July 2018 – Page 7 – mystudenthelp

Response to teacher – why a nurse practioner would have to spend more time with a patient with HIV

Type of document Essay

1 Page Double Spaced

Subject area Nursing

Academic Level Master

Style APA

References 4

Order description:

Please explain why a nurse practioner would have to spend more time with a patient with HIV and use some of these readings and resources as references

Learning Resources

This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below.

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Chapter 8, “Principles of Antimicrobial Therapy” (pp. 111-134)

This chapter covers factors that impact the selection of an antimicrobial treatment regimen. It also examines the clinical uses, adverse events, and drug interactions of various antimicrobial agents such as penicillin.

Chapter 12, “Fungal Infections of the Skin” (pp. 163-196)

This chapter explores the pathophysiology of several fungal infections of the skin as well as related drug treatments and examines the importance of patient education when managing these infections.

Chapter 14, “Bacterial Infections of the Skin” (pp. 181-196)

This chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.

Chapter 32, “Urinary Tract Infection” (pp. 519-526)

This chapter covers drugs used to treat urinary tract infections and identifies special considerations when treating geriatric patients, pediatric patients, and women.

Chapter 35, “Sexually Transmitted Infections” (pp. 512-535)

This chapter outlines the causes, pathophysiology, and drug treatment of six sexually transmitted infections, including gonorrhea, syphilis, and human papilloma virus infection (HPV). It also examines the importance of selecting the proper agent and monitoring patient response to treatment.

Chapter 49, “Human Immunodeficiency Virus” (pp. 843-860)

This chapter presents the causes, pathophysiology, diagnostic criteria, and prevention methods for HIV. It also covers various methods of drug treatment and patient factors to consider when selecting, administering, and managing drug treatments.

Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23(5), 550–561.

Note: Retrieved from the Walden Library databases.

This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011.

Note: Retrieved from the Walden Library databases.

This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Antimicrobials. Baltimore, MD: Author.

This media presentation outlines principles of antimicrobial therapy

Note: The approximate length of this media piece is 7 minutes.

Optional Resources

Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312–314.

Note: Retrieved from the Walden Library databases.

In addition, refer to the Optional Resources listed in Week 1.

Human immunodeficiency virus (HIV) – Advanced Pharmacology

Type of document Essay

1 Page Double Spaced

Subject area Pharmacology Academic Level Master

Style APA References 3

Order description:

Please respond to Catherines post by who provided a different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research

Please use the readings and resources as some of the references

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Chapter 8, “Principles of Antimicrobial Therapy” (pp. 111-134)

Chapter 12, “Fungal Infections of the Skin” (pp. 163-196)

This chapter explores the pathophysiology of several fungal infections of the skin as well as related drug treatments and examines the importance of patient education when managing these infections.

Chapter 14, “Bacterial Infections of the Skin” (pp. 181-196)

This chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.

Chapter 32, “Urinary Tract Infection” (pp. 519-526)

This chapter covers drugs used to treat urinary tract infections and identifies special considerations when treating geriatric patients, pediatric patients, and women.

Chapter 35, “Sexually Transmitted Infections” (pp. 512-535)

Chapter 49, “Human Immunodeficiency Virus” (pp. 843-860)

Note: Retrieved from the Walden Library databases.

This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011.

Note: Retrieved from the Walden Library databases.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Antimicrobials. Baltimore, MD: Author.

This media presentation outlines principles of antimicrobial therapy

Note: The approximate length of this media piece is 7 minutes.

Optional Resources

Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312–314.

Note: Retrieved from the Walden Library databases.

In addition, refer to the Optional Resources listed in Week 1.

Catherines post

Introduction

Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system, precisely the CD4 cells (T cells), which aid the immune system fight off infections. Unmanaged, HIV reduces the number of CD4 cells (T cells) in the body, making the patient more susceptible to other infections. These opportunistic infections take advantage of a fragile immune system and signal that the person has AIDS, the last stage of HIV infection (CDC, 2016). The Acquired immune deficiency syndrome (AIDS) is the most common and perhaps the most deadly immunodeficiency disorder the world has ever witnessed in the last century. AIDS is a result of a chronic retroviral infection that leads to, life-threatening CD4 helper T lymphocyte dysfunctions. Retroviruses RNA is transcribed into double-stranded DNA and then integrated into the host genome following infection with HIV. The virus replicates and infects other cells, repeating the process each time. The virus continues to reproduce, which leads to a progressive decline in CD4 T lymphocytes over the course of months to years, infected individuals may remain asymptomatic for 5-10 years (CDC. org, 2016). It is transmitted by exposure to infected body fluids or sexual or perinatal contact. Acute HIV infection usually present with fatigue, pharyngitis, myalgias, rash, lymphadenopathy, and significant viremia but without detectable anti-HIV antibodies.

