This case study involves a 53-year-old African American man who presents with elevated blood pressure. Key findings include a loud S2, sustained PMI at the 5th intercostal space, and an S4 gallop. Additional tests show LVH by voltage on EKG and prediabetes based on fasting blood glucose and A1C. The summaries address the patient's diagnoses of hypertension and prediabetes, pharmacologic treatment plan starting ACE inhibitors/ARBs and metformin, and lifestyle modifications recommended.
New class of therapeutic agents called soluble guanylate cyclase (sGC) stimulators.
Impairment of NO synthesis and signaling through the NO-sGC–cGMP pathway is involved in the pathogenesis of pulmonary hypertension.
Dual mode of action,
Directly stimulating sGC independently of NO, and
Increasing the sensitivity of sGC to NO.
vasorelaxation , antiproliferative and antifibrotic effects
Naturopathic Treatmentfor the Prevention ofCardiovascular Disease: A Randomized Pragmatic TrialCCNM – Journal Club Sept 30th, 2010Dugald Seely, ND, MScDirector; Research & Clinical EpidemiologyThe Canadian College of Naturopathic Medicine
Effect of hydrocortisone on development of shock amongDr fakhir Raza
effects of hydrocortisone on development of shock among patients with severe sepsis the HYPRESS Randomized Clinical Trial American Medical Association caring for the critically ill patients Surviving sepsis campaign, to determine weather hydrocortisone therapy in patients with severe sepsis prevents the development of septic shock
New class of therapeutic agents called soluble guanylate cyclase (sGC) stimulators.
Impairment of NO synthesis and signaling through the NO-sGC–cGMP pathway is involved in the pathogenesis of pulmonary hypertension.
Dual mode of action,
Directly stimulating sGC independently of NO, and
Increasing the sensitivity of sGC to NO.
vasorelaxation , antiproliferative and antifibrotic effects
Naturopathic Treatmentfor the Prevention ofCardiovascular Disease: A Randomized Pragmatic TrialCCNM – Journal Club Sept 30th, 2010Dugald Seely, ND, MScDirector; Research & Clinical EpidemiologyThe Canadian College of Naturopathic Medicine
Effect of hydrocortisone on development of shock amongDr fakhir Raza
effects of hydrocortisone on development of shock among patients with severe sepsis the HYPRESS Randomized Clinical Trial American Medical Association caring for the critically ill patients Surviving sepsis campaign, to determine weather hydrocortisone therapy in patients with severe sepsis prevents the development of septic shock
Running Head Homework 2 Homework 2 Homework 2.docxwlynn1
Running Head: Homework 2
Homework 2
Homework 2
Care plan for MI
NUR3125
Fall 2017
This patient is presenting to the emergency with symptoms that indicate a Myocardial Infarction. The patient, who is a 48-year-old man, is stating a 3-day history of sub sternal chest pain that is radiating to his back. The symptoms started up while he was mowing his lawn. He stated the pain has eased up over time. He also reported mild trouble with breathing and some nausea but no vomiting. He exercises daily, but does report that he eats a lot of fast food. His last total cholesterol was 232 mg/dL. He also has a 15-year history of tobacco use and family history of myocardial infarction (MI), specifically his father had an MI at age 54 and his grandfather at age 58. His current blood pressure is elevated at 158/98 and heartrate of 102 bpm, his respiratory rate is currently high at 26 breaths/min and noted mild use of accessory muscles upon examination. Lungs are noted to have slight inspiratory crackles at both lung bases. Jugular venous distention is noted at less than 2cm bilaterally. His lab work reveals an elevated Troponin at 2.9 ng/ml, elevated Creatinine phosphokinase at 141 units/L, and an elevated CK-MB/CK isoenzyme at 2%. Elevated troponin indicates damage to the heart muscle, and the elevated Creatinine phosphokinase and CK-MB/CK isoenzyme along with all these other symptoms and labs indicate a heart attack. ECG is done and shows ST elevation and T wave inversion, also noted with premature ventricular contractions. The lab values and ST elevation point to a Myocardial Infarction and Transmural ischemia that will require immediate attention.
I have chosen three NANDA nursing diagnoses for this patient, with the first one being the priority. The three I choose are:
· Decreased Cardiac Output related to altered heart rate and ischemia as evidenced by ECG showing an ST elevation, elevated Troponin, and patient stating he has had chest pain for three days.
· Acute Pain related to tissue damage in the myocardium from inadequate blood supply as evidenced by elevated troponin labs and patient reporting chest pain that radiates to back for three days.
