for instance.
3. Integrative Function
Description:
The integrative function is the integration of the stimuli and the generation of meanings, decision and action. This function helps in the demonstration of different behaviours, thoughts and in the regulation of the internal environment of the body.
How It Works:
Central Nervous System (CNS): Includes the Central Nervous System which is the brain and spinal cord that is used in the processing of sensations and decision making.
Neural Networks: The neurons within the CNS interconnect in such a way as to allow for perception, thought and co-ordinated response.
Examples:
Decision Making: The brain uses the input that it gets from the environment and applies it so as to determine the right action to be taken.
Memory: Some information is stored and retrieved from different areas of the brain and as such has a direct bearing on learning and behavior.
4. Homeostatic Regulation
Description:
The nervous system is in a position to regulate and integrate almost all the activities of the body in order to sustain the normal status of the physiological variables of the body.
How It Works:
Autonomic Nervous System (ANS): A division of the PNS that is involved in the regulation of automatic processes of the body inclusive of heart rate, digestion and respiratory rate.
Feedback Mechanisms: The ANS functions in response to the information received from the body in regard to its functions and requirements.
Examples:
Temperature Regulation: Nervous system also plays part in the control of heat by making the body to produce sweat when the temperature is high or make the body to shiver when it is cold.
Blood Pressure: Nervous system is responsible for controlling the blood Pressure by controlling the diameter of the blood vessels and the beating rate of the heart.
5. Cognitive and Emotional Functions
Description:
Nervous system is very essential in brain activities such as thinking, learning and the control of emotions. These functions are mainly influenced by the higher cerebral centres of the brain.
How It Works:
Cortex: Cerebral Cortex has several sections of the brain that has different functions such as reasoning, language and even emotions.
Limbic System: Is involved in the regulation of emotions and the formation of memory
Examples:
Emotions: The limbic system it self is involved in processing for emotion and controlling behavior in relation to the emotional stimuli.
Cognition: The frontal lobes of brain are used in the aspects of planning, problem solving and decision making.
Summary
The nervous system performs several vital functions:The following are some of the functions of the nervous system:
Sensory Function: Recognise and discuss the stimulus in the environment.
Motor Function: Is in charge of the voluntary and involuntary aspect of the body that is the muscular and glandular system.
Integrative Function: Perceives and interprets the stimuli to come up with decisions and actions to be taken.
Homeostatic Regulation: It is useful in regulating internal environment of the body and playing a part in homeostatic mechanisms.
Cognitive and Emotional Functions: Regulates the cognitive and perceptual processes, the learning processes, and the affective processes, and other higher order processes.
Karen Cole Scenario 1
Karen Cole
Scenario 1
Patient arrives at the unit with her husband. You have introduced yourself to the patient, and she is now in bed."
Initial Assessment
Introduction and Rapport Building
Thank you for coming and welcome to the facility Karen and her husband.
You should take your time and Introduce yourself, your position and what you are about to do.
Patient Identification and Safety
Make sure you check her details that is her full name and her date of birth from the ID band.
Therefore, the patient’s medical record should be checked to have a grasp of how the patient was and is at present.
Key Questions to Ask
The Present Status and the Presenting Complaint
Ask Karen: “How do you feel at the moment, are there any problems that you are having at the moment?”
Inquire about any pain or discomfort: “Are you currently experiencing any pain or discomfort? If so, please could you describe it?”
Previous Health and Recent Trends in Health Status of the Population
“Have you observed any alterations in your health or the appearance of any new signs or symptoms?”
Look at her past illnesses and surgeries, and past hospitalizations.
Medication and Treatment History
“At the moment what medications are you on, this may include the prescription medication, over the counter medication and supplements?”
Is there any change in medication in the last few weeks or she is already taking some new medication.
Support and Preferences
Ask Karen and her husband about any preferences for care: “Are there any specific thing you like or do not like while you are here?”
Request her whether she has any form of an advance directive or specific instruction to be made.