Increased Complacency Due to More Advanced Drug Treatment Options For HIV/AIDS

The incredible success with the new highly active antiretroviral therapies (HAART), which offers hope, and extends the life of those living with HIV and AIDS has improved their quality of life, and lead to a reduction in morbidity and mortality rate. The success indeed relates to the potent combination of antiretroviral therapy. Despite this achievement, the incidence of adults and adolescents affected by HIV have increased to an alarming rate in the developed and developing countries due to complacency. The CDC currently estimates that 1.1 million people in the US are living with HIV (CDC.org 2016), this is a significant number of people, though it may be a small percentage of the USA population. The figure indicates that the fight against HIV and AIDS is not yet over. Complacency about HIV, in my opinion, could be a barrier to the control of this disease; this complacency may also be linked to the progress recorded in the area of research and development towards finding a cure for the disease. A more troubling part of contentment comes from the reporting of the smaller number of people who are living with or dying from the disease every year around the world by all the agencies involved in the documentation (Arcangelo and Peterson 2017). Still, there is no cure yet, and all stakeholders must maintain focus on the prevention of the disease, increasing access to HARRT should not be allowed to slow down the prevention and control measures that were previously initiated for the control of the disease. According to CDC.org, another factor that further indicates complacency is that 1 in 7 of those infected is not aware of their HIV status. These individuals may engage in unprotected sexual intercourse and expose their partners to the risk of infection. Based on this complacency, there is the need for all stakeholders involved to embark on developing educational strategies targeting vulnerable groups of people to increase their knowledge about the disease and its prevention.

Educating HIV Positive Patients: Adherence and Reducing Risk

Medicare and commercial insurance providers measure and encourage health care providers to inform their patients on the importance of adherence in the management of chronic conditions such as hypertension, diabetes, etc., this approach could also be useful in driving compliance with antiretroviral medications. There are several examples of one-on-one counseling methods used for risk reduction counseling among HIV positive individuals. Healthcare Providers should provide education to patients whenever the opportunity presents itself. While the number of AIDS cases has reduced, the number of people living with HIV infection is growing every day because of the current lifestyle. Clinicians have an excellent opportunity to enhance awareness and increase the knowledge of the certainties of HIV. First, providers can teach individuals that HIV disease management is a life-long process. The focus of control of the HIV disease is to sustain suppression of the HIV viral load, to restore and to improve the immune system, to enhance the quality of life, and to reduce illnesses and death from HIV complications. The professional can also explain, to the patient, the possibility of emergency medical complications that are associated with HIV.

Educational Strategies

Health care providers must implement strategies not only to increase drug observance but also to decrease the risk of infecting others. Patients with a diagnosis of HIV must be thaught to adhere to the regimen of medication therapy to attain the full benefits. The goal of treatment is adherence and protection. Individuals must be given information as it relates to safe sex practices and avoids needle sharing. The healthcare professionals have to explain the factual information of life-long clinic appointments, medication adjustment based on laboratory results, and medication compliance. Providers can form a personal adherence and prevention program to educate the community about the dangers of HIV. The HIV advocate may have a positive relationship with associates and partners. This approach will allow for an excellent opportunity to teach many people within their community the importance of adherence, prevention, and successful treatment (Bruce, D. et al. 2013).

UNESCO recommended HIV and sexuality education among groups of people. The organization also wants efforts directed at vulnerable individuals in hyper-endemic communities, such as drugs users who are likely to share or reuse needles, homosexual men and women or girls in poor neighborhoods who may be enticed to have sex for money. Education plays several roles that go beyond sharing information about the spread of the disease, in women and girls, it may also help build women’s self-esteem and capacity to act on HIV prevention messages, improving their economic prospects, influencing the power balance in relationships, and affect their social and sexual networks (UNESCO 2009). Hence, several approaches can be implemented by counselors in providing education and prevention counseling to individuals who are at risk and those who have been infected with the virus. Additional attention should be focused on the Minority AIDS Initiative (MAI) which serves as a vital resource to improve Health and Human Services Commision (HHSC) agencies and offices’ ability to enhance HIV-related outcomes and reduce HIV related disparities among racial and ethnic minority communities (UNESCO 2009).

Conclusion

From the advent of the HIV/AIDS epidemic in the 1980s to today, the world population has suffered on an unpredictable scale. Effective long-term treatments for HIV/AIDS have improved dramatically since the beginning of the epidemic and what was once an uncontrollable disease has become more manageable and chronic disease, despite all this management, there is still the prevalence of the disease. A condition as complicated as HIV/AIDS is still a disease that needs better understanding and continued study (Bruce, D. et al. 2013).

Reference

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017).

Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Bruce, D., Harper, G., & Suleta, K. (2013). Sexual risk behavior and risk reduction beliefs among HIV-positive young men who have sex with men. AIDS Behavior, 17, 1515-1523.

Centers for Disease Control and Prevention. (CDC). (2016). CDC fact sheet Today’s

HIV/AIDS Epidemic. Retrieved from https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/todaysepidemic-508.pdf

Mmbaga EJ. (2013) HIV Prevalence and Associated Risk Factors: Analysis of Change over

Time in Mainland Tanzania. DHS Working Paper. No. 85.

