What have you discovered about the professional practice, personal strengths and weaknesses
What have you discovered about the professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. I have to talk about a little about every single of this topics in class. Reference are highly appreciated
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities"
1. Population Health Concerns
Professional Practice:
Involves enhancing health status for the people in a population not for individuals.
Embraces the use of data to determine patterns of health, factors that contribute to the development of health problems, and the outcomes of put forwarded strategies.
Personal Strengths and Weaknesses:
Strengths: Knowledge at the technical level to consider the data and its implication, the candidate demonstrates a passion for enhancing the health of the community.
Weaknesses: For that perhaps may experience difficulties in responding to the needs of different populations or in delivering intervention for multiple quantities.
Additional Resources:
Data Analytics Tools: For instance, geographic information systems (GIS) would assist in the provisioning of geographical density of health status or dosage of hazards that would fetch heightened risky populations.
Community Health Workers: Locating people in the society such as the community healthcare volunteers can be helpful in identifying the requirements of certain segments.
References:
Kindig, D. A. & Stoddart, Gl (2003). What is population health? Am J Public Health. 1993 Mar;83(3):380-3.
2. Information Technology: Its Place in Enhancing Health Care Outcomes
Professional Practice:
Explores the use of EHRs, telemedicine and health app to improve care service and patients’ involvement.
Use of advanced technology enhances the ways of data collection and management, increases diagnostic capabilities, and take care of remote patients.
Personal Strengths and Weaknesses:
Strengths: Knowledge on how technology can be used in to enhance patient’s care, awareness of digital technologies and their uses.
Weaknesses: Technical aggressiveness issues or perhaps resistance to change technological assets.
Additional Resources:
Telehealth Platforms: Facilities such as Teladoc, or Doxy. me for remote consultations.
Health Informatics Systems: EHR systems like Epic and Cerner as both a general and a more detailed record.
References:
M. B. Buntin, M. F. Burke, M. C. Hoaglin & D. Blumenthal 2011. The benefits of health information technology: A number of the carried out studies indicate a positive influence of the intervention. Health Affairs, 30(3), 464-471.
3. Health Policy
Professional Practice:
Constitutes the process of knowing and changing policies that act as determinants of access to health care, the quality, and the prices or costs at which the services are proffered.
Involved in lobbying, research and formulation of policies as well as formulation and enforcement of health laws.
Personal Strengths and Weaknesses:
Strengths: Policy-making capabilities or lobbying skills for changes in policy, awareness on different regulations.
Weaknesses: Policies are intricate and possibly challenging to implement due to some aspects.
Additional Resources:
Policy Analysis Tools: Software that measures effectiveness of the health policies.
Professional Associations: Organisations such as the American Public Health Association (APHA) for organisational membership and information.
References:
S. Glied & G. Solon, (2016). Health policy and the transformation of the US health care system. Milbank Q, 94(3), 413-426.
4. Leadership and Economic Models
Professional Practice:
Leadership is the coordination and administration of people and assets in the direction of organizations in order to enhance well being organizations.
Health care economics is the use of economic theories that assist in the explanation of the financial consequences of each sector within health care.
Personal Strengths and Weaknesses:
Strengths: In personal attributes, it possessed political skills particularly in leadership, the expertise in terms of ability to make rational decisions on matters economic.
Weaknesses: Problems of working in regard to lower budgets while offering quality care, possible deficiencies in leadership skill pool.
Additional Resources:
Leadership Training Programs: Instructing students in healthcare leadership such as a course or a workshop.
Economic Modeling Software: For the disease model, decision TreeAge or Excel for cost-benefit analysis.
References:
Kotter, J. P. (2012). Leading change. Harvard Business Review Press.
Drummond et al, 201; Claxton et al, 201; Stoddart et al, 201; Torrance et al, 201. Let’s start with Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press.
5. Health Disparities
Professional Practice:
Emphasizes a decrease of disparities in a ratio of health and treatment between those and other population categories.
It entails the assessment and management of factors associated with difference in health status.
Personal Strengths and Weaknesses:
Strengths: Thus, commitment to equity and understanding of social determinants of health come here to stay.
Weaknesses: Possible challenges when it comes to changing organisational structures and power relations as well as providing equitable treatment.
Additional Resources:
Community Health Initiatives: Services that will enhance the provision of health care to minority groups.
Health Equity Data: Things like the Health Equity Tracker for tracking disparities.
References:
Williams, D. R. and Mohammed, S. A. (2009). Discrimination and racial disparities in health: al findings and research that can be carried out in future. Journal of Behavioral Medicine, 32, 20-47.
Discuss how functional patterns help a nurse understand the current and past state of health for a patient
Discuss how functional patterns help a nurse understand the current and past state of health for a patient. Using a condition or disease associated with an elimination complexity, provide an example."
Functional patterns can be described as approaches to the systematic evaluation of one or another aspect of a patient’s life and health and are often grouped by specific functional areas. These patterns enable the nurse to develop an overall systems approach to a patient’s health needs, acute and chronic. That is why, with the help of such patterns, nurses are able to identify shift or trends in the data, notice differences from the norm, and develop the further course of treatment and therapy.
The Way in Which Functional Patterns Contribute to the Assessment of Health Status
Holistic Assessment: The functional patterns provide the entire picture of a patient since these loss areas are viewed under categories of physical, psychological and social. This approach assist in defining not only the disease symptoms, but also how the condition interferes with the patient’s life.
