Narrative word count is 500 words or more. Two (2) current, scholarly nursing references (articlesThere are numerous medications to treat disorders of the cardiovascular system. Below are just four of the medication categories used to treat hypertension.DiureticsACE inhibitors (Links to an external site.)Calcium Channel BlockersVasodilator1.Discuss the difference between each medication.2. Choose from one of the four categories listed above. Provide an example patient scenario (can be from your own experience as a nurse) where a patient would be treated with the class of medication you chose from the four listed above. (You only need to provide one scenario, but make sure it is using a medication that correlates to one of the four classes above).For example…Patient A has _________ diagnosis. His baseline BP is _______. The physician would most likely prescribe this class of medication ___________ and more specifically this drug ________.(Of course this is just an example to get you started). Please elaborate on your patient scenarios and support your statements with evidenced based literature.

For this discussion, identify a real-world social issue and discuss how biological or genetic factors may influence the issue. Examples of social problems include bullying, criminology, obesity, and alcoholism. Select a social issue for this post and discuss some of the biological or genetic factors that can negatively influence this issue.Consider the following in your initial post:What does the biological approach reveal about the issue?Is there one biological or genetic factor that appears to have more influence than other factors that negatively impact the social issue?Could there be several biological or genetic factors that negatively impact the issue?Be sure to find and cite supporting evidence for your viewpoint.

FOLLOW RUBRICWrite a 1-2 page introduction. Identify the approved phenomenon of concern (problem) in the area of quality care or patient safety that exists on an inpatient unit or in an outpatient setting. Explain why this phenomenon of concern needs to be changed. Note any negative impact it has on the organization. Make sure to provide supportive evidence and write in complete APA format. IMPORTANT: Do not use the name of the hospital or organization. Simply refer to them as the organization, hospital, or facility.*USE MY ATTACHED REFLECTIVE JOURNAL FOR ASSISTANCE FOR KEY POINTS DO NOT COPY OR PASTE OR CITE ATTACHED JOURNAL. USE NEW CITATIONS WITH HYPERLINKS ON SEPERATE PAGE FROM REFERENCE PAGE SO I CAN REFER BACK IF NEEDED.*TOPIC: Burnout and its Effects on Healthcare SafetyUSE NURSING JOURNAL ARTICLES TO1. Identify a phenomenon within a healthcare organization.2. Describe the need for change.3. Describe the process of change.4. Describe the role of the leader as the change agent.

1) Explain WHY each article is relevant or meet the criteria to support your PICOT question2) Identify quantitative, qualitative and mixed methods research in each article. IF the articles are quantitative; identify the Independent and Dependent VARIABLES. If the articles are Qualitative, just note the methodology.3) IDENTIFY what you think is the Level of Evidence for the article4) identify the hypothesis testing, Reliability & Validity: Can you believe what you are reading? are they( the articles) statistically significantArticlesAllen, N. B., Siddique, J., Wilkins, J. T., Shay, C., Lewis, C. E., Goff, D. C., … Lloyd-Jones, D. (2014). Blood pressure trajectories in early adulthood and subclinical atherosclerosis in middle age. JAMA, 311(5), 490–497. doi:10.1001/jama.2013.285122Johnson, H. M., Warner, R. C., LaMantia, J. N., & Bowers, B. J. (2016). “I have to live like I’m old.” Young adults’ perspectives on managing hypertension: a multi-center qualitative study. BMC family practice, 17, 31. doi:10.1186/s12875-016-0428-9

1. Interview a local advocacy group in your community: Community Advocacy & Family Services. 2. Share why you selected this organization. Determine the scope of the organizations role and how they support the community. 3. What other organizations do they work with and in what ways do they support and encourage others in the community to be involved with the organization. In your interview determine: 4. The interviewers role, title, and duties. Their education background and experience in the field. 5. The mission and vision of the organization and why the organization was established. 6. Types of support offered, and services provided. 7. Identify the level of advocacy in relation to Brofenbrenners ecological model (see chapter1) and how this organization impacts early childhood education across the systems of this model. Text Kieff, J. E. (2009). Informed advocacy in early childhood care and education: Making a difference for young children and families. (1st ed). Merrill. ISBN-13: 978-0131707337 Read: Chapter 1 – Building a Case for Advocacy Chapter 6 – Becoming Informed 8. Provide a brief summary of your experience, any aha moments you had during the conversation (what surprised you) and what you found most valuable in this field work experience.
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Write a paper on information from one of these chapters. Choose any of the “Reflect On” statements/questions at the end of each chapter to write a paper over your chosen chapter. Be sure to cite support for the statements in your paper by citing quotes from your book BUT do not quote your entire paper or even half of it.