· Ineffective Health Maintenance related to deficient knowledge about self-care and treatment as evidenced by patient stating he eats fast food often and has had elevated blood pressure and cholesterol at past appointments, and patient admitting to smoking ½ pack of cigarettes daily despite family history of MI.
Care Plan Diagnosis #1 Myocardial Infarction
NANDA Diagnosis 1: Decreased Cardiac Output related to altered heart rate and ischemia as evidenced by ECG showing an ST elevation, elevated Troponin, and patient stating he has had chest pain for three days.
NOC (Nursing Outcome Classification) Label: Tissue Perfusion
Expected Client Outcomes:
1. Patient will demonstrate adequate cardiac output evidenced by blood pressure, heart rate, and heart rhythm within normal pa.
Case Study, Chapter 34, Management of Patients With Hematologic Neop.docxdrennanmicah
Case Study, Chapter 34, Management of Patients With Hematologic Neoplasms
1. John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5)
a. What nursing management should the nurse provide the patient?
Explain the indication and action of the various medications ordered to treat the patient’s symptoms.
2. Susan Clare, age 38, is admitted to the medical oncology unit with acute myeloid leukemia (AML). She has many areas of ecchymosis and petechiae on her skin, as well as generalized pallor. She states she has lost 15 pounds in the last 2 months, and often has a low-grade fever. On physical assessment, you find her liver and spleen to be enlarged on palpation. (Learning Objective 3)
a. What laboratory results would you anticipate due to her ecchymosis and petechia?
Why would it be important to inspect her gums and teeth?
a. Why is her liver enlarged?
Case Study, Chapter 37, Management of Patients With HIV Infection and AIDS
1. The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center. (Learning Objectives 1 and 4)
a. What should the nurse include in the session considering the needs of the older population?
2. Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a pregnancy visit. The physician informs the patient that her HIV screen test is positive. The patient has no evidence of AIDS. The nurse provides patient education regarding what HIV is and what the clinical management entails. (Learning Objective 5)
a. What clinical management is recommended for the patient during the pregnancy to help decrease the risk of transmitting HIV to the unborn child?
The patient asks the nurse how zidovudine (Retrovir) will help her unborn child from getting HIV. How should the nurse respond?
What explanation about Retrovir should the nurse provide?
The patient asks the nurse if it will be safe to breast-feed her infant after the delivery. The nurse should provide what explanation?
a. The patient asks the nurse what testing schedule for the HIV antibody is needed after her baby is born. How should the nurse respond?
Case Study, Chapter 31, Assessment and Management of Patients With Hypertension
1. Joan Smith, 55 years of age, is a female patient who presents to the intensive care unit with the diagnosis of intracranial hemorrhage. The patient stopped taking her antihypertensives suddenly because of the cost of .
Chapter 19 Nursing Management of Pregnancy at Risk PregnancyMorganLudwig40
Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy-Related Complications
Case 1
Teresa is a 36-year-old primigravida who is expecting twins. She is 26 weeks pregnant. She stays after your “What to Expect with Twins” class to talk to you. Although Teresa is a nurse, she has many questions and concerns. Her twins are a result of years of trying to get pregnant and in vitro fertilization. She is nervous about whether she will have a vaginal delivery or a cesarean section. She is worried about having the babies prematurely. She wants you to tell her everything that could go wrong so she can be prepared
1. Why is Teresa’s pregnancy considered a high-risk pregnancy
Incorrect answer.
Teresa’s pregnancy is considered high risk pregnancy because most of IVF pregnancies require induced labor or caesarean section.
Also, most babies conceived through IVF are born prematurely or with a low birth weight. Incorrect.. there is a higher incidence of preterm birth due to multiple gestation, IVF itself does not increase the risk factor
IVF increases the risk of Down syndrome as well. Incorrect as IVF allows for early genetic testing.
2. Discuss potential pregnancy-related complications for Teresa.
What else?
Some of the potential pregnancy –related complications for Teresa are late miscarriage, She is 26 weeks pregnant.. this is no longer a complication.
ovarian hyper stimulation syndrome, She is 26 weeks pregnant.. this is no longer a complication.
This is for IVF not the pregnancy
high blood pressure, pre-eclampsia, premature delivery, low birth weight,
birth defects, Fetal not maternal
and stress.
3. Discuss the potential risks to the babies.
You only discuss problems of prematurity.. what else?