Identifying Trends and Changes: In this way, the functional patterns can be analyzed with the aim to find out the changes over time and, therefore the changes in the patient’s state. This is convenient in tracing the aggressiveness of diseases, as well as in assessing the impact of interventions.
Comprehensive History: Other form pattern includes elements less significant and more concrete than personal identifies, but still parts of a patient’s record of health, like life style, eating habits, and inheritance. This information is essential in complicating current health with past health especially when practicing in the health sector.
Tailored Care Planning: Perceiving of functional patterns gives the nurses an opportunity to plan ways on how to off er care to the patients and identifying areas of concern to get overall functional patterns.
Example: CKD and the measure of JRFS was analyzed to determine their association with the degree of elimination complexity in the human body.
Condition: Chronic Kidney Disease also called Chronic Renal Disease
Functional Patterns:
Elimination Pattern: This pattern evaluates the patient’s urinary usability like the frequency and volume of urination as well as problems with the same. In CKD, this becomes more critical owing to the fact that the renal function to clear wastes and fluids is compromised.
How Functional Patterns Help:
Assessing Current Health Status: Evaluation of elimination in a CKD patient entails changes in urine production, occurrence of oedema and features of fluid accumulation. For instance, a decline in the urine production or hematuria, or presence of protein in the urine, may be signs of the deteriorating renal function.
Understanding Past Health: Evaluating patient’s history regarding the kidney function can be helpful in understanding the development of the CKD. For instance, data on past experiences such as previous UTI episodes or hypertension might assist in the determination of the development and aggressiveness of CKD.
Identifying Complications: Some of the complications that may arise from CKD and which may be manifested through change in the elimination pattern include; Increased frequency of urination or nocturia.
Tailoring Interventions: Thus, after the assessment of the elimination pattern it is possible to define some specific measures. For example, the goals might involve regulation of the amount of consumed fluid, regulation of electrolyte levels, or getting in touch with a CKD-specialized nephrologist.
Example Scenario:
A patient diagnosed of CKD complains of more frequent formation of urine and passing of urine at night. On evaluating these symptoms, they realize that the patient has had a change in bowl movement and for the past one month the urine output has improved tremendously. The nurse also performs patient head and tail and realizes that the patient has a history of diabetes with poor glycemic control, a known CKD risk factor. The care plan can then be changed so that the nurse will be more vigilant in monitoring the kidney function, the diet taken by the patient and any changes in medication that are required to regulate the fluid balance of the patient.
Conclusion
However, functional patterns are important for holistic evaluation of the patient’s condition. Nurses, for example, by focusing on particular patterns such as elimination, can identify the effect of such diseases as CKD, measure changes, and apply suitable interference in patient care practice.
Kindly tutors, make me understand the case below. Thank you.
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.
As nurses are at the front line of the COVID-19 outbreak response and are exposed to hazards that put them at risk of infection, it is vital that they are supported to protect themselves with specific infection prevention procedures and sufficient provision of protective gear at their practice settings, including ventilators, masks, robes, eye cover, face shields, and gloves.3 Nursing managers and instructors must include guidance to nurses and support personnel on emerging COVID-19 problems and hazards that are unique to their field of work.
Currently, there has been substantial confusion about the methods of transmission of COVID-19, who is at risk of spreading or catching the virus, and where spreads originate.4 These misconceptions may circulate across mainstream media, on social networking platforms or in society, and they can conflict with attempts to respond to public health issues. Nurses hold a vital function, as one of the most distinguished health service teams, in delivering public awareness regarding disease prevention and in decreasing the dissemination of myths regarding the epidemic. This involves countering myths, guiding people to available health services, and supporting evidence-based patient management and infection reduction initiatives.
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."
What pleases the _______ in molecular biology is the __________ to the __________ amino acid __________ for ___________.
Answer: Ubiquitin attaches to the lysine amino acid site for proteins for degeneration.
Explanation: Ubiquitin in molecular biology is a small protein that targets proteins that has Lysine residues with the aim of being degraded by the proteasome. This type of processing is crucial with regard to the control of the abundance of proteins in the cell, and also the removal of proteins that are no longer useful or have been damaged by oxidation.
Energy is compulsory to the Ubiquitin-proteasome dilapidation trail. Justify or falsify inference.
Answer: Falsify.
Explanation: The Ubiquitin-proteasome pathway does not conform to the obvious notion of ‘vigor’ but proclaims the happening of certain molecular events. The pathway it depends on the ubiquitin protein attachment to other proteins and proteasome that degrades these proteins. Apparently, vigor is not stipulated in the requirements of this particular career path.
State whether the following is true or false: Thymus varies greatly in size and function where the thymus of children is negligible with comparison to the thymus of an adult.
Answer: False.
Explanation: Thymus is relatively larger in children compared to the other persons in the growth of age. This was also established to play a role in the generation of T lymphocytes during the first years of a child’s life.
Where is the development of the lymphocytes?
Answer: In the thymus.
Explanation: Lymphocytes and T cells are trained in thymus gland which is seen as the place for such cells differentiation.
What chemical is emanated and synthesized by the human brain and associate with skin tone? The following player is to know the gland secreting it;
Answer: Skin colour is then linked to a compound called melanin.