Stephen J. McPhee, Gary D. Hammer. (2014). Pathophysiology of disease: an introduction to

clinical medicine. New York: McGraw-Hill Education Medical.

UNESCO (2009). A Strategic Approach: HIV & AIDS and Education. Retrieved on July 18

from http://unesdoc.unesco.org/images/0016/001627/162723e.pdf

Old Imperialism (1400s-1600s) to New Imperialism (1800s-1914) – Part 3

Type of document Essay

1 Page Double Spaced

Subject area History

Academic Level High School

Style APA

References 1

Order description:

Answer all three question please.. Thank you for your help.. It’s due July 25

Part 3. Long Essay over Textbook and Lecture Material. you will have to write an essay (40 points).

Compare Old Imperialism (1400s-1600s) to New Imperialism (1800s-1914). How were they different? Give examples of New Imperialism in Africa.
What problems did Latin and South American countries faced in general as they tried to gain independence and solidify those governments in the 19th century?

Reasons for HIV Increase – Advanced Pharmacology response 2

Type of document Essay

1 Page Double Spaced

Subject area Pharmacology

Academic Level Master

Style APA

References 3

Order description:

Please respond to Gayla post by who provided a different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research

Please use the readings and resources as some of the references

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Chapter 8, “Principles of Antimicrobial Therapy” (pp. 111-134)

Chapter 12, “Fungal Infections of the Skin” (pp. 163-196)

This chapter explores the pathophysiology of several fungal infections of the skin as well as related drug treatments and examines the importance of patient education when managing these infections.

Chapter 14, “Bacterial Infections of the Skin” (pp. 181-196)

This chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.

Chapter 32, “Urinary Tract Infection” (pp. 519-526)

This chapter covers drugs used to treat urinary tract infections and identifies special considerations when treating geriatric patients, pediatric patients, and women.

Chapter 35, “Sexually Transmitted Infections” (pp. 512-535)

Chapter 49, “Human Immunodeficiency Virus” (pp. 843-860)

Note: Retrieved from the Walden Library databases.

This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011.

Note: Retrieved from the Walden Library databases.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Antimicrobials. Baltimore, MD: Author.

This media presentation outlines principles of antimicrobial therapy

Optional Resources

Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication aG

When considering the increase in the prevalence of HIV infection, there appears to be a variety of factors at play in the increase rather than increase complacency related to the improvements in antiviral therapy.

Reasons for HIV Increase

Individuals diagnosed with HIV infections are referred to clinics which transmissions in the management of monitoring CD4 T-cell counts and viral load and resistance testing (Spooner, 2017). A variety of antiviral treatment regimens are available to manage disease progression while keeping in mind individual preferences, adverse effects, and co-occurring health problems (Spooner, 2017). Individuals living with HIV now have been able to live longer, which is causing the need for management of conditions noted in the general aging population (Zingmond, Arfer, Gildner, & Leibowitz, 2017). With this longer life expectancy, there is the need to educate patients to prevent transmission of the disease. Several social factors were noted to contribute to disease transmission such as intravenous drug use, sex trades, and male-to-male disease transmission.

While the prevalence of HIV infections in intravenous drug users has been noted to be decreasing, there is an increase in comorbid conditions in this population (Singh, Song, Johnson, McCray, & Hall, 2018). Deaths from comorbid conditions and heroin overdoses may contribute to the prevalence (Singh, Song, Johnson, McCray, & Hall, 2018). However, to decrease HIV prevalence in this population, a multi-faceted approach is needed which includes HIV and blood borne disease testing and treatment; needle exchange programs; access to condoms, as well as safe needle disposal systems (Singh, Song, Johnson, McCray, & Hall, 2018).

Individuals involved in the sex trade industry are at increased risk for disease transmission of both sexually transmitted infections and HIV (Wilson, 2015). Access to health care, as well as fears related to stigma and prosecution, are factors which can impact treatment and disease transmission (Wilson, 2015). Preventative care with population focused intervention have been found to be effective in reducing HIV infections; however, funding can be a crucial factor in meeting this global need (Wilson, 2015).

Lastly, the researchers noted an increase in HIV infections among men who have sex with men (Singh, Song, Johnson, McCray, & Hall, 2018). The percentage of undiagnosed HIV infections were noted to be higher among Latino, African American and Asian populations (Singh, Song, Johnson, McCray, & Hall, 2018). Males who have sex with males were contributed with the highest percentage of new infections (Singh, Song, Johnson, McCray, & Hall, 2018). Thus prevention and education interventions are needed in this at risk population group.