The babies are at a higher risk of being born with breathing problems because mostly twins who are conceived through in vitro fertilization are born prematurely and therefore it means that their respiratory system and organs like lungs are not fully developed. They are also at risk of jaundice or sepsis.
Case 2
Sarah is 19-year-old G1P0 at 36 weeks' gestation. Sarah has been followed weekly in the clinic for mild–moderate preeclampsia. At her clinic appointment today, Sarah’s blood pressure reading was 188/104. She is admitted to the antepartum unit for management of her worsening preeclampsia. You perform her admission assessment and note that her reflexes are brisk, her heart rate is 94, she complains of having an intense headache, and is seeing spots before her eyes. You perform an abdominal assessment and note that she has significant epigastric tenderness. (Learning Objective 5)
1. Develop a plan of care for the woman experiencing preeclampsia, eclampsia, and HELLP syndrome.
this is a definition not a care plan
The best way to treat Sarah for preeclampsia is to deliver the baby because at 36 weeks’ gestation, the baby is full grown and it will be safer to deliver the baby and avoid further complications. In some cases, this c ...
After reviewing the Coleman (2016) article on executive compensation.docxAMMY30
After reviewing the Coleman (2016) article on executive compensation and reading this week's assigned readings, choose one of two statements below and construct an argument supporting your position:
The market trend towards escalating executive compensation reflects the critical importance of an executive to an organization’s long-term viability.
The growing compensation inequity between executive management and the average employee threatens to destabilize organizational morale and societal justice.
.
After reviewing the chapter on Recognizing Contributions, perform .docxAMMY30
**After reviewing the chapter on Recognizing Contributions, perform a self reflection and evaluate how well you recognize the contributions of your staff. For the assignment, develop an action plan for the next 12 months to improve your recognition efforts.
***Please write about and share what you gained.***
**Reflection paper and action plan (12 months) is the assignment requirement.
Textbook Reference
Kouzes, J. & Posner, B. (2012). The leadership challenge : how to make extraordinary things happen in organizations. San Francisco, CA: Jossey-Bass.
.
After reviewing the chapter on Recognizing Contributions, perform a .docxAMMY30
After reviewing the chapter on Recognizing Contributions, perform a self reflection and evaluate how well you recognize the contributions of your staff. For the assignment, develop an action plan for the next 12 months to improve your recognition efforts.
***Please reply when you are finished with this self-reflection and share what you gained.*** 2 page
Textbook Reference
Kouzes, J. & Posner, B. (2012). The leadership challenge : how to make extraordinary things happen in organizations. San Francisco, CA: Jossey-Bass.
.
After reviewing the background materials and doing your own research.docxAMMY30
After reviewing the background materials and doing your own research, discuss the value in looking at other countries’ policy successes and failures. How can it be beneficial to health policy development in our own country?
Be sure to support your answer with citations from reliable sources.
.
After reviewing the articles and videos, please address the followin.docxAMMY30
After reviewing the articles and videos, please address the following questions:
https://hbr.org/2016/05/different-cultures-see-deadlines-differently
https://hbr.org/video/2363497345001/reaching-across-cultures-without-losing-yourself
https://www.youtube.com/watch?v=4DSV1NUGS3o
1. How do you define cultural communication?
2. Do you agree with the concepts presented by Molinsky as he reviews the importance of global dexterity? Why or why not?
3. In your organization, what ideas regarding cultural communication do you think are important? How will you apply them as a leader?
Please reference a minimum of three external sources to support our points.
.
After reviewing Georgia v. Randolph and Fernandez v. Californi.docxAMMY30
After reviewing
Georgia v. Randolph
and
Fernandez v. California
, answer the following questions:
What defenses, if any, were asserted in these cases?
How did these cases impact law enforcement and prosecutors?
Do you agree with the U.S. Supreme Court’s decisions?
Were these decisions consistent with each other? How does consistency in legal decisions positively and negatively impact law-enforcement officers and attorneys?
.
After reviewing chapter 11 of the E-Text and the Required Resources .docxAMMY30
After reviewing chapter 11 of the E-Text and the Required Resources please discuss the following:
Discuss the challenges that law enforcement faces when seizing digital evidence and propose at least two solutions.
Discuss the five-paragraph SMEAC that should ideally find a place in any investigation plan. Which one of these do you feel is the most important? Why?
.
After reading Library ArticlesDevine, K., Kloppenborg, .docxAMMY30
After reading
Library Articles:
Devine, K., Kloppenborg, T. J., & O’Clock, P. (2010). Project measurement and success.
Journal of Health Care Finance,
38–50.
