Learning Objectives Covered
1. Explain Respiratory Failure and the two types of respiratory failure: hypoxemic and hypercapnic respiratory failure
2. List and describe the indications and objectives for ventilator support
3. Explain the advantages and disadvantages of volume and pressure ventilation>
Background
Mechanical Ventilation is indicated to assist the patient who cannot maintain adequate oxygenation, alveolar ventilation or lacks the ability to protect his or her own airway.The inability of a patient to maintain either the normal delivery of oxygen to the tissues or the normal removal of carbon dioxide from the tissues is referred to as acute respiratory failure. Though the three common indications for mechanical ventilation includes inability to maintain adequate oxygenation, inability to maintain adequate alveolar ventilation and/or inability to protect one’s own airway. There are more specific indications for mechanical ventilation and can be found in the table below.
Indications
Definition
Example
Apnea
Absence of breathing
Cardiac Arrest
Acute
Respiratory Failure (ARF)
Inability of a patient to maintain adequate: PaO2, PaCO2, and, potentially, pH.
Hypoxemic RF
Hypercapnic RF
Impending
Respiratory Failure
Respiratory failure is immi-nent in spite of therapies.
Commonly defined as: Pt is barely maintaining (or gradually deteriorating) normal blood gases but with significant WOB.
Neuromuscular
Disease (N-M)
Status Asthmaticus
Chronic
Respiratory Failure
Repeated failures after attempts to liberate from the ventilator (extubations, Trach Collar trials, etc.)
SEVERE:
Obesity Hypoventilation Syndrome
COPD
Pulmonary Fibrosis
Prophylactic
Ventilatory Support
Clinical indication = high risk of respiratory failure.
Ventilatory support is instituted to ↓ WOB,minimize O2consumption and hypoxemia, reduce cardiopulmonary stress, and/or control airway with sedation.
Brain injury
Heart muscle
Injury
Major surgery
Shock (prolonged)
Smoke injury
Trauma (some)
Hyperventilation Therapy
Ventilatory support is instituted to control and manipulate PaCO2 tor lower than normal level
Acute head injury
(↑ ICP)
(not immediately
after injury)
*respiratoryupdate.com
Respiratory failure can be acute or chronic and is classified as either hypoxemic or hypercapnic. During hypoxemic respiratory failure, the patient’s ventilatory demands exceed the lung's ability to provide blood oxygenation resulting in muscle fatigue. Hypoxemic respiratory failure is defined as a PaO2 below the predicted normal range for the patient’s age under ambient conditions. A normal PaO2 for a patient that is 60 years or younger on room air is 80-100mmHg. When a patient is hypoxemic their body naturally responds to the low PaO2by increasing respiratory rate and/or tidal volume (an increase in minute ventilation). An increase in minute ventilation leads to hyperventilation. During hyperventilation, a greater than normal amount of CO2 is exhaled resulting in a low PaCO2 (h ...
These slides represent how to manage patients on a mechanical ventilator? Easy understanding of using ventilators. indication of mechanical ventilator use. How to wean a patient from a mechanical ventilator? How to fine-tune the ventilator settings?
Mechanical Ventilation Cheat Book for Internal Medicine ResidentsThe Medical Post
This short cheat book talks about basic concepts and physiology of artificial ventilation and also elaborates on point guided approach in maneuvering different modes of mechanical ventilation. Consider this as a basic overview and is intended for all internal medicine residents.
These slides represent how to manage patients on a mechanical ventilator? Easy understanding of using ventilators. indication of mechanical ventilator use. How to wean a patient from a mechanical ventilator? How to fine-tune the ventilator settings?
Mechanical Ventilation Cheat Book for Internal Medicine ResidentsThe Medical Post
This short cheat book talks about basic concepts and physiology of artificial ventilation and also elaborates on point guided approach in maneuvering different modes of mechanical ventilation. Consider this as a basic overview and is intended for all internal medicine residents.
PART B Please response to these two original posts below. Wh.docxsmile790243
PART B
Please response to these two original posts below. When
responding to these posts, please either expand the
thought, add additional insights, or respectfully disagree
and explain why. Remember that we are after reasons
and arguments, and not simply the statement of
opinions.