Role of Health Care Professionals

Health care professionals have a variety of responsibilities in providing preventative care and education for all individuals. When completing medical and social history, it is important to consider a variety of risk factors such as intravenous drug use, safe sex practices, and occupational risk for HIV infections. Spooner (2017) noted, “prevention is the key to avoiding transmission” (p.843). Sexual contact is the most common transmission route (Spooner, 2017). Education into safe sex practices should be provided during well care visits. For those individuals living with HIV, education regarding healthy lifestyle choices is critical to preventing and managing co-morbid health conditions (Zingmond, Arfer, Gildner, & Leibowitz, 2017). Providing education into medication management, which includes both scheduling and managing adverse effects (Spooner, 2017). Advocacy is also needed regarding social programs for populations at risk, such as those in the sex trades, or suffering from mental illness and substance abuse. Nurses have an ethical obligation to advocate for social justice in health care both in their community and globally (American Nurses Association, 2015).

Education Regarding Medication Adherence and Safety Practices

Advanced practice nurses should educate patients regarding the treatment benefits for the individualized treatment regimen. Discussion should include information on adverse effects and ways to manage symptoms to maintain treatment adherence (Spooner, 2017). Open and honest communication should be encouraged between the patient and the treatment team, which allows the patient to partner in their care. Consideration regarding medication schedule challenges should be reviewed with the patient to determine the best treatment regimen for both decreasing viral loads and adherence.

Safe sex practices should be discussed. Education regarding the advantage of early diagnosis and treatment of HIV and sexually transmitted infections should be provided (Spooner, 2017). Males who engage in sex with other male partners, as well as other at-risk populations, such as those involved in intravenous drug use and sex trades should be encouraged to receive screening for HIV and other blood borne diseases (Singh, Song, Johnson, McCray, & Hall, 2018; Wilson, 2015).

For those individuals who use intravenous drugs, education regarding preventing disease transmission through needle exchange programs is crucial (Singh, Song, Johnson, McCray, & Hall, 2018). Use of these programs also assists in ensuring the safe disposal of used syringes.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD. Retrieved from: https://www.nursingworld.org/coe-view-only

Singh, S., Song, R., Johnson, A. S., McCray, E., & Hall, H. I. (2018). HIV Incidence, Prevalence, and Undiagnosed Infections in U.S. Men Who Have Sex with Men. Annals of Internal Medicine, (10). 685. doi:10.7326/M17-2082.

Spooner, L.M. (2017). Human immunodeficiency virus. In Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed., pp. 843-859). Philadelphia, PA: Lippincott Williams & Wilkins.

Wilson, D. (2015). HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs. PLOS Medicine, 12(6), doi:10.1371/journal.pmed.1001808

Zingmond, D. S., Arfer, K. B., Gildner, J. L., & Leibowitz, A. A. (2017). The cost of comorbidities in treatment for HIV/AIDS in California. Plos ONE, (12), doi:10.1371/journal.pone.0189392

Pathophysiology of Inflammatory Bowel Disease – Advanced Pathophysiology response 2

Type of document Essay

1 Page Double Spaced Subject area Nursing

Academic Level Master

Style APA

References 3

Order description:

Please respond to chikas post Offer alternative common treatments for the disorders.

Share insight on how the factor you selected impacts the treatment of alterations of digestive function also use the some of the following readings and resources as references

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Chapter 35, “Structure and Function of the Digestive System”

This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.

Chapter 36, “Alterations of Digestive Function”

This chapter presents information relating to disorders of the gastrointestinal tract and accessory organs of digestion. It also covers the pathogenesis, clinical manifestations, evaluation, and treatment of gastroesophageal reflux disease, gastritis, peptic ulcer disease, inflammatory bowel disease, and irritable bowel syndrome.

Chapter 37, “Alterations of Digestive Function in Children”

This chapter presents information relating to disorders of the gastrointestinal tract and liver that affect children. It focuses on congenital impairment, inflammatory disorders, metabolic disorders, as well as the impairment of digestion, absorption, and nutrition.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Chapter 13, “Gastrointestinal Disease”

This chapter provides a foundation for exploring gastrointestinal disorders by reviewing the structure and function of the GI tract. It also describes mechanisms of regulation of GI tract disorders such as acid-peptic disease, inflammatory bowel disease, and irritable bowel syndrome.

Chapter 14, “Liver Disease”

This chapter reviews the structure and function of the liver. It then explores the clinical presentation, etiology, pathogenesis, pathology, and clinical manifestations of three liver disorders: acute hepatitis, chronic hepatitis, and cirrhosis.

Chapter 15, “Disorders of the Exocrine Pancreas”

This chapter begins by reviewing the anatomy, histology, and physiology of the exocrine pancreas. It then examines the clinical presentation, etiology, pathology, pathogenesis, and clinical manifestations of acute and chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer.

de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787

Required Media

Laureate Education, Inc. (Executive Producer). (2012c). The gastrointestinal system. Baltimore, MD: Author.

This media presentation outlines the pathophysiology of the gastrointestinal system and associated alterations.