Research Paper Question: – Why did President Suhartos authoritarian New Order regime come to an end in 1998? The research essay needs to engage deeply with a question, which they need to choose from the list below. This essay should demonstrate a range of academic skills including analytical skills, the development of an evidence-based argument, research, referencing and general literacy skills. In order to provide a persuasive argument that is based on academic evidence, I expect there to be a wide range of sources for this essay, especially books and academic journal articles.

This order is for the term paper (#3) highlighted in yellow on the attached syllabus. This professor enjoys seeing analysis and evaluation in his student’s papers. He wants to see us evaluating the pros and cons of a given matter. Also, he wants to see creativity and problem-solving in a public administrator’s role. This paper is about urban public planning. The learning outcomes are in the syllabus.

Consider the following quotations: “A general principle of vocabulary selection has been that of frequency. We can decide which words we should teach on the basis of how frequently they are used by the speakers of the language. The words which are most commonly used are the ones we should teach first. Another principle that has been used in the selection of vocabulary is that of coverage. A word is more useful if it covers more things than if it only has one very specific meaning….” “Especially at intermediate levels and above, discovery techniques (where students have to work out rules and meanings for themselves rather than being given everything by the teacher) are an appropriate alternative to standard presentation techniques. This is certainly true of vocabulary learning where students will often be asked to ‘discover for themselves’ what a word means and how and why it is being used” What ideas would you bring to the classroom to make the learning of vocabulary more interesting and rewarding? Your answer should be between 500 and 750 words. It should show research and personal examples and ideas. Please use references to show where any information has come from