Gland: Pineal gland.
Explanation: Melatonin produced from tryptophan in the pineal gland of the brain and thus the product’s role extends beyond the sleep wake cycle regulation, it can even change skin colour.
The following is related with changes of the partial pressure of oxygen, the concentration of hydrogen ions and glucose in the blood.
Answer: Inhalation or the respiratory system and cardiovascular .
Explanation: The respiratory system regulates concentration of oxygen in the blood, the removal of carbon dioxide, the circulatory system transports glucose and help in regulating hydrogen ion concentration.
Where is the touch, pressure and temperature receptors found?
Answer: From this, they concluded that in somatosensory cortex.
Explanation: To regulate various feelings for instance touch, pressure and temperature, some special parts of the brain usually referred to as the somatosensory cortex is used.
State whether the statement below is true or false: This organ is situated on the right-hand side of the abdominal cavity and is slightly above the diaphragm.
Answer: False.
Explanation: Spleen is situated in the upper left quadrant of the belly while thoracic cavity is in lower right quadrant of the body. It is situated in the sub-diaphragmatic area.
What is included in the white pulp, as a major part?
Answer: Lymphocytes.
Explanation: Similarly, pulp in the spleen is also comprised of large quantity of lymphocytes and also it has immunity function.
Draw a clear description of the size of the spleen.
Answer: Flying fish attain a size that their body length is in the range of 12-14cm or 5-6 inches.
Explanation: In majority of the adults, the size of the spleen is about 12-14 cm lengthwise; it can vary where circumstances or age of a person are a concern.
Mr Jungala's Case Study
Mr Willie Jungala is a 71-year-old gentleman that has been admitted to hospital post fall with soft tissue injury to right hip.
from the case study :
Hospital policy is that Mr Jungala receive the assessments below. For this assessment, the student needs to:
1. Detail the goal or the purpose of each assessment,
2. give an example of a tool used in the Australian hospitals and the frequency it is utilised.
3. Explain how this assessment is related to Mr Jungala case and who you would report abnormal findings to.
The assessments are the following:
Image transcription text
Physical Assessment data Temp 36.0, Pulse 100, Resps 20, Sp02 94% RA,
BP 150:95, BGL 3.9mmolle, Pain 6 out of '1 0 G83 '13 Pupils equal and
reactive to light Lethargic, eves open when spoken to, follows c... Show more
Image transcription text
History Assessment data Patient profile Willie Jungala, 71-year-old man from
Alice Springs Chief complaint Pain to right hip following fall Was going to
kitchen to make a sandwich and tripped on kids tonka truck. La... Show more
Cognitive assessment
Falls assessment
Functional assessment"
1. Physical Assessment
Goal/Purpose:
Assess Vital Signs: In order to understand about the general health of Mr Jungala pathophysiologic alterations that are acute must be evaluated.
Pain Assessment: So as to understand how much pain the patient feels and how it slows him and his recovery process as Mr. Jungala down.
Neurological Status: For this reason, it can be a method of screening for neurological deficits that may indicate complication.
Example Tool:
Vital Signs Chart: The Australian hospitals use EHR systems containing the principles of the vital signs checking that is usually done and noted – like peri operatively, or at least once every 4 hours for patients admitted to the hospital.
Relation to Mr. Jungala’s Case:Connection to Mr. Jungala’s Case:
Vital Signs: The patient has hypertension, which is recorded at 150/95; the patient’s oxygen level is at 94% RA, this may have been occasioned by stress or other effects that come from the fall. These have to be assumed in order to avoid or manage their impacts at the correct time.
Pain Assessment: In this case the level of reported pain was 6/10 PA and to promote healing well needs to be controlled.
Neurological Status: Sleeping and sedation have to be checked to identify whether there were complications at all for example head injury during the fight.
Report Abnormal Findings To:
Primary Nurse/Healthcare Provider: Any frequent changes which may exist should be communicated so that time appropriate actions can be embarked on – there should be the time reactions and alterations.
Medical Team: Any variations for instance a high blood pressure that is always high, low levels of oxygen should be communicated to the doctor on call.
2. History Assessment
Goal/Purpose:
Gather Comprehensive Background: In achieving this following aspects are of paramount importance; an overall impression of the patient and medical history of the patient.
Example Tool:
Patient History Form: At times used in recording patients’ private, health and other relevant information in Australian hospitals. This is normally received at the first visit of the client and may be changed from time to time.
Relation to Mr. Jungala’s Case:Connection to Mr. Jewla’s Case:
Background Information: The patient has history of the fall and current pain which will be used to assess the degree of his injury and on how to handle him.
Report Abnormal Findings To:
Healthcare Team: Any matter that may be ‘contradictory’ or any matter concerning or potentially affecting the regime should be reported to the medical team.
3. Cognitive Assessment
Goal/Purpose:
Assess Mental Status: To evaluate the degree of mental state and consciousness of Mr. Jungala since they may block his understanding of the further treatment and safety orders.
Example Tool:
Mini-Mental State Examination (MMSE): done to assess mental state, can be done at admission, then as necessary at certain time intervals.
Relation to Mr. Jungala’s Case:In relation with Mr. Jungala’s case there are down sides as follows:
Lethargy and Responsiveness: Since he is reported to be currently Presented as lethargic, and only awakens when spoken to, it would be valuable to do a cognitive assessment in order to assess increased clues or new acute changes in this patient’s mental status following the fall and the findings on the imaging.