Optional Resources

American Liver Foundation (2016). Retrieved from http://www.liverfoundation.org/

National Digestive Diseases Information Clearinghouse. (2016). Retrieved from http://digestive.niddk.nih.gov/index.aspx

The Pathophysiology of Inflammatory Bowel Disease

There are two types of inflammatory bowel disease (IBD) namely Ulcerative Colitis and Crohn’s disease. The pathogenesis of both diseases is still unknown. Mucosal ulceration and inflammation of the GI tract are features they both have in common (Hammer & McPhee, 2015). With Crohn’s disease, the inflammation can affect any part of the GI tract, the ascending colon, and transverse colon is the most common site of the disease, although the large and small intestines, particularly the ileum, may also be involved (Huether & McCance, 2017). A characteristic feature is the presence of a discontinuous pattern of ulceration and inflammation that occurs in the bowel wall (Hammer & McPhee, 2015). This feature creates a cobblestone appearance forming projections of inflamed tissue that surround the ulcerations (Huether & McCance, 2017). Common complications of Crohn’s Disease include perforation, fistula formation, abscess formation, and small intestinal obstruction (Hammer and McPhee, 2015). Common symptoms include diarrhea, rectal bleeding if the colon is involved, weight loss, abdominal pain. Malabsorption of vitamin B12 may occur if the ileum is involved causing anemia. Deficiencies in folic acid and vitamin D absorption also occurs, and proteins may be lost leading to hypoalbuminemia (Huether & McCance, 2017).

In Ulcerative Colitis (UC), the inflammation occurs mostly in the mucosa of the rectum and sigmoid colon. The inflammation begins at the base of the crypt of Lieberkuhn in the large intestine, while the disease begins in the rectum and may spread across the entire colon (Huether & McCance, 2017). The mucosa becomes hyperemic and appears dark red and velvety and occurs continuously. The destruction and inflammation of the mucosa cause bleeding, cramping pain, and an urge to defecate. Common symptoms include diarrhea, with the passage of a small amount of blood and purulent mucus (Huether & McCance, 2017). Severe UC may affect the entire colon and causes abdominal pain, fever, increased pulse rate, bloody stools, frequent diarrhea. Fluid loss, bleeding and inflammation results in weight loss, dehydration, fever, and anemia (Huether & McCance, 2017).

The Pathophysiology of Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is characterized by recurrent episodes of abdominal pain, bloating, and diarrhea alternating with constipation in the absence of detectable organic disease or structural deformities (Hammer & McPhee, 2015). A main characteristic of IBS is an alternation between diarrhea and constipation. IBS has unknown pathophysiology although there is increasing evidence that suggests the presence of organic causes of the disease (Huether & McCance, 2017). According to Hammer & McPhee (2015), stress has an impact on the symptoms associated with IBS. In reference to stool formation, individuals with IBS are grouped into diarrhea-predominant, constipation-predominant, mixed/alternating and unsubtyped IBS (Blagden et al., 2015). Clinical manifestations of IBS include lower abdominal pain and constipation in women and diarrhea in men (Huether & McCance, 2017).

Similarities and Differences Between IBD and IBS

A major similarity between IBD and IBS is the presence of abdominal pain, however a major difference is that with IBD, acute flares of inflammation followed by periods of remission occurs while in IBS, there is the occurrence of altered bowel habits and abdominal pain, in the absence of an organic cause (Ceuleers et al., 2016). Another difference is that IBD is a treatable disease but IBS cannot be cured, only its symptoms can be managed. Both diseases are chronic and has a debilitating effect, the pathology of IBD is well known as well as its diagnosis and treatment, however, the etiology of IBS is undefined causing frustration among patients who regards the illness as “nothing diagnosis” for their symptoms (Blagden et al., 2015, p. 268). Several features they both have in common include chronic abdominal discomfort, diarrhea and constipation, urgency and bloating; they also differ from each other in that in IBS, there is the absence of symptoms inflammation such as weight loss, fever (Casey, 2017). Also, individuals with IBS, do not experience malnutrition (anemia and iron deficiency), obstructive symptoms and blood in the stool (Casey, 2015).

Common Treatments for IBD and IBS

The treatment of IBD is geared towards the severity of the symptoms along with the extent of the mucosal damage, and as a result, it is usually individualized (Huether & McCance, 2017). The goal of treatment is to promote mucosal healing. 5-aminosalicylate therapy followed by steroids can be used to treat mild to moderate symptoms while severe symptoms are treated with thioprine and immunomodulatory agents (cyclosporine and tumor necrosis factor (Huether & McCance, 2017). For patients that are malnourished, total parental nutrition may be required. Surgical resection of the colon may be necessary for patients with unsuccessful therapy. Unfortunately, there is no cure for IBS, and its treatment is also individualized. Treatments for symptoms include the use of laxatives and fiber, antidiarrheal, antispasmodic, low-dose antidepressants. Patients with Crohn’s Disease who smoke can be encouraged to quit smoking because smoking increases the risk of developing a severe form of the disease and might result in poor response to treatment (Huether & McCance, 2017).