Sandrik, K. M. (2008). Navigating today's opportunities for capital.
Healthcare Financial Management, 62
(12), 78–83.
Schuhmann, T. M. (2009). Hospital capital spending: Shifting and slowing even before the financial meltdown.
Healthcare Financial Management, 63
(11), 92–102.
Answer the following:
Investment Decisions
What types of decisions would need to be made before the investment is made? Indicate the main kinds of information/data needed to evaluate this capital investment project.
.
After reading Trifles by Susan Glaspell complete the following works.docxAMMY30
After reading Trifles by Susan Glaspell complete the following worksheet:
“Trifles” Worksheet
Name: ___________________ Period ____
1. Title Implications: Explain what the word “trifles” literally means. ____________________________________________________________________ 2. Symbolic Setting.
A. Outside: What is the weather? ________________
Specifically, where is the murder site/ farmhouse located? ________________
B. Inside the house:
List two things that let the audience “feel” how literally cold it is: ____________________________________________________________________
3. List three significant details that are evidence of a poorly kept kitchen: ___________ ____________________________________________________________________
4. Thumbnail Sketch: Make a comment about each of the characters
A. Attorney Henderson_________________________________________________ B. Sheriff Peters ______________________________________________________ C. Mr. Hale __________________________________________________________ D. Mrs. Peters ________________________________________________________ E. Mrs. Hale _________________________________________________________
5. List two “put down” comments the men make against women: __________________ ____________________________________________________________________ ____________________________________________________________________
6. What evidence is there to suggest that John Wright was a hard man to live with ? ________________________________________________________________
7. Why hadn’t Mrs. Hale gone to see Minnie Wright in over a year? _______________ _____________________________________________________________________
8. Why does Mrs. Peters not like the phrase “married to the law”? _________________ ____________________________________________________________________
9. Why do the women hide the dead bird? ____________________________________
_____________________________________________________________________
10. What other action might they have taken?___________________________________
_____________________________________________________________________
How is each of these important?
A. John Wright’s decision not to pay for a party [shared] telephone line
B. Bird cage with broken door
C. Dead bird with its neck rung
D. Millie sang in the choir thirty years before
E. The quilt pieces
(The Log Cabin quilt pattern has been a favorite because it was a wonderful & frugal pattern for using up fabric scraps. In many of the old quilts the center square was red to symbolize the hearth of the home, its symbolic heart. The overall effect of the log cabin quilt is achieved by the use of light and dark fabrics and how they are arranged.)
.
After reading through Chapter 1, the focus was on targeting the five.docxAMMY30
After reading through Chapter 1, the focus was on targeting the five communities that make up the core field for ICT-enabled policy-making. Please answer the following question.
What are those five communities involved,
Provide a brief narrative for each community above to support your response
.
After reading There Is No Unmarked Woman, by Deborah Tannen, a.docxAMMY30
After reading "There Is No Unmarked Woman," by Deborah Tannen, answer the following question in a response 200 words long:
What is Tannen's strongest argument, or her strongest point, to support her thesis that women are unfairly scrutinized in society? Do you agree with her overall? Have things changed since she wrote this article in 1993?
.
After reading the U.S. Constitution and the Amendments respond t.docxAMMY30
After reading the U.S. Constitution and the Amendments respond to the following questions:
(i) What is the institutional power and the personal right you believe to be the most important, and explain why;
(ii) What is the institutional power and the personal right you would remove, and explain why;
(iii) What institutional power and personal right would you add to the U.S.
An institutional power is one that authorizes or limits action and/or organization of one of the three branches of government. Examples include the power of the legislative branch "to lay and collect taxes" (Art. I) or to not "make no law respecting an establishment of religion." (First Amendment)
A personal right is one that protects or empowers the people, such as "the right of the people to keep and bear arms." (Second Amendment)
Suggested length is 3-5 pages
Your points will be allocated on the following criteria:
Offering creative and/or critical opinions;
Expressing yourself clearly and concisely;
Forming logical arguments and conclusions;
Identifying and discussing counter-arguments;
Grammar and compliance with APA (6th edition).
.
After reading the two short primary source documents listed below, c.docxAMMY30
After reading the two short primary source documents listed below, construct an essay based on the following question:
How and why did black people use the language of the American Revolution—of natural rights—in freedom petitions to argue for their freedom and the abolition of slavery?
Your essay should be based on your reading and analysis of the primary source documents. Your paper should be 2 to 3 pages in length and use double-spacing and 12 point font. Please use MLA style.