Report Abnormal Findings To:
Healthcare Provider/Neurologist: Any change in the patient’s cognitive status should be reported to the other doctor or a Neurologist for review and appropriate management.
4. Falls Assessment
Goal/Purpose:
Evaluate Risk Factors: In order to search for any antecedent conditioning that may have attributed to the fall of Mr. Jungala and for the purpose of averting similar incidences in future.
Example Tool:
Falls Risk Assessment Tool (FRAT): Admitted in NSW Public Hospitals for the purpose of assessing their risk of falls. This assessment is normally conducted often at the time the patient is admitted and at other times according to the severity of the clinical condition of the patient.
Relation to Mr. Jungala’s Case:Connection to Mr. Jungala ’s case:
Risk Identification: It can also be used to prevent other falls in future due to some causes and or reasons that has been discussed above especially given Mr. Jungala’s age and the nature of fracture that he has.
Report Abnormal Findings To:
Fall Prevention Team/Nurse: High risk factors if seen should be reported to the fall prevention team or the nurse to be taken through intervention measures to minimize future cases of falls.
Summary:
In the treatment as well as recovery process of Mr. Jungala each of the assessments act as useful in focusing. The physical assessment offers the information concerning the patients’ current health threats; the history assessment gives background information; the cognitive assessment tests the patient’s consciousness; and the falls assessment prevents the threats for such cases. And it can contain such results as increased temperature, tachycardia or hypertension, and any other pathology that requires a patent to be treated in a certain way.
References:
Safety and Quality in Health care South Australia. (2020). The following are national safety and quality Health Service standards:The following are national safety and quality Health Service standards:
The above work has been developed with the assistance of the Australian Institute of Health and Welfare. (2021). Vital signs monitoring guidelines.
The discovery rule, as described in Bernson, allows accrual of the cause of action even if the plaintiff does not have reason to suspect the defendant's identity.
The discovery rule, as described in Bernson, allows accrual of the cause of action even if the plaintiff does not have reason to suspect the defendant's identity. (See Bernson, supra, 7 Cal.4th at p. 932, 30 Cal.Rptr.2d 440, 873 P.2d 613.) The discovery rule does not delay accrual in that situation because the identity of the defendant is not an element of a cause of action. (See Norgart, supra, 21 Cal.4th at p. 399, 87 Cal.Rptr.2d 453, 981 P.2d 79; Bernson, supra, 7 Cal.4th at p. 932, 30 Cal.Rptr.2d 440, 873 P.2d 613.) As the court reasoned in Norgart, ""[i]t follows that failure to discover, or have reason to discover, the identity of the defendant does not postpone the accrual of a cause of action, whereas a like failure concerning the cause of action itself does."" (Norgart, supra, 21 Cal.4th at p. 399, 87 Cal.Rptr.2d
668
668 453, 981 P.2d 79.) In Norgart, we distinguished between ignorance of the identity of the defendant and ignorance of the cause of action based on ""`the commonsense assumption that once the plaintiff is aware of' the latter, he `normally' has `sufficient opportunity,' within the `applicable limitations period,' `to discover the identity' of the former."" (Norgart, supra, 21 Cal.4th at p. 399, 87 Cal.Rptr.2d 453, 981 P.2d 79, quoting Bernson, supra, 7 Cal.4th at p. 932, 30 Cal.Rptr.2d 440, 873 P.2d 613.)
Question 1
Is cavernous sinus thrombosis a complication of meningitis?
Question 2
What is the mechanism of paraparesis that comes as a late (i.e. postresolution) complication to meningitis?141
Question 3
Is lumbar puncture contraindicated in meningococcal meningitis?
Question 4
What should the cerebrospinal fluid (CSF) picture be when the treatment
of acute bacterial meningitis is complete, and after how many days of
treatment?
Question 5
In the management of meningococcaemia, can chloramphenicol be
used as an alternative? Are there any advantages practically? The book
quotes benzylpenicillin or cefotaxime (alternative). Are they a standard
regimen?
Question 6
'The immediate management of suspected meningococcal meningitis
infection is benzylpenicillin 1200 mg either by slow IV injection or
intramuscularly, prior to investigations.'
Is this always true? Should you not perform a lumbar puncture for
culture first?
Question 7
Should children with bacterial meningitis be treated with steroids to
prevent complications?
Question 8
What is the role of anticonvulsants in a case of encephalitis and how long
should one continue them?
Question 9
How effective are steroids in the treatment of radiculomyelitis?
Question 10
Should you treat a patient who has a brain cysticercosis lesion? The text
seems to say 'Yes' but there is great uncertainty about it.
Also, should one 'worm' the patient's gut when you find brain lesions;
if so, with what?"
Cavernous sinus thrombosis; Question 1 False.
Of course, cavernous sinus thrombosis is one of the possible complications that may develop after meningitis. Meningitis, especially bacterial meningitis, can give rise of septic thrombi which can extend to the cavernous sinus and thus lead to CSVT. This is a serious condition which might need intervention and should therefore be reported immediately.