Original Post 1
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
To begin, I would like to remind us that being intrinsically valuable
means having values for just being us and nothing else. I believe
that human lives are intrinsically valuable in virtue of our
uniqueness. As a bio nerd, I would like to state the fact that there
are a lot of crossover events during meiosis, which create trillions
of different DNA combinations. Hence, from a biological
standpoint, without considering other aspects, being you is
already valuable because you are that one sperm that won the
race and got fertilized. On a larger scale, there are hardly two
people whose look and behaviors are the same in the same
family, unless they are identical twins. However, identical twins
still act differently and have differences (such as fingerprints).
Since we are raised in different families, we are taught different
things and have different cultures. In general, we all have
different genetic information, appearances, personalities, senses
of humor, ambitions, talents, interests and life experiences. These
characteristics make up our “unique individual value” and make
us so unique and irreplaceable.
I would also love to discuss how our diversities enrich and
contribute to society, but that would be a talk about our extrinsic
values.
Original Post 2
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
I believe that human lives are intrinsically valuable due to a
number of reasons. Firstly, human lives aren’t replaceable. You
can’t replace a human being with another just like you can
replace a broken laptop with brand new one. Part of the reason
why we tend to think this way is that we were nurtured with the
notion that there is, indeed, a special value to human life. This
could be in virtue of our uniqueness-- the fact that we are
sentient and capable of complex thoughts and emotions
separates us from any other species on this planet. From a
scientific standpoint, this is also one of the reasons as to why
humans became the dominant species in today’s age.
Moreover, human lives aren’t disposable. I think this is largely due
to us humans having the ability to empathize with others. We
understand that it’s morally inappropriate to take the life of
another individual even if they’re complete strangers because
they’re another human being like us who has their own thoughts,
values, memories, and stories. In a way, we have a strong
emotional connection to our own species. As .
Part C Developing Your Design SolutionThe Production Cycle.docxsmile790243
Part C Developing Your Design
Solution
The Production Cycle
Within the four stages of the design workflow there are two distinct parts.
The first three stages, as presented in Part B of this book, were described
as ‘The Hidden Thinking’ stages, as they are concerned with undertaking
the crucial behind-the-scenes preparatory work. You may have completed
them in terms of working through the book’s contents, but in visualisation
projects they will continue to command your attention, even if that is
reduced to a background concern.
You have now reached the second distinct part of the workflow which
involves developing your design solution. This stage follows a production
cycle, commencing with rationalising design ideas and moving through to
the development of a final solution.
The term cycle is appropriate to describe this stage as there are many loops
of iteration as you evolve rapidly between conceptual, practical and
technical thinking. The inevitability of this iterative cycle is, in large part,
again due to the nature of this pursuit being more about optimisation rather
than an expectation of achieving that elusive notion of perfection. Trade-
offs, compromises, and restrictions are omnipresent as you juggle ambition
and necessary pragmatism.
How you undertake this stage will differ considerably depending on the
nature of your task. The creation of a relatively simple, single chart to be
slotted into a report probably will not require the same rigour of a formal
production cycle that the development of a vast interactive visualisation to
be used by the public would demand. This is merely an outline of the most
you will need to do – you should edit, adapt and participate the steps to fit
with your context.
There are several discrete steps involved in this production cycle:
Conceiving ideas across the five layers of visualisation design.
Wireframing and storyboarding designs.
Developing prototypes or mock-up versions.
219
Testing.
Refining and completing.
Launching the solution.
Naturally, the specific approach for developing your design solution (from
prototyping through to launching) will vary hugely, depending particularly
on your skills and resources: it might be an Excel chart, or a Tableau
dashboard, an infographic created using Adobe Illustrator, or a web-based
interactive built with the D3.js library. As I have explained in the book’s
introduction, I’m not going to attempt to cover the myriad ways of
implementing a solution; that would be impossible to achieve as each task
and tool would require different instructions.
For the scope of this book, I am focusing on taking you through the first
two steps of this cycle – conceiving ideas and wireframing/storyboarding.
There are parallels here with the distinctions between architecture (design)
and engineering (execution) – I’m effectively chaperoning you through to
the conclusion of your design thinking.