Family and Social Support
“With whom can one discuss the concerns regarding the patient’s care or the people who should be included in the decision making? “
Documentation and Communication
Document Findings
Any information that the patient is going through, feelings, and/or symptoms that the patient may be having, as well as, preferences and medical records.
It should also be ensured that all and sundry is properly documented in Karen’s file.
Team Communication
The other team members should be informed on the issue with Karen and any advice that she provided or issues that she has.
Explain to the healthcare team that she needs a good care plan to be made as she is a unique individual.
Follow-Up Actions
Plan for Care
Revise or create the care plan whilst using the information that has been obtained:
Ensure that all aspects in relation to Karen’s care are provided for; this is her pain, medication and any investigations that might be required.
Patient Education
Ensure that the family of the patient especially Karen and her husband is informed of the care plan, the procedure to be done, or any changes that will be made on the treatment plan.
Ensure that they know how to approach the healthcare providers if they have some questions or problems regarding their health.
Research the topic of quality and safety in health care in Australia
Research the topic of quality and safety in health care in Australia then identify and analyse scholarly literature that
is relevant to your assignment topic, namely your: chosen standard, a clinical care activity relevant to this standard,
process and outcome data required to monitor outcomesfimprovements relevant to the standard. Follo... Show more"\
1. Research Topic Overview
Quality and Safety in Healthcare in Australia:Healthcare Quality and Safety in Australia:
Quality and safety in healthcare is the management of quality of services given to patients, prevention of adverse occurrences and improved patient outcomes. In Australia, this is under various standards and frameworks for instance the Australian Commission on Safety and Quality in Health Care (ACSQHC).
2. Choose a Standard
Example Standard: The National Safety and Quality Health Service (NSQHS) Standards are:
Relevance:
The NSQHS Standards are intended to provide a baseline for safety and quality in healthcare organisations. The issues covered in the paper are clinical governance, patient safety, clinical care and so on.
3. Here is a definition of a Clinical Care Activity:Here is a definition of a Clinical Care Activity:
Example Clinical Care Activity: A foundation of the care plan
Relevance:
This is because the management of patient and the results of the treatment depend on the level of the adherence to medication. It encompasses the tasks of drug prescription and drug distribution and also the monitoring of the patient on the drug.
4. Process and Outcome Data
Process Data:
Medication Administration Records (MARs): History of the medical care of the patient including drug administration, the drug used, the dose, and the time of administration.
Prescription Orders: The position involves in the monitoring of medication orders.
Outcome Data:
Adverse Drug Events (ADEs): Monitoring and surveillance of = adverse drug events.
Patient Outcomes: Evaluating the effectiveness of drug in making purposeful alterations in the health status of a patient.
5. A critical analysis of the literature that is available in peer reviewed scholarly journals.
1. Scholarly Article Analysis:
Article 1:
Title: Systematic review of the literature on Quality and safety of Medication Management in Australian Hospitals.
Authors: [Author Names]
Journal: [Journal Name]
Summary: The purpose of this paper is to review the current status of medication management in Australian hospitals and to determine the issues and their solutions.
Article 2:
Title: NSQHS Standards for Medication Safety Implementation Challenges and Strategies in the public health system
Authors: [Author Names]
Journal: [Journal Name]
Summary: This paper is aimed at discussing medication safety, the application of the NSQHS Standards and the possible steps to deal with the challenges of the implementation.
Article 3:
Title: ”_Outcomes of medication therapy management: a literature review of the Australian context_
Authors: [Author Names]
Journal: [Journal Name]
Summary: Within this paper the available outcome measures used in Australia to assess the effectiveness of medication management will be critically analyzed.
2. Synthesize Information:
Key Findings:
Quality and Safety: Medication management is one of the areas that are of great significance in the nursing practice since it promotes safety of the patient. Adherence to the NSQHS Standards aids in minimising the occurrence of medication related incidents.
Challenges: Some of the problems are to ensure that the right medication is given to the patient and to monitor for drug side effects.