Reference: The coincidence of bacteremia and thrombosis in meningitis: The coincidence of bacteremia and thrombosis in meningitis ncbi. nlm. nih. gov/pmc/articles/PMC4926135/
Question 2: What is the mechanism by which paraparesis occurs in cases where it arises as a late (that is post resolution) feature of meningitis?
Paraparesis occurring as a complication of meningitis is generally considered a post- infectious inflammatory process or post meningitis syndrome. Meningitis may cause inflammation of the spinal cord affecting the patients especially when meningitis was severe of prolonged. This may lead to injury of one or many of the spinal cord nerve root or the spinal cord resulting to paraparesis.
Reference: Post-meningitis sequelae: https://pubmed. ncbi. nlm. nih. gov/29357131/
Question 3: In practicing lumbar puncture, is it best avoid or is it contraindicated when dealing with patient with meningococcal meningitis?
Lumbar puncture is therefore not absolutely contraindicated in meningococcal meningitis, but should be done carefully. In instances where there are signs of raised intracranial pressure or suspicion of brain herniation, then the CT may be required before doing the lumbar puncture to avoid complications.
Reference: Recommendations for performing lumbar puncture: [LINK]: ncbi. nlm. nih. gov/pmc/articles/PMC5477825/
Question 4: What should the results of the cerebrospinal fluid examination be once the management of ABCM is done, and at what days of treatment.
Routine investigations should reveal normal picture in nearly all parameters after the adequate management of acute bacterial meningitis. This includes:
Low riding leukocyte levels (which is less than 5 leukocytes per µL).
Average glycemic levels: mainly excludes level of hyperglycemia or hypoglycemia which are above or below the normal age standard respectively.
Normal protein levels (these are less than 45 mg/d L).
It is advised that the CSF should be repeated generally after 48-72 hours of instituting the treatment to check the response.
Reference: CSF findings in treated bacterial meningitis: The following are the possible CSF findings in children treated for bacterial meningitis; ncbi. nlm. nih. gov/pmc/articles/PMC3045706/
Question 5: Is chloramphenicol a suitable substitute for using in meningococcemia? I am only left with the question of whether there are any advantages practically.
There are very fewer defects of chloramphenicol which makes it acceptable to be used as the second line of treatment in management of meningococcemia those patients who develop severe allergies to beta-lactams or in the resource-deficient areas. However, in each case benzylpenicillin and cefotaxime are normally used since it has been found to work better and have fewer side effects when treating Neisseria meningitidis.
Reference: Prophylactic of meningococcal infection: https://www. ncbi. nlm. nih. gov/pmc/articles/PMC4697440/
Question 6: The immediate management of the suspected meningococcal meningitis infection is the benzylpenicillin 1200 mg either given by a slow intravenous injection or intramuscular before doing investigations When is this statement always true? Why did you not do a lumbar puncture for culture first?
Benzylpenicillin or cefotaxime is vital in the early management of suspected meningococcal meningitis but Lumbar puncture is vital in diagnosis it should be done before or simultaneously with the start of antibiotics if possible. This helps in ensuring that CSF cultures can be got in order to help in confirming the diagnosis and also to be used in the management of the disease.
Reference: First care for likely meningitis: https://www. ncbi. nlm. nih. gov/pmc/articles/PMC1485279/
Question 7: Is it recommendable to treat children with bacterial meningitis with steroids in order to avoid some of the effects?
Children should be given steroids for bacterial meningitis as they minimizes inflammation and may become worse by causing complication such as hearing impairment. Of these, dexamethasone is widely employed in this regard.
Reference: » Use of steroids in bacterial meningitis: https://www. ncbi. nlm. nih. gov/pmc/articles/PMC2725759/
[8] How do anticonvulsants fit in when treating encephalitis, and for how long should one use them?
There are medications that are used to control seizures that may arise in case of encephalitis. They should be maintained as long as the seizure is ongoing, and at times even after the management of the seizure has been completed for some time so as to ensure that there is no relapse again.
Reference: We have seen that Anticonvulsants in encephalitis here https://pubmed. ncbi. nlm. nih. gov/28315095/
The ninth question: ‘How efficient the steroids in treating radiculomyelitis?’
Steroids help to ease inflammation and are often prescribed for use in patients with symptoms of radiculomyelitis. Although they may be applied in the attempt to reduce immune-mediated tissue injury and to enhance functional recovery.
Reference: Steroids in radiculomyelitis http ncbi. nlm. nih. gov/26652455/
Question 10: Should you manage a patient with a brain cysticercosis lesion? It would be erroneous to regard the text as a definite ‘Yes,’ while at the same time it is characterized by a considerable degree of uncertainty. Moreover, is there some causality reasoning which lets ‘worm’ the patient’s gut each time one detects brain lesions; if so, with what?
yes, brain cysticercosis does need to be treated, and can be with antiparasitic drugs like albendazole, or praziquantel. Also, proper administration of antihelmintics to the affected gut for instance praziquantel should be done the eradicate the source of the disease and prevent re-infection.
Reference: The management of neurocysticercosis: https ncbi. nlm. nih. gov/pmc/articles/PMC3545580/
The nurse practitioner successfully places an intraosseous access port.
The nurse practitioner successfully places an intraosseous access port. Which of the following medications cannot be given via this route?