To fulfil this, Part C presents a detailed breakdown of the many design
.
More Related Content
Similar to Learning Objectives Covered1. Explain Respiratory Failure and th.docx
PART B Please response to these two original posts below. Wh.docxsmile790243
PART B
Please response to these two original posts below. When
responding to these posts, please either expand the
thought, add additional insights, or respectfully disagree
and explain why. Remember that we are after reasons
and arguments, and not simply the statement of
opinions.
Original Post 1
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
To begin, I would like to remind us that being intrinsically valuable
means having values for just being us and nothing else. I believe
that human lives are intrinsically valuable in virtue of our
uniqueness. As a bio nerd, I would like to state the fact that there
are a lot of crossover events during meiosis, which create trillions
of different DNA combinations. Hence, from a biological
standpoint, without considering other aspects, being you is
already valuable because you are that one sperm that won the
race and got fertilized. On a larger scale, there are hardly two
people whose look and behaviors are the same in the same
family, unless they are identical twins. However, identical twins
still act differently and have differences (such as fingerprints).
Since we are raised in different families, we are taught different
things and have different cultures. In general, we all have
different genetic information, appearances, personalities, senses
of humor, ambitions, talents, interests and life experiences. These
characteristics make up our “unique individual value” and make
us so unique and irreplaceable.
I would also love to discuss how our diversities enrich and
contribute to society, but that would be a talk about our extrinsic
values.
Original Post 2
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
I believe that human lives are intrinsically valuable due to a
number of reasons. Firstly, human lives aren’t replaceable. You
can’t replace a human being with another just like you can
replace a broken laptop with brand new one. Part of the reason
why we tend to think this way is that we were nurtured with the
notion that there is, indeed, a special value to human life. This
could be in virtue of our uniqueness-- the fact that we are
sentient and capable of complex thoughts and emotions
separates us from any other species on this planet. From a
scientific standpoint, this is also one of the reasons as to why
humans became the dominant species in today’s age.
Moreover, human lives aren’t disposable. I think this is largely due
to us humans having the ability to empathize with others. We
understand that it’s morally inappropriate to take the life of
another individual even if they’re complete strangers because
they’re another human being like us who has their own thoughts,
values, memories, and stories. In a way, we have a strong
emotional connection to our own species. As .
Part C Developing Your Design SolutionThe Production Cycle.docxsmile790243
Part C Developing Your Design
Solution
The Production Cycle
Within the four stages of the design workflow there are two distinct parts.
The first three stages, as presented in Part B of this book, were described
as ‘The Hidden Thinking’ stages, as they are concerned with undertaking
the crucial behind-the-scenes preparatory work. You may have completed
them in terms of working through the book’s contents, but in visualisation
projects they will continue to command your attention, even if that is
reduced to a background concern.
You have now reached the second distinct part of the workflow which
involves developing your design solution. This stage follows a production
cycle, commencing with rationalising design ideas and moving through to
the development of a final solution.
The term cycle is appropriate to describe this stage as there are many loops
of iteration as you evolve rapidly between conceptual, practical and
technical thinking. The inevitability of this iterative cycle is, in large part,
again due to the nature of this pursuit being more about optimisation rather
than an expectation of achieving that elusive notion of perfection. Trade-
offs, compromises, and restrictions are omnipresent as you juggle ambition
and necessary pragmatism.
How you undertake this stage will differ considerably depending on the
nature of your task. The creation of a relatively simple, single chart to be
slotted into a report probably will not require the same rigour of a formal
production cycle that the development of a vast interactive visualisation to
be used by the public would demand. This is merely an outline of the most
you will need to do – you should edit, adapt and participate the steps to fit
with your context.
There are several discrete steps involved in this production cycle:
Conceiving ideas across the five layers of visualisation design.
Wireframing and storyboarding designs.
Developing prototypes or mock-up versions.
219
Testing.
Refining and completing.
Launching the solution.