Strategies for Improvement: Appropriate measures like the use of HITs for instance EHR, supervision and staff trainings can enhance medication management.
3. Recommendations for Monitoring Outcomes and Improvements:The following are some of the recommendations that can be used in monitoring outcomes and improvements:
Regular Audits: Conduct standard 6 assessments of the medication administration processes and the patients’ outcomes in terms of the NSQHS Standards from time to time.
Data Collection: Make sure that you get the information from the different cases of medication errors, ADEs, and the feedback of the patients to know the areas that need change.
Continuous Improvement: A process and outcomes data have to be used to formulate certain measures that can help to improve medication safety and patient care.
Conclusion
Thus, after the analysis of the literature and the data concerning the medication management, healthcare professionals can identify the gaps and achieve the quality and safety standards. Both process and outcome data need to be collected and integrated so as to determine the quality of care that is being given in Australian healthcare services
How does genetics impact the Pathophysiology of leukemia?
Genetic factors are very significant in the development and the advancement of leukemia due to the fact that it is a genetic disease. Here’s a detailed look at how genetics impacts leukemia:
1. Genetic mutations and Chromosomal Abnormalities
Acute Lymphoblastic Leukemia (ALL): Philadelphia chromosome (BCR-ABL fusion) is prevalent and other genetic anomalies may be present as well. This chromosomal translocation results in the formation of the BCR-ABL chimeric protein that encodes a constitutively active tyrosine kinase with ability to promote cell proliferation and inhibit cell death.
Acute Myeloid Leukemia (AML): Some of the genetic mutations and chromosomal changes which are linked with AML include: Some of the most frequent genetic alterations are the FLT3 gene mutation, the NPM1 gene mutation, and the CEBPA gene mutation, and the chromosomal translocation t(8;21) involving the RUNX1-RUNX1T1 gene.
2. Genetic Predisposition
Familial Syndromes: Some hereditary disorders put one at an increased risk of acquiring leukemia. For instance, patients with Down syndrome are at an increased susceptibility of developing acute leukaemia including ALL and AML.
Inherited Genetic Mutations: Genetic alterations in genes that are linked with disorders such as Li-Fraumeni syndrome, such as TP53 gene or genes that are linked with breast and ovarian cancer, such as BRCA1/2 can raise one’s risk of leukemia.
3. Epigenetic Modifications
DNA Methylation and Histone Modification: Methylation and demethylation of DNA and histone modifications affect the expression of tumour suppressor genes as well as oncogenes. For instance, the methylation of genes concerning cell cycle can lead to leukemia.
4. Gene Expression Changes
Oncogene Activation and Tumor Suppressor Gene Inactivation: Some genes are mutated and produce too much of a protein called an oncogene (e. g. , MYC) or produce little or none of a protein called a tumor suppressor gene (e. g. , p53), which interferes with normal blood formation and encourages leukemic cell growth.
5. Pharmacogenomic: Genotypes and Drug Response
Pharmacogenomics: The genetic differences can influence the outcome of the treatment of leukemia patients. For instance, variations in the TPMT gene represent genetic variations that affect the metabolic rate of thiopurines, which are drugs used in cancer treatment especially leukemia, with regard to both effectiveness and side effects.
Key Points:
Genetic Mutations: Leukaemia results from particular genetic alterations such as mutations and chromosomal translocations that cause unregulated cell proliferation and survival.
Inherited Risk: Congenital and inherited influences as well as familial syndromes make an individual vulnerable to leukemia.
Epigenetics: Epigenetic modifications can influence the levels of gene expression and they can contribute to the development of leukemia.
Drug Response: Genetic polymorphisms affect the risk-benefit profile of leukemia therapies.
Conclusion
The factors that make genetics contribute to leukemia include direct mutations and chromosomal changes, inherited risk factors, and epigenetic changes. Identifying these genetic factors is important to help detect, treat and prevent leukemia, and to establish individualised care plans.