.
After reading the section titled Dominant Microprocessor Company In.docxAMMY30
After reading the section titled “Dominant Microprocessor Company Intel Adapts to Next Trend” (Chapter 11 pg. 384-385) and the article titled “2018-2019 Intel Corporate Responsibility Report: Creating Value through Transparency,” complete a list of reasons how a single firm like Intel comes to dominate some markets.
Submission Details:
Response should be no less than 250 words
Follow the APA style of writing with in-text citations and a reference list.
.
After reading the section titled Dominant Microprocessor Compan.docxAMMY30
After reading the section titled “Dominant Microprocessor Company Intel Adapts to Next Trend” (Chapter 11 pg. 384-385) and the article titled “2018-2019 Intel Corporate Responsibility Report: Creating Value through Transparency,” complete a list of reasons how a single firm like Intel comes to dominate some markets.
Submission Details:
Response should be no less than 250 words
Follow the APA style of writing with in-text citations and a reference list.
.
After reading the paper for this week, Steinfield C, LaRose R, C.docxAMMY30
After reading the paper for this week, Steinfield C, LaRose R, Chew H, Tong S. Small and Medium-Sized Enterprises in Rural Business Clusters: The Relation Between ICT Adoption and Benefits Derived From Cluster Membership. Information Society. 2012;28(2):110-120. doi:10.1080/01972243.2012.651004, please answer the following questions in a 2-page main body APA formatted document. Please make sure that there is a title and references page. All references listed need to be cited in the document.
What kind of study is this? (Hint: the videos you watched)
Please make sure that you address the type of study and why you think this was used in this paper.
How is this paper related to the topics in this course?
Do you agree with the author’s conclusions?
.
After reading the Martin Luther King, Jr. speech in the attached lin.docxAMMY30
After reading the Martin Luther King, Jr. speech in the attached link, please write a 1-2 page response which addresses the following task: Summarize the excerpts from Martin Luther King, Jr.’s 1961 address defending the student sit-ins. Then, in your opinion, discuss the three main points made in Martin Luther King, Jr.’s address. Please explain your opinion in detail.
.
After reading the material from Shafer-Landau concerning the appeal .docxAMMY30
After reading the material from Shafer-Landau concerning the appeal of hedonism and the potential objections to the theory, what is your considered view on hedonism? Is it true or false as a moral theory? Do the advantages of hedonism outweigh the difficulties raised against it, or are the objections to hedonism fatal to the theory?
.
After reading the IMAA article this week on Effective Manageme.docxAMMY30
After reading the IMAA article this week on
Effective Management of Change during Mergers and Acquisition
, review the case study noted within the article on item 7. It is about a merger between AOL and Time Warner in 2001. There is a chart listed with the summary that shows the cultural differences between the two companies. Review that chart.
Using this as an example, conduct some research and find two companies that similarly merged or that was acquired by another company. Write a two-page summary of the merger or acquisition to include:
1 – the reasons why it occurred and when it occurred
2 - the approximate size of each company before the merger
3 - the organizational challenges faced
4 - was the merger successful or not and
why
5 - the state of the company now
Then include a simple four column chart similar to the example and show at least five cultural elements of the companies, the cultural differences in the two companies before the merger took place and then in the fourth column include the culture now in the acquiring company. List at least five cultural elements in the chart.
Cultural Element / AOL culture / Time Warner culture / Culture adopted
Your written assignment should be no less than 700 words. Avoid using direct quotes. Use your own words. If you do use any direct quotes, increase the length of your paper accordingly. Use APA citations and ensure you document where you found your data in a separate reference listing.
.
After reading the essay, Why Rational People Buy into Conspiracy Th.docxAMMY30
After reading the essay, "Why Rational People Buy into Conspiracy Theories," answer the following questions. Provide specific details to justify your reasoning:
What is a conspiracy theory? Identify and discuss at least two recent conspiracy theories mentioned on the news, social media, and/or internet.
How does the Internet and other media help "perpetuate paranoia" (12)?
Why do you think "rational people buy into conspiracy theories"?
.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
2. Patient Background Information and Assessment
Case Study Question:
A 53-year-old African American man is in for follow up of
his elevated blood pressure. He was seen last week in your
office for a Department of Transportation commercial driver’s
examination where his blood pressure was 176/92. Subjective
questioning is negative. BP today is 174/94.
His physical exam is remarkable for a loud S2, sustained PMI at
5icslmcl, an S4 gallop is present. The remainder of his physical
exam is unremarkable.