Naturally, the specific approach for developing your design solution (from
prototyping through to launching) will vary hugely, depending particularly
on your skills and resources: it might be an Excel chart, or a Tableau
dashboard, an infographic created using Adobe Illustrator, or a web-based
interactive built with the D3.js library. As I have explained in the book’s
introduction, I’m not going to attempt to cover the myriad ways of
implementing a solution; that would be impossible to achieve as each task
and tool would require different instructions.
For the scope of this book, I am focusing on taking you through the first
two steps of this cycle – conceiving ideas and wireframing/storyboarding.
There are parallels here with the distinctions between architecture (design)
and engineering (execution) – I’m effectively chaperoning you through to
the conclusion of your design thinking.
To fulfil this, Part C presents a detailed breakdown of the many design
.
PART A You will create a media piece based around the theme of a.docxsmile790243
PART A:
You will create a media piece based around the theme of “alternative facts.
Fake News:
Create a
series of 3
short, “fake news” articles or news videos. They should follow a specific theme. Make sure to have a clear understanding of WHY your fake news is being created (fake news is used by people, groups, companies, etc to convince an unsuspecting audience of something. It’s supposed to seem real, but the motivation behind it is to deceive. As part of this option, consider what your motivations are for your deception).
Part A: should be around 750 words for written tasks (or 250 for each 3 part task)
PART B:
The focus for this assignment is to demonstrate a
clear understanding of media conventions
, as well as
purpose
and
audience
. Therefore, along with your media product, you’ll also be required to submit a short
reflection
detailing why you created your product and for whom it was intended. You must discuss and analyze the elements within your media product (including why & how you used the persuasive techniques of ethos, logos and pathos) as well as the other elements of media you used and why.
.
Part 4. Implications to Nursing Practice & Implication to Patien.docxsmile790243
Part 4. Implications to Nursing Practice & Implication to Patient Outcomes
Provide a paragraph summary addressing the topics implications to nursing practice and patient outcomes. This section is NOT another review of the literature or introduction of new topics related to the PICOT question.
You may find if helpful to begin each topic with -
Nurses need to know …
Important patient outcomes include …
Example
– please note this is an older previous students work and so some references are older than 5 years.
Be sure to provide the PICOT question to begin this post.
PICOT Question:
P=Patient Population
I=Intervention
C=Comparison
O=Outcome
T=Time (duration):
In patients in the hospital, (P)
how does frequently provided patient hand washing (I)
compared with patient initiated hand washing (C)
affect hospital acquired infection (O)
within the hospital stay (T)
Implications to Nursing Practice & Patient Outcomes
Nurses need to know that they play a significant role in the reduction of hospital acquired infection by ensuring by health care workers and patients wash hands since nurses have the most interactions with patients. Implementing hand hygiene protocol with patients can enhance awareness and decrease healthcare associated infection (HAI). Both nurses and patients need to know that HAI is associated with increased morbidity and mortality as well cost of treatment and length of hospital stay. Nurses and patients also need to know that most HAI is preventable. Gujral (2015) notes that proper hand hygiene is the single most important, simplest, and least expensive means of reducing prevalence of HAI and the spread of antimicrobial resistance. Nurse and patient hand washing plays a vital role in decreasing healthcare costs and infections in all settings.
References
Gujral, H. (2015.) Survey shows importance of hand washing for infection prevention. American Nurse Today, 10 (10), 20. Retrieved from hEp://www.nursingworld.org/AmericanNurseToday
.
PART AHepatitis C is a chronic liver infection that can be e.docxsmile790243
PART A
Hepatitis C is a chronic liver infection that can be either silent (with no noticeable symptoms) or debilitating. Either way, 80% of infected persons experience continuing liver destruction. Chronic hepatitis C infection is the leading cause of liver transplants in the United States. The virus that causes it is blood borne, and therefore patients who undergo frequent procedures involving transfer of blood are particularly susceptible to infection. Kidney dialysis patients belong to this group. In 2008, a for-profit hemodialysis facility in New York was shut down after nine of its patients were confirmed as having become infected with hepatitis C while undergoing hemodialysis treatments there between 2001 and 2008.
When the investigation was conducted in 2008, investigators found that 20 of the facility’s 162 patients had been documented with hepatitis C infection at the time they began their association with the clinic. All the current patients were then offered hepatitis C testing, to determine how many had acquired hepatitis C during the time they were receiving treatment at the clinic. They were considered positive if enzyme-linked immunosorbent assay (ELISA) tests showed the presence of antibodies to the hepatitis C virus.