Behavior as an Impact on IBD and IBS

Examples of behavior that have an impact on the pathogenesis of both IBD and IBS include smoking, the use of oral contraceptive, living in an urban environment, perinatal or childhood exposure to infection and antibiotics and atypical mycobacterial infections (Quigley, 2016). Stress as also been reported to increase the severity of both diseases, especially chronic sustained stressors (Bengtsson, Sjoberg, Candamio, Lerman & Ohlsson, 2013). These writers furthered explained that anxiety and depression have been linked to a severe manifestation of IBD and IBS and shows an increasing number of mast cells.

References

Bengtsson, M., Sjoberg, K., Candamio, M., Lerman, A., & Ohlsson, B. (2013). Anxiety in close relationships is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease. European Journal of Internal Medicine, 24(3), 266-272.

Blagden, S., Kingstone, T., Soundy, A., Lee, R., Singh, S., & Roberts, L. (n.d). A Comparative Study of Quality of Life in Persons with Irritable Bowel Syndrome and Inflammatory Bowel Disease. Gastroenterology Nursing, 38(4), 268-278

Casey, G. (2017). Inflammatory bowel disease. Kai Tiaki Nursing New Zealand, 23(2), 20-26.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Quigley, E. M. (2016). Overlapping irritable bowel syndrome and inflammatory bowel disease: less to this than meets the eye?. Therapeutic Advances In Gastroenterology, 9(2), 199-212. doi:10.1177/1756283X1562123

Financial Statement Restatement and Ethics

Type of document Essay

3 Pages Double Spaced

Subject area Accounting

Academic Level Master

Style APA

References 3

Order description:

Assignment 1: Financial Statement Restatement and Ethics

Due Week 3 and worth 200 points

Search the Internet or Strayer databases for a company that recently restated its earnings. Based on the company researched and identified:

Write a two to three (2-3) page paper in which you:

Assess the factors that contributed to the financial statement restatement, signifying the executive management team’s attitude toward the restatement. Suggest how the restatement may have been avoided during the initial reporting process.

Explain the impact to the company’s stock price when the restatement was released and to future earnings forecast, indicating whether or not you believe the impact to the stock price was justified.

Evaluate the restatement in terms of management’s ethical violations according to the requirements of the Sarbanes-Oxley Act, providing recommendations to management on how to avoid these problems in the future. Provide support for your recommendations.

Use at least two (2) quality academic resources in this assignment. Note: Wikipedia and other Websites do not quality as academic resources.

NURS-6501-15: Advanced Pathophysiology – Inflammatory Bowel Disease – Advanced Pathoophysiology response 1

Type of document Essay

1 Page Double Spaced

Subject area Nursing

Academic Level Master

Style APA

References 3

Order description:

Please respond to post Offer alternative common treatments for the disorders.

Share insight on how the factor you selected impacts the treatment of alterations of digestive function also use the some of the following readings and resources as references

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Chapter 35, “Structure and Function of the Digestive System”

This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.

Chapter 36, “Alterations of Digestive Function”

Chapter 37, “Alterations of Digestive Function in Children”

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Chapter 13, “Gastrointestinal Disease”

Chapter 14, “Liver Disease”

Chapter 15, “Disorders of the Exocrine Pancreas”

Required Media

Laureate Education, Inc. (Executive Producer). (2012c). The gastrointestinal system. Baltimore, MD: Author.

This media presentation outlines the pathophysiology of the gastrointestinal system and associated alterations.

Optional Resources

American Liver Foundation (2016). Retrieved from http://www.liverfoundation.org/

National Digestive Diseases Information Clearinghouse. (2016). Retrieved from http://digestive.niddk.nih.gov/index.aspx

This is traceys post to respond to

Tracey Rusnak

WK 8 Discussion

COLLAPSE

NURS-6501-15: Advanced Pathophysiology – Inflammatory Bowel Disease

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is an umbrella term used to describe diseases associated with a chronic inflammation of the intestines (Drugs.com, 2012). Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic relapsing disorders thought to be caused by susceptibility genes, environmental factors, alterations in epithelial cell barrier functions, or an altered immune response to intestinal micro-flora (Huether & McCance, 2017). When an environmental factor or infectious agent alters the barrier function of the mucosal epithelium it leads to a loss of immune tolerance to normal intestinal antigens. Dendric cells become activated and trigger the production of proinflammatory cytokines and chemokines. UC begins in the rectum and may extend proximally to the entire colon (Huether & McCance, 2017). The mucosa becomes hyperemic with a dark red and velvety appearance. Small erosions lead to ulcers, abscess formation, and necrosis of the mucosa. This destruction of the mucosa and inflammation is responsible for the bleeding, cramping pain, urge to defecate, and frequent diarrhea associated with UC. CD can be difficult to differentiate from UC. CD can occur anywhere in the colon but the most common sites are the ascending and transverse colon. Projections of inflamed tissue surrounded by ulcerations give CD a cobblestone appearance (Huether & McCance, 2017). Symptoms of CD are similar to UC and depend on the location and severity of the inflammation. Clinical manifestations of IBD include diarrhea, weight loss, anemia, fatigue, abdominal cramping, and bloody stools (National Digestive Diseases Information Clearinghouse, 2016).