Family history is remarkable for high blood pressure.
Self describes his lifestyle as pretty sedentary due to driving
long hours every day. Diet is often fast food with many cups of
coffee.
· EKG – NSR with LVH by voltage
· CBC – normal
· CBP – normal except for glucose 154 (fasting). Fingerstick
last week was 152
· A1C – 7.8
1. List five subjective questions. It would be very important to
know about this patient.
3. 2. Explain the significance of the loud S2 finding.
3. What does the finding of his PMI indicate?
4. Explain the significance of the PMI in the normal location.
5. Explain the significance of the S4 finding.
6. Explain the finding of LVH, given his current circumstances.
7. What additional diagnostics or testing (if any) you would like
to order?
8. What are the top two diagnoses you are going to address at
this time?
9. What is your pharmacologic plan for this man? Why did you
choose the agent you did? Be sure to state your rationale and
references.
10. Identify 5 lifestyle modifications to improve his health that
he could implement in his current situation.
S Question 2
O Question 1, 4
A Question 3
P Question 5, 6
Question 1 – Subjective Questions
The purpose of this paper is to review the patient’s chart and
answer the questions above. Below are the five subjective
essential questions I would ask the patient in order for me to
fully carry out my assessment and diagnoses of his conditions:
1. Do you have a family history of hypertension or diabetes?
Hypertension and diabetes tend to run in the family due to
different gene mutations (Gabb et al., 2016).
2. Do you currently take any medication for high blood
pressure, both prescribed and/or non-prescribed? (some patients
already have a diagnose of hypertension but do not follow their
treatment. Taking blood pressure medication inadequately could
create a rebound effect (Challa et al.,2020).
3. Do you experience any abnormality in your breathing? Do
you feel a pounding sensation with your pulses? Especially in
your neck vein? And have you been diagnosed with any
Coronary Artery Diseases in the past? This question is asked to
4. assess the adverse effect of his conditions that could potentially
make him a higher risk for other serious and urgent issues like
myocardial infarction, hypertensive retinopathy, and
cerebrovascular accidents; for example, the presence of
pheochromocytoma can increase the secretion of
catecholamines, which will lead to a higher level of blood
pressure (Hu et al., 2015)
4. What is your current diet plan like? (saturated food
consumption will increase blood pressure, and inadequate
consumption of sugar and coffee can raise the blood glucose
level in patients with diabetes.
5. Do you have any other stress factor in your life that could be
possibly affecting your health status both physically and
mentally?
It is crucial to accurately diagnose the patient. A nurse
practitioner cannot conduct a thorough assessment without
gathering historical data, especially from the patient
themselves. Those data, in addition to the clinician clinical
background, will allow the nurse practitioner to do a full and
accurate diagnose of their condition (Volpe et al., 2019)
Question 2 – Loud S2 Finding
The S2 sound is an auditory second heartbeat that tends to be
brief and has two basic elements. One of the elements is
characterized by the closure of the aortic valve observed as A2,
and the other elements is characterized by the closure of the
pulmonic valve (P2). S2 is also characterized as the closure of
the aortic valve to signify the pressure in the left side of the
patient’s heart. Therefore, a louder and lengthy S2 sounds can
signify a severe hypertensive state. Given the patient's objective
information, it is appropriate to suspect the loud S2 finding is
due to hypertension (Dornbush, Turnquest, 2019)
Question 3 – Point of Maximal Impulse (PMI Indication)
The point of maximal impulse is defined as the point where a
maximal impulse can be felt against the chest wall. Most
frequently, this is felt from the apex or at the tip of the heart. A
5. normal point of maximal can be normally located towards the
mid-clavicular point at intercostal space 5 (Aronow, 2017).
There should be no other impulses felt at the other location
apart from the apical region. The normal finding should be non-
sustained tapping, and it is normally not larger than 2-3cm in
diameter. On the other hand, Abnormal finding of PMI, which is
usually sustained and forceful outward movement is prolonged
throughout systole, would be an indication of a ventricle doing
pressure and harder work normally seen with left ventricular
hypertrophy or states of outflow block causing the heart to
pump harder, e.g., high blood pressure. Especially In this
scenario mentioned above. High pressure can affect the left
ventricle secondary to the increased workload, which will
eventually increase the size and thickness of the chamber. In the
given case study, the patient most likely had uncontrolled high
blood pressure, which prompted modifications at the pressure
and level of this heart. (Amin, Siddiqui,2019)
Question 4- PMI in the Normal Location
A normal point of maximal can be located towards the mid-
clavicular point at intercostal space 5. There should be no other
impulses felt at the other location apart from the apical region.