Health officials did not test the workers at the hemodialysis facility for hepatitis C because they did not view them as likely sources of the nine new infections. Why not?
Why do you think patients were tested for antibody to the virus instead of for the presence of the virus itself?
Ref.: Cowan, M. K. (2014) (4th Ed.). Microbiology: A Systems Approach, McGraw Hill
PART B
Summary:
Directions for the students: There are 4 essay questions. Please be sure to complete all of them with thorough substantive responses. Current APA Citations are required for all responses.
1. Precisely what is microbial death?
2. Why does a population of microbes not die instantaneously when exposed to an antimicrobial agent?
3. Explain what is wrong with this statement: “Prior to vaccination, the patient’s skin was sterilized with alcohol.” What would be a more correct wording?
4. Conduct additional research on the use of triclosan and other chemical agents in antimicrobial products today. Develop an opinion on whether this process should continue, providing evidence and citations to support your stance.
.
Part A post your answer to the following question1. How m.docxsmile790243
Part A post
your answer to the following question:
1. How might potential reactions to an adolescent’s questioning of their sexual identity, or gender role, impact their social environment, behavior and self-esteem?
2. As social workers, what role can we play in assuring the best outcomes for these adolescents?
Please use the Learning Resources to support your answer.
Part B
post
your answer to the following question:
1. How can social workers work toward assuring the best outcomes for adolescents questioning their sexual orientation or gender identity.
Please use the Learning Resources to support your answer.
.
PART BPlease response to these two original posts below..docxsmile790243
PART B
Please response to these two original posts below. When responding to
these posts, please either expand the thought, add additional insights, or
respectfully disagree and explain why. Remember that we are after reasons
and arguments, and not simply the statement of opinions.
Original Post 1
"What is moral relativism? Why might people be attracted to it? Is
it plausible?"
First of all, moral relativism is the view that moral truths are
subjective and depend on each individual's standpoints. Based
on this, everyone's moral view is legitimate. This can be attracted
because it sounds liberating and there is no need to argue for a
particular position. Moral relativism seems convincing in some
cases. For example, some people are okay with giving money to
homeless people, thinking that it's good to provide for the people
in need. Some people, on the other hand, claim that they can
work to satisfy their own needs. Moral relativism works well in
these cases because they all seem legitimate. However, there are
cases that moral relativism does not seem reasonable. For
example, child sacrifice in some cultures seems cruel and
uncivilized to most people. Hence, moral relativism is not
absolutely true.
Original Post 2
“Is your death bad for you, specifically, or only (at most) for others? Why
might someone claim that it isn’t bad for you?”
I'd start off by acknowledging what the two ancient philosophers,
Lucretius and Epicurus, outlined about death. They made the
point that death isn't necessarily bad for you since no suffering
takes place and that you yourself don't realize your own death. In
this way, one could make the claim that death isn't intrinsically
bad for you.
Another perspective I wanted to add was the influence of death
(both on you and others around you). Specifically, the event of
death itself may not be bad for you, but the idea of impending
death could impact one's life. Some may live freely, totally care-
free, accepting of death and enjoy life in the moment. Others may
be frightened by the idea of death that they live in constant fear
and hence death causing their mental health to take its toll. In
this way, I'd argue that death could, in fact, be bad for you. One
common reason for being afraid of death is the fear of being
forgotten. Not to mention the death of an individual certainly
affects others; death doesn't affect one's life but also all that is
connected to it. Focusing back to the point, it's clear that the
very idea of death directly affects the concerned individual. The
fact that those who live in fear of death are looking for legacies
and footprints to leave after they leave this world is telling of how
death could be arguably bad for you before it even happens.
PART A
Pick one or more questions below and write a substantive post
with >100 words. Please try to provide evidence(s) to support
your idea(s).
Questions:
• Do we have a duty to work out whe.
Part A (50 Points)Various men and women throughout history .docxsmile790243
Part A (50 Points):
Various men and women throughout history have made important contributions to the development of statistical science