Irritable Bowel Syndrome

According to Hammer & McPhee (2014), irritable bowel syndrome (IBS) is characterized by altered bowel habits and abdominal pain in the absence of any detectable organic pathological process or structural abnormalities. An alteration between diarrhea and constipation are the characteristics of IBS. The cause of IBS is thought to be a dysfunction of how the brain and the intestines work together. The intestines can become more sensitive (visceral hyperalgesia) and change how the muscles in your bowel contract (peristaltic contractions) which leads to diarrhea, constipation, or both. The most common symptoms of IBS are abdominal pain, diarrhea, constipation, bloating, whitish mucus in the stool, and a feeling of incomplete defecation (National Digestive Diseases Information Clearinghouse, 2016).

Treatment

Treatment for IBD involves promoting mucosal healing and reducing the inflammation. Pharmacological treatment includes corticosteroids, aminosalicylates, immunosuppressive agents, antibiotics, and biological agents. The type of pharmacological agent used is dependent on the presence of UC or CD, the severity of disease, and whether the treatment is targeted at active disease or maintenance of remission. Surgical resection of the colon may be required if other forms of therapy are unsuccessful (Arcangelo, Peterson, Wilbur, & Reinhold, 2017).

Treatment for IBS aims at treating the symptoms. Therapies include laxatives, fiber, antidiarrheals, antispasmodics, prosecretory drugs, low-dose antidepressants, visceral analgesics, and serotonin agonists and antagonists (Huether & McCance, 2017). No specific diet works for all patients so an individualized adjustment of foods is recommended to control symptoms (Drugs.com, 2018). Other therapies include stress reduction, avoidance of caffeine, prebiotics and probiotics, exercise, or cognitive-behavioral therapy (Huether & McCance, 2017).

Behaviors: Diet & Stress

Dietary changes can help reduce symptoms of IBD and IBS. Dietary recommendations include avoiding carbonated drinks, increasing fluid intake, and eating small frequent meals. A high fiber diet is advised for the treatment of IBS; however, popcorn, vegetable skins, and high-fiber foods should be avoided while symptoms of IBD are present. Keeping a food diary for both disorders is recommended to help identify troublesome foods (National Digestive Diseases Information Clearinghouse, 2016). Lastly, avoiding stress through exercise and behavior health therapies can help reduce symptoms and decrease exacerbations.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017).

Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA:

Lippincott Williams & Wilkins.

Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis,

MO: Mosby.

National Digestive Diseases Information Clearinghouse. (2016). Retrieved from http://digestive.niddk.nih.gov/index.aspx

Interviewing a Master’s or Doctoral-Prepared Nurse

Type of document Essay

2 Pages Double Spaced

Subject area Nursing

Academic Level Undergraduate

Style APA

References 1

Order description:

NS310 Professional Issues in Nursing

Directions: Be sure to make an electronic copy of your answer before submitting it to Ashworth College for grading. Unless otherwise stated, answer in complete sentences, and be sure to use correct English spelling and grammar. Sources must be cited in APA format. Refer to the “Assignment Format” page for specific format requirements.

Interviewing a Master’s or Doctoral-Prepared Nurse

Objectives

Determine educational program characteristics to consider when choosing a program

Assignment Overview

In this assignment, you will interview a master’s or doctoral-prepared nurse about the decision to pursue a graduate degree and career path.

Deliverables

A two-page (500-word) paper

Step 1

Choose a nurse with a master’s or doctoral degree to interview.

The nurse you choose can be an advanced practice registered nurse or can have a graduate degree in a specialty area in nursing or another field. The nurse must hold a position in health care.

Interview the nurse.

Questions to ask during your interview include:

What degrees do you have in nursing and in other fields?
What is your current position?

iii. What are the educational requirements for your position?

What program characteristics did you consider when researching possible graduate programs?
What graduate degrees did you consider?
What influenced your decision to obtain the graduate degree you did?

vii. Are you considering further education? If so, what degrees are you considering and why?

a grading rubric is also uploaded.

Assignment 08

NS310 Professional Issues in Nursing

Directions: Be sure to make an electronic copy of your answer before submitting it to Ashworth College for grading. Unless otherwise stated, answer in complete sentences, and be sure to use correct English spelling and grammar. Sources must be cited in APA format. Refer to the “Assignment Format” page for specific format requirements.

Interviewing a Master’s or Doctoral-Prepared Nurse

Objectives

Determine educational program characteristics to consider when choosing a program

Assignment Overview

In this assignment, you will interview a master’s or doctoral-prepared nurse about the decision to pursue a graduate degree and career path.

Deliverables

A two-page (500-word) paper

Step 1

Choose a nurse with a master’s or doctoral degree to interview.

The nurse you choose can be an advanced practice registered nurse or can have a graduate degree in a specialty area in nursing or another field. The nurse must hold a position in health care.