The normal finding should be non-sustained tapping, and it is
normally not larger than 2-3cm in diameter. About 75% of
people will have palpable PMI. Therefore, it is crucial to
determine if the patient has any displacements of this normal
impulse beat. Any abnormal location or displacement can be an
indication of a variety of heart conditions (Amin,
Siddiqui,2019)
Question 5- S4 significance Finding
The S4 heart sound (S4) is characterized as an abnormal delayed
or late diastolic sound caused by a forcible atrial contraction in
the occurrence of decreased ventricular compliance. S4 heart
sound occurs from the pumped blood thumping into the left
6. ventricle from the atria. S4 may signify diastolic heart failure
that happens when the left ventricular hypertrophy becomes
severe. Clinicians can notify the finding on the ECG located
between the P wave endpoint and the beginning of the Q wave.
According to (Gabb et al., 2016), When an S4 heart sound is
heard at the level of the left ventricle, this is due to systemic
hypertension, coronary artery pathology, or aortic stenosis.
(Liu, Wu, Ma,2018)
Question 6- Explanation of Left Ventricular Hypertrophy (LVH
Findings)
The LVH discoveries finding is an indication that the cardiac
muscles have thickened, causing hypertension in a person, as
seen in the patient above. LVH placed the patient at very high
risk for complicated issues like heart failure or high blood
pressure. The left ventricle is in direct contact with the systemic
circulation through the aorta. And because of that, the high
pressure eventually creates a resistance effect on the LV, whi ch
needs to increase its capacity in order to be able to sustain the
pump function of the heart. Condition like this is categorized to
be a compensatory mechanism usually seen in the case of
patients with prolonged high values of blood pressure.
(Aronow,2017)
Question 7-Additional Testing and Diagnostics
There are numerous testing that should be done on the patient
based on his condition; I would order various tests to monitor
and assess his pathologies condition, especially his
cardiovascular status, which could indicate that the patient has a
higher risk of complications.
These are the following testing’s I would initiate based on the
rationale attached to it:
· Echocardiography – is one of the accurate testings to
determine the patient's cardiovascular value and output,
especially of the left ventricle. The rationale for doing this
testing is to consider when the mass index of the ventricle is
over 125 g/m2 in men and over 110 g/m2 in women.
7. · Glycated hemoglobin (A1C) test. This lab work indicates the
patient’s average blood sugar level for the past three months.
The blood work measures the percentage of blood sugar in the
oxygen-carrying protein in red blood cells (hemoglobin). The
higher the patient’s blood sugar levels, the higher the
hemoglobin level. If the patient’s A1C level is higher on two
separate tests, that would indicate a sign of diabetes. Normal
AIC level is
· Lipid panel profile (which includes the LDL, HDL, VLDL,
and Triglycerides) - these blood work based on the results could
be indicative of various complications in a patient.
Complications like CAV, hypertension, and diabetes. In this
particular case, The cholesterol level could indicate the
possibility of the left ventricular thickening.
· Kidney Profile- of the patient which includes blood uric acid,
the blood urea nitrogen, and serum creatinine) – This testing
allows me to see if the patient's complication is affecting his
organs like the kidney.
· Eye examination - to assess the patient for hypertensive
retinopathy complications.
Question 8 – Top Two Diagnoses
My first main diagnoses for the patient would be type 2 level
Hypertension based on his two testings (his highest readings
was 176/92 mm Hg; the second reading was 174/94. The second
diagnosis would be pre- Diabetes based on the patient fasting
blood glucose level of 154 mg/dl. Normal blood glucose should
be under 125 mg/dl. On the other hand, his HbA1c is also higher
at a range of 7.8%, which indicates abnormal blood glucose, and
his blood sugar level is not controlled. A normal HbA1c should
be lower than 6%
Question 9 -Pharmacologic Plan for this condition
The pharmacologic plan will focus on the first and second
medication therapy to implement for the patients based on the
two diagnoses. The plan will start with the assessment question
specifically to see if the patient is on any maintenance
medication treatment and if the answer is yes. Therefore, I will
8. adjust either the current dosage, increased it, or change the
medication to another drug.