Diazepam
Dopamine
Mannitol
Succinylcholine
All of the above"
Diazepam
Diazepam cannot be administered via an IO access port. The IO route is generally reserved for life threatening conditions, but is good for fluids, electrolytes and select medications. Nevertheless, medications that are considered inadvisable for IO administration include diazepam because it is irritating to tissues and is known to complicate the procedure and/or cause local tissue damage.
Dopamine: May be delivered though IO access if the situation calls for it.
Mannitol: Can be installed through IO access though it is not very popular.
Succinylcholine: Can be self-administered with help of IO access at emergent situations.
Hence Diazepam is said to be this medication that should not be used for IO administration.
Can you help me find a case study on Diabetic health literacy in older Adults?
Academic Databases:
PubMed: Instead, use such phrases as ‘diabetic health literacy older adults case study’ or ‘health literacy diabetes elderly. ’
Google Scholar: Add the same words and in the search options tick case studies or articles published in the last month.
CINAHL: The electronic system, established for nursing and allied health literature has been described.
Specific Journals:
Journal of Diabetes Research
Diabetes Educator
Journal of Aging and Health
University Libraries:
If you are in possession of a university library card then they have many electronic resources and you can always ask a librarian for help.
Professional Organizations:
It is possible to find publications or reports of such organizations as American Diabetes Association (ADA) or American Association of Diabetes Educators (AADE).
Search Terms:
Some of the specific terms that should given include health literacy diabetes management in older adults or a case study on diabetes education in elderly people.
Online Research Networks:
Perhaps, there are some researchers with their case studies on ResearchGate.
For example, you might find articles like these helpful:For example, you might find articles like these helpful:
"Improving Diabetes Self-Management in Older Adults: A review of the article titled “Health Literacy: An Approach to Improving Diabetes Management in Older Adults;” a case study.
"Health Literacy and Diabetes Management: Conference Papers & Proceedings: “Diabetes Management in Elderly “Case Studies in Older Populations” – An exploratory study about the problems and interventions to enhance diabetes health literacy among the elderly
McCurdy Case Study
Appellant John A. McCurdy, Jr., M.D., is a licensed physician practicing cosmetic surgery in the State of Hawaii through the professional corporation of John A. McCurdy, Jr., M.D., FACS, Inc., wholly owned by McCurdy (collectively referred to as ""McCurdy""). McCurdy filed for bankruptcy after a jury awarded a former patient $2 million in her malpractice suit against him. Thereafter, on June 10, 1996, McCurdy filed a complaint in the United States District Court for the District of Hawaii against the American Board of Plastic Surgery (""ABPS"") (the appellee here), the Hawaii Plastic Surgery Society, the American Society of Plastic and Reconstructive Surgeons, Inc., seven individual plastic surgeons, and two professional medical corporations. McCurdy alleged unfair competition, unlawful restraint of trade and various antitrust violations in the field of cosmetic plastic surgery under the Clayton Act, 15 U.S.C. � 15 (1994), the Sherman Act, 15 U.S.C. �� 1-2 (1994), and Haw.Rev.Stat. � 480-13(a)(1). Among the overt acts alleged was the testimony of a California plastic surgeon on behalf of the plaintiff in the malpractice suit. On October 4, 1996, McCurdy filed an amended complaint, pursuant to Fed.R.Civ.P. 15(a), naming an additional defendant, the American Board of Medical Specialties (""ABMS"").
Question 1
In the case of anterior spinal artery occlusion is bladder function
preserved or is there urine retention?181
Question 2
In the case of anterior spinal artery occlusion, can the patient have intact
sensations in the lower limbs?
Question 3
In the case of anterior spinal artery occlusion, will the paraplegia be of a
spastic or a flaccid type?
Question 4
Can fasciculations occur in radiculopathy or peripheral neuropathy or is
it pathognomonic to anterior horn cell lesion?
Question 5
Is ibuprofen recommended in prophylaxis or treatment of Alzheimer's
dementia?
Question 6
What are the principal causes of frontotemporal dementia and how can
the cause be diagnosed?
Question 7
What are the associated features of meningomyelocele other than
hydrocephalus, urinary incontinence and paraplegia? Do patients have
congenital heart disease and congenital dislocation of hips?
Question 8
Can a patient with neurofibromatosis type I have a neurofibroma arising
from a nerve root or radicle causing cervical or compressive lumbar
radiculopathy?
Question 9
Is there a way to retard the rate of development of cutaneous or other
manifestations of neurofibromatosis type 1? Has a cure for this condition
yet been found?
Question 10
How does neurofibromatosis type 2 (NF2) affect the heart"
Question 1
Regarding anterior spinal artery occlusion, is bladder function intact, or is there constipation, and urine retention?
Another possible complication of anterior spinal artery occlusion is dysfunction of bladder control; a patient may be unable to urinate or have incomplete control over the process. This condition usually afflicts the grey matter in the AI of the spinal cord that is involved in the regulation of bladder.
Question 2
Can the patient have intact sensations in the lower limbs if he/she is suffering from anterior spinal artery occlusion?
On the contrary, in anterior spinal artery occlusion patients may present with paralysis and loss of sensation in the lower limbs only. This type of occlusion operates on the anterior part of the spinal cord where the pathways of pain and temperature are located; these sensations are missing, but the person may be able to feel his body position in space.
Question 3
If the anterior spinal artery is occluded, will the resulting paraplegia be of the spastic or the flaccid sort?