Interview the nurse.

Questions to ask during your interview include:

What degrees do you have in nursing and in other fields?
What is your current position?

What are the educational requirements for your position?

What program characteristics did you consider when researching possible graduate programs?
What graduate degrees did you consider?
What influenced your decision to obtain the graduate degree you did?

Are you considering further education? If so, what degrees are you considering and why?

Grading Rubric

Please refer to the rubric below for the grading criteria for this assignment.

Points Awarded x Multiplier=
Total Points

CRITERIA

Excellent (4)

Good (3)

Fair (2)

Poor (1)

Not Demonstrated (0)

Weighting

Points Awarded

(0-4)

Multiplier

Total Points

content

*Clear language

*Information is accurate and thorough

*Sufficient and accurate supporting information

* Main idea is clearly stated

*Language used is mostly clear

*Information is accurate and fairly thorough

*Sufficient and accurate supporting information

* Main idea is clearly stated

*Language used is not very clear

*Information is inaccurate or not thorough

*Supporting information is insufficient but mostly accurate

* Main idea is not clearly stated

*There are many issues with language usage

*Information is inaccurate or not thorough

*Supporting information is insufficient or inaccurate

* Main idea is not clearly stated

*The assignment was not completed

*The assignment is poorly written, and the information used is inaccurate and insufficient

* There is no attempt to address main idea

*The language used was inappropriate

50%

_____

12.5

= _____

organization

* Well-organized; appropriate flow

* No citation errors

* Appropriate length

* No format errors

* Good organization and flow

* Few citation errors

* Appropriate length

* Few format errors

* There are issues with the organization and flow

* There are a few citation errors

* The length is not appropriate

* There are a few format errors

* There are issues with the organization and flow

* There are many citation errors

* The length is not appropriate

* There are many format errors

* The assignment was not completed

*The assignment is not organized in any way; formatting is incorrect

* Proper citations were not used

30%

_____

7.5

mechanics

No spelling, grammar, or punctuation errors

Spelling, grammar, or punctuation are mostly error-free

A few spelling, grammar, or punctuation errors

Many spelling, grammar, or punctuation errors

*The assignment was not completed

*The assignment is full of spelling, grammar, or punctuation errors

20%

_____

100%

Total Points

(out of 100)

National Infrastructure Protection Plan

Type of document Case Study

3 Pages Double Spaced

Subject area Case Study

Academic Level Master

Style APA

References 4

Order description:

please follow the rubric ,

and must be professional memo

Thank you ,

On your first day as an Information Systems Security director, you met with the Chief Information Officer. During the meeting, he revealed to you his deep concerns about the Infrastructure Protection Plan. He asked you to read the Department of Homeland Security. (2009). National Infrastructure Protection Plan. Retrieved from http://www.dhs.gov/xlibrary/assets/NIPP_Plan.pdf carefully and focus more on chapter 6: Ensuring an Effective, Efficient Program Over the Long Term.

Since he realizes that you are new to this position he asked you to deliver the final plan, memo and budget in 7 weeks (week 8) but he setup 3 checkpoints for you to deliver parts of the plan to ensure consistent progress of the deliverables before the big presentation in week 8.

Phase 1: Memo – due in week 3

In this phase, you need to create 3-5 page professional memo about your assessment of what needs to be done to meet the standards based on the National Infrastructure Protection Plan. You need to make sure that the language in the memo is clear of free of errors. You also need to be creative in presenting this information to capture the most important points from the National Infrastructure Protection Plan. You need to demonstrate critical thinking to prioritize the action items based on your findings.

Requirements for the Corporate Computing Function

Type of document Proofreading

3 Pages Double Spaced

Subject area Case Study

Academic Level Master

Style APA

References 4

Order description:

please follow the rubricAssignment 2: Requirements for the Corporate Computing Function

Your new corporate CIO has devised a nine-point mission statement for the company. As one of the operations managers in the department, you have received a memo on the new policy and an associated task. The CIO wants to address the new strategy in a three-phase rollout plan and wants your feedback on LAN and MAN technology. Refer to Table 3.1 in Chapter 3 of the textbook for the nine points of the mission statement.

Write a three to four (3-4) page paper in which you:

From Table 3.1, speculate why the fifth point, “Meet information requirements of management”, is in the CIO’s list of nine (9) points.
Imagine only three (3) points are to be rolled out in the first phase. Evaluate each point to determine the most important three (3) for the initial rollout phase.
Recommend one (1) additional point the CIO should include in order to ensure the topic of securityis addressed in the mission statement. Explain your rationale for the inclusion.
Use at least four (4) quality resources in this assignment. Note:Wikipedia and similar Websites do not qualify as quality resources.

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required page length.

The specific course learning outcomes associated with this assignment are:

Describe the needs of communication networks in a business environment.
Use technology and information resources to research issues in communication networks.
Write clearly and concisely about communication networks using proper writing mechanics and technical style conventions.