If the answer is no, then I will start the patient on a low dose of
blood pressure medication treatment as soon as possible. Based
on his assessment, the patient is at a higher risk of
cardiovascular complications. Lifestyle adjustments alone will
not be sufficient enough to control his pathology. There are
multiple medications to start the patient on based on research
evidence. Based on the information given and diagnoses, the
patient’s hypertension is categorized as level 2 grade
hypertension (systolic value between 160-179 mmHg or the
diastolic values between 100-109 mm HG). I will prescribe
angiotensin-converting enzyme (ACE) inhibitors or angiotensin
II receptor blockers (ARBs). These medications are the first line
of drug for patients with diabetes diagnoses who have elevated
blood pressures above 140/90 mm Hg (Hu, Han, Ge, Wu,2015).
I will look at metformin as the initial pharmacologic agent for
the treatment of his diabetes diagnosis.
Question 10- Lifestyle Modification
Patient education is important. Based on the patient's current
status and conditions, lifestyle modifications, in addition to the
appropriate medication, is important in reducing his risk for
cardiovascular complications. These are the lifestyle
modification given to the patient:
· The patient needs to exercise 2 to 3 times a week as tolerated
(30 minutes per day) and to maintain a healthy and sustainable
weight.
· The Patients need to reduce any saturated intake and eat
healthy foods.
· The patient needs to monitor his blood sugar daily. Supply,
teaching, and resources will be provided (Challa, Upaluri,2020)
· The patient needs to meal prep, especially because of his job
to be able to maintain a proper eating diet and habits.
· Patients need to limit the intake of sodium to a maximum 100
mmol/ day.
· Ensure that the patient is having an adequate intake of both
9. Mg and Ca. and potassium.
· Place the patient on a smoking patch and encourage him to
stop smoking.
· The patient needs to limit alcohol intake and also coffee
drinks.
· The Patient needs to drink a lot of fluids throughout the day to
prevent dehydration.
References
Gabb, G. M., Mangoni, A. A., Anderson, C. S., Cowley, D.,
Dowden, J. S., Golledge, J., & Schlaich, M. (2016). Guideline
for the diagnosis and management of hypertension in adults—
2016. Medical Journal of Australia, 205(2), 85-89.
Poulter, N. R., Dolan, E., Gupta, A. K., O’Brien, E.,
Whitehouse, A., & Sever, P. S. (2019). Efficacy and Safety of
Incremental Dosing of a New Single-Pill Formulation of
Perindopril and Amlodipine in the Management of
Hypertension. American Journal of Cardiovascular
Drugs, 19(3), 313-323.
Volpe, M., Gallo, G., Battistoni, A., & Tocci, G. (2019).
Highlights of ESC/ESH 2018 Guidelines on the management of
hypertension: What every doctor should know.
Dornbush S, Turnquest AE. (2019) Physiology, Heart Sounds.
In: StatPearls [Internet]. Treasure Island (FL):
StatPearls Publishing; Retrieved on October 17 from
https://www.ncbi.nlm.nih.gov/books/NBK541010/
Amin H, Siddiqui WJ. (2019) Cardiomegaly. ,In: StatPearls
[Internet]. Treasure Island (FL): StatPearls Publishing;
Retrieved on October 17 from:
10. https://www.ncbi.nlm.nih.gov/books/NBK542296/
Liu, Q., Wu, X., & Ma, X. (2018). An automatic segmentation
method for heart sounds—biomedical engineering online, 17(1),
106.
Aronow W. S. (2017). Hypertension and left ventricular
hypertrophy. Annals of translational medicine, 5(15), 310.
Hu, C. S., Han, Y. L., Ge, J. B., Wu, Q. H., Liu, Y. N., Ma, C.
S., Tkebuchava, T., & Hu, D. Y. (2015). A novel management
program for hypertension. Cardiovascular diagnosis and
therapy, 5(4), 316–322.
Challa HJ, Tadi P, Uppaluri KR. (2020) ,DASH Diet (Dietary
Approaches to Stop Hypertension) In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
Available from:
https://www.ncbi.nlm.nih.gov/books/NBK482514/
Unit IV (A)
QUESTION 1
A recent new hire has joined Fig Technologies. The individual
is of a cultural background that is perceived as very different
from the mainstream workplace environment. As a manager,
how would you integrate this individual into the organizational
culture and address any existing perceptions?
Your response must be at least 500 words in length.
11. QUESTION 2
Fig Technologies has acquired a network services firm that has
several Native American workers. The events team in the local
office is putting together the calendar of events for the next
year. How do you educate, inform, and assimilate Native
American culture and traditions into a self-described White
Anglo-Saxon Protestant workplace environment?
Your response must be at least 500 words in length.