Spinal cord injury due to anterior spinal artery thrombosis is of paraplegic nature and spastic in most of the cases. This is attributed to corticospinal tract which influences the motor neuron and results to spastic paralysis.
Question 4
Are fasciculations possible in radiculopathy or peripheral neuropathy and therefore not unique to anterior horn cell lesions?
Fasciculations are a feature of radiculopathy and peripheral neuropathy but are more characteristic of the anterior horn cell lesions (for example, amyotrophic lateral sclerosis).
Question 5
What about the use of ibuprofen in either prophylaxis or in the management of Alzheimer’s dementian?
Ibuprofen should not be used in Alzheimer’s dementia either in prophylaxis or in the course of the disease. There is no good evidence that NSAIDs such as ibuprofen are effective in treating or preventing Alzheimer’s disease. Experimental studies have not indicated any beneficial role of NSAIDs in the management of Alzheimer’s disease.
Question 6
Some of the main causes of frontotemporal dementia are described as follows: How is the cause of frontotemporal dementia diagnosed?
Principal causes of frontotemporal dementia include:Principal causes of frontotemporal dementia include:
Frontotemporal lobar degeneration (FTLD)
Some of these include; mutations in the genes such as the MAPT, GRN, or C9orf72 genes.
Tauopathies
TDP-43 proteinopathies
Excludes cases diagnosed clinically, by neuroimaging such as MRI or PET scans, and genetic studies when required.
Question 7
What are other manifestations of meningomyelocele with the exception of hydrocephalus, urinary incontinence and paraplegia? Are patients diagnosed with congenital heart disease, and congenital dislocation of hips?
Associated features of meningomyelocele may include:Associated features of meningomyelocele may include:
Chiari malformation
Scoliosis
Musculoskeletal deformities
Infection to the skin in the locality of the defect
Both congenital heart disease and congenital dislocation of hips do not commonly co-exist with meningomyelocele though they may exist in other congenital syndromes.
Question 8
Can a patient with neurofibromatosis type I have a neurofibroma arising from a nerve root or radicle and produce cervical or compressive lumbar radiculopathy?
Note that a patient with neurofibromatosis type I (NF1) may develop neurofibromas along the nerve root/radicle producing cervical or compressive lumbar radiculopathy through nerve root compromise.
Question 9
Can one slow the progression of such cutaneous or other signs of neurofibromatosis type I? Has there been a discovery that leads to a cure of this condition?
Currently there is no known cure for Nf1. Management comprises of treatment of the symptoms and the complications. For cutaneous manifestations as a whole, there is not a strategy for slowing the rate of development, apart from frequent examinations and supportive measures in relation to symptoms and their effects.
Question 10
This paper seeks to answer the following question: Does neurofibromatosis type 2 (NF2) have an impact on the heart?
The disease known as Neurofibromatosis type 2 (NF2) occurs in the nervous system and is not related to the heart. But it can cause vestibular schwannomas (acoustic neuromas) and other central nervous system tumours. In contrast, cardiac involvement is not a feature of NF2 and hence would not typically be expected even in the case of generalized disease.
Mortality rates in a population usual vary most with which one of the following ""person variables?
Sex, age, ethnic group, or occupation"
Mortality rates in a population usually vary most with age
McCurdy Case Study
McCurdy anticipated that the court would apply the same reasoning to ABPS, which like ABMS had been served under Hawaii's long-arm statute. Therefore, McCurdy sought to moot the issue of personal jurisdiction under the state long-arm statute by reserving ABPS under the Clayton Act, which provides that process on a corporate defendant ""may be served in the district of which it is an inhabitant, or wherever it may be found."" 15 U.S.C. � 22 (1994). McCurdy believed that the October 4 filing of the first amended complaint initiated a new 120-day time period in which to serve ABPS, but even that period would have expired on February 3, 1997. On February 5, 1997, McCurdy filed an ex parte motion requesting the court to exercise its discretion under Fed. R.Civ.P. 4(m) to extend the 120-day period by nine days. On February 7, 1997, while the ex parte motion was pending, the amended complaint was personally served on ABPS. Although the first service was designated in counsel's cover letter as under the Hawaii long-arm statute, the February service was ostensibly under the nationwide service provision of the Clayton Act. A week later, the Hawaii magistrate judge denied without prejudice McCurdy's ex parte motion to enlarge the time in which to serve. On February 27, 1997, ABPS moved to quash the February 7, 1997 service on the ground that it was untimely under Rule 4(m). The record contains no indication of any ruling on that motion.
Question 1
1. How often is leprosy a cause of mononeuritis multiplex?
2. How often is diabetes mellitus a cause of mononeuritis multiplex?
Question 2
What is the expected response of straight leg-raising if the meningeal
stretch test is positive? Is it back pain, pain in the sciatic distribution, or
limitation in the range of leg-raising?
Question 3
1. Does radiculopathy due to systemic disease produce positive
meningeal stretch signs or are these limited to radiculopathy as a
result of disc prolapse?
2. Where no cause is found for radiculopathy, is steroid treatment
indicated?
Question 4
What are the most common causes of radiculopathy?
Question5
1. Does the absence of a positive straight leg-raising test exclude
radiculopathy?
2. Can radiculopathy be diagnosed by meningeal stretch tests or is it
diagnosed electrophysiologically?