Cardiology/Endocrine Case StudyCourse Student Learning OutcomesUpon completion of the case study, students will be able to …1. Apply the principles of pharmacology relative to pharmacotherapeutics across age levels including the effect of race, gender, ethnic group, and special populations.2. Describe the uses, actions, effects and nursing implications of general classifications of drugs and selected specific drugs.3. Investigate media resources and information technologies to enhance knowledge base of pharmacology.4. Analyze the responsibilities of the nurse when administering drugs.5. Apply pharmacological research to nursing practice.Purpose The purpose of this case study is to apply concepts from pharmacology andpathophysiology, national guidelines, and evidenced based clinical practices in the management of chronic disease. Remember this paper must follow APA guidelines for font, in text citations, reference list etc. No abstract is needed. Provide headings for the different questions in your paper.Setting This case study takes place in a primary care setting in a small rural hospital clinic that provides health care services to predominately Latino field workers and their families. The rural clinic serves children and adults for all medical needs including well care, acute care, and chronic conditions. Some clients have seasonal insurance, state health insurance, or no insurance. Many live below poverty level according to the federal guidelines. Most do not own a vehicle. Most do not speak English; so, a translator is provided at each visit. The clinic is one hour from the nearest city where higher level of care can be offered to patients in need of specialty care. The clinic is staffed by one family medicine physician, an internist, two nurse practitioners, an RN, two LVNs, a lab tech, eight MAs and support staff. Once a week a cardiologist, podiatrist, pain specialist, orthopedist and ophthalmologist service the clinic. There is an on-site lab and a pharmacy two blocks away. There are two ambulances servicing the entire south end of the county with poor availability for emergencies.ClientJose is a 47 year old morbidly obese Latino male who presents to the clinic for follow up evaluation of headaches, dizziness, ringing in his ears and frequent urination. He reports having a headache that “comes and goes” with ringing in his ears and sometimes he sees spots. Jose has taken acetaminophen and states that seems to help. Due to his work schedule of six 12 hour days, Jose has not had preventive care. He reports fatigue and is depressed regarding his current income situation. Jose has just been laid off for the season and will lose his insurance in 30 days until the restart of the harvesting season in March. He is concerned about paying for any health care that may go beyond his benefit period. Jose lives with his pregnant wife, who does not work, and their seven children in a three bedroom one bath house that they share with his parents and his brother’s family of three.Review of Systems Subjective DataGeneral: occasional fatigue, gradual weight gain over the past ten yearsHEENT: (+) visual and hearing changes with HA; (-) cold or recent upper respiratorychanges, (-) rhinorrhea or nose bleeds,Cardiac: (-) chest pain or tightness, no palpitationsRespiratory: no asthma, (+) snores at nightGI: (-) pain, nausea, vomiting, constipation, visible fecal blood, (+) GERD, reports occasional indigestion after meals,GU: (+) frequent urinary for 1 month with increased thirstMS: (+) chronic bilateral shoulder and low back pain for 7+/- years, takes ibuprofen prn.Neuro: (+) headaches 2- 3 times a week relieved with acetaminophen, (+) dizziness, sees spots with HA which are not related to activity, (-) weakness, (+) numbness and tingling in both feet,(-) changes in speech or memorySkin: (-) rashes or lesionsAllergies (-)Psych: (+) Depressed about income, wife is unable to work and is pregnant7 children ages 2 years-13 years.Past Medical History: Denies problems No preventative care. Only acute care for cold or flu.Past Surgical History: NoneMedications: NoneSocial History: (-) substance abuse, (+) ETOH, drinks 1-2 beers a day and 5-6 beers on the weekend with family on Saturday and Sunday. Drinks 2 cups of coffee with cream and sugar in the AM, does not exercise except working in the fields picking broccoli, likes to watch TV at night, eats a high carbohydrate diet of rice, beans, potatoes, corn and tortillas (8-10 a day) eats at home, does not eat out often. Drinks water, no sodas or junk food. Reports drinking freshly made jimaca (hibiscus) tea with sugar and fresh cucumber lime drink with sugar three times a week. Rarely eats deserts.Family History: Parents and siblings all living. 2 brothers and 3 sisters. (+) hypertension – father and mother, 2 brothers and 2 sisters (+) diabetes-father, mother, 1 brother and 1sister, (+) coronary heart disease- father, mother, 1 brother, (+) hypercholesterolemia- father, mother, 1 brother, 2 sistersPhysical Examination – Objective FindingsHt. 64 inches Wt. 294 lbs. BP 176/104 mmHg HR: 92 RR: 24 T: 98.8 FGeneral: Well appearing, well groomed, NAD, looks stated age, morbidly obeseEyes: PERRLA, Fundoscopy with no AV nicking or copper or silver appearance, nopapilledema, EOMINeck: supple, (-) lymphadenopathy, (-) thyromegaly,CV/Heart: RRR, (-) murmur, rubs or gallops, lifts or heaves, tenderness to palpate, (-) carotid bruits, (-) pedal edemaLungs: CTA bilaterally, respirations equal and unlaboredAbdomen: (+) BS x 4, soft, round, non-tender, (-) masses, organomegaly, bruitsMS: (+) steady gait, FROM all EXT, no cyanosis, clubbing, pedal pulses present, feet warm, monofilament test abnormal at R great toe, 2+ patellar DTR,Neuro: CN 2-12 grossly intact, (-) Rhomberg, (-) Pronator drift, (-) Dix HallpikeSkin: (-) rashes or lesions, color even WNL, hair normal distributionPsych: appears anxiousPrevious Lab and Diagnostic Testing: None available. Reports labs done in Mexico 10 years ago, does not remember results.Current Lab Test Results – Fasted 12 hours – completed 1 week prior to clinicappointmentComplete Blood Count/ Basic Metabolic PanelWBC 5.0RBC 4.8Hgb 14HCT 45.2MCV 78MCH 27Glucose 238Creatinine 0.6 mg/dlCarbon dioxide 25 mEq/LChloride 100 mEq/LPotassium 4.0 mEq/LSodium 142 mg/dlCalcium 9 mg/dlBUN 16 mg/dlAST 68ALT 82Triglycerides 457Cholesterol 368LDL 325HDL 38Vit D 16A1c 10.9TSH 4.95CRP 6UAClear, pale yellowpH 5.4Specific gravity 1.021Protein negativeGlucose 500++Ketones NegBlood NegCardiology/Endocrine Case StudyAnswer the questions below using current national clinical practice guidelines, your pharmacology course textbook, previous pathophysiology coursework, and other sources such as journal articles to support your answers. Please review the grading rubric that will be used to evaluate your submission (100 points = 20% of total grade)1. Based on the patient’s labs and the Subjective and Objective data, what are the patient’s diagnoses? (Hint: There are at least 8.)2. Briefly discuss the pathophysiology of the top three diagnoses.3. Discuss the guidelines for diabetes management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Explain the importance of aspirin in diabetes. Describe how these medications work to stabilize and provide optimum health.4. Discuss the JNC 8 guidelines for hypertension management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Describe how these medications work to stabilize and provide optimum health.5. Discuss the AACE 2017 guidelines for dyslipidemia management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Describe how these medications work to stabilize and provide optimum health.6. Discuss non-pharmacological interventions to assist Jose in reaching his optimal health. This includes supplements/alternative/integrative medicine….7. List factors that increase the patient’s risk for cardiovascular disease (including labs).Calculate Jose’s 10 year atherosclerotic cardiovascular disease (ASCVD) risk using the Framingham and Mesa calculators.8. Discuss consequences of obesity as the one major cause of this patient’s problems that if corrected can impact all of his diagnoses. Explain how the related factors of his lifestyle affect his diagnoses. What type of diet is recommended according to the latest research? Is Jose a candidate for bariatric surgery and how does bariatric surgery help?9. Jose has expressed his inability to afford all of the medications he needs. What medication is required and how can his other diagnoses be treated? List other disciplines that could provide a multidisciplinary team approach to assist Jose in reaching optimal health.