Question 6
Why does ascending paralysis occur in the Guillain-Barr� syndrome?
Question 7
Is systemic steroid therapy indicated in cases of carpal tunnel syndrome
not responsive to conservative measures?
Question 8
Is there a role for acetazolamide in the treatment of carpal tunnel
syndrome? What is the dose? How can paraesthesia induced by the drug
be overcome?
Question 9
Can an MRI scan of the cervical spine detect cervical rib or does this
merit an individual scan?
Question 10
Please explain the mechanism by which cervical spondylosis causes
acroparaesthesia without proximal sensory affection. Does this happen
by compromising the blood supply?200"
Question 1
How frequent is leprosy as a cause of mononeuritis multiplex?
Mononeuritis multiplex is a syndrome more commonly associated with arteritides but leprosy is one of the rare causes of this condition. It is more often observed in endemical regions or in patient with history of leprosy; however, is not a regular presenting pathology to the general practitioner.
How frequent is diabetes mellitus as a cause of mononeuritis multiplex?
Diabetes mellitus is a much more frequent etiology of mononeuritis multiplex, especially in cases with inadequate glycemic control. It has potentiality to produce mononeuritis multiplex because of peripheral nerve involvement but it does not involve simultaneously but different nerves asymmetrically.
Question 2
The expected response of straight leg-raising if the meningeal stretch test is positive is that the pain will be reproduced and this indicates an inflammation of the meninges.
Restriction in the degree of elevation of the legs is the anticipated finding if the meningeal stretch test including straight leg raise test is pathologic. This test aids find signs of radiculopathy or irritation of the nerve roots.
Question 3
Does radiculopathy due to systemic disease produce positive meningeal stretch signs or are these restricted to only radiculopathy due to disc prolapse?
Positive straight leg raise is normally considered to be a meningeal stretch sign and this is normally a feature of radicular pain caused by prolapsed disc or other local factors and not systemic causes. These diseases sometimes manifest with radiculopathy but are frequently not seen as producing these signs of the syndrome.
Is steroid treatment warranted for patients with negative etiology for radiculopathy?
There is evidence that in radiculopathy that is otherwise ‘idiopathic’, that is no specific cause can be found, steroid treatment might be justifiable, especially in a situation that some form of inflammation is probably at work. But it must be concluded that such treatment is concerned with clinical considerations and other diagnostic results.
Question 4
From the viewpoints of the frequency, what diseases can potentially lead to radiculopathy most often?
The most common causes of radiculopathy include:The most common causes of radiculopathy include:
Herniated intervertebral disc
Degenerative disc disease
Spinal stenosis
Spondylolisthesis
Trauma
Question 5
Can negative straight leg-raising test rule out radiculopathy?
No, as it has been discovered that a negative straight leg raising test cannot rule out radiculopathy. Dexamethasone might be negative in certain situations, predominantly if the nerve root is not adequately inflamed, or in a mild radiculopathy case.
Is radiculopathy diagnosed from the result of performing meningeal stretch tests or is it diagnosed from the electrophysiologic tests.
Radiculopathy is clinically assessed by physical examination based on the meningeal stretch tests and diagnostic nerve conduction tests and EMG for confirmation of nerve root compromise and assessment of extension of the disease.
Question 6
How does it come about that ascending paralysis is witnessed in patients suffering from the Guillain-Barré syndrome?
In Guillain-Barré syndrome the paralysis is an ascending type because the peripheral nervous system is attacked and destroyed by the immune system, the motor nerves initially are selectively affected commonly in the lower limbs and then moves upwards. This is generally done by desmyelination of peripheral nerves with an intention of causing paralysis and muscle weakness.
Question 7
Is there a clinical indication for systemic steroid therapy in cases of steroid-resistant carpal tunnel syndrome?
In described carpal tunnel syndrome, systemic steroid is not recommended for the treatment. Initial management that the patient undergoes are initial conservative interventions and they include application of splint and inactive approach. If all of these are inexorable, surgery is often preferred over systemic steroids.
Question 8
Can acetazolamide be used as a part of the conservative management for carpal tunnel syndrome? What is the dose? What can be done to counter the implication of paraesthesia that arises from the use of the drug?
Acetazolamide does not form part of the traditional management of carpal tunnel syndrome at all. It is employed in the management of some ailments such as mountain sickness and glaucoma. For carpal tunnel syndrome, the treatments are conservative or surgeries are involved. As for paraesthesia brought about by acetazolamide, the dose can be reduced or the medicine can be stopped.
Question 9
Is cervical rib visible from the cervical spine MRI or does one need an individual scan for it?
Cervical ribs are thus not best visualized through MRI scans of the cervical spine. Cervical ribs are better diagnosed through a chest X-ray or a CT scan of the thoracic outlet.
Question 10
Would you describe the manner through which cervical spondylosis leads to the development of acroparaesthesia and yet the sensation appear to have no relation with the proximal part of the body? Does this occur at the expense of blood supply?
Cervical spondylosis can present acroparaesthesia (tingling sensation in the limbs inclusive of hands and feet ) without affecting the primary sensory nerve tracts in the upper part of the spinal cord or the nerve roots. This may happen without distal involvement because of compression of the nerve roots or diminution in the blood supply of nerve roots at certain segments resulting in changes mainly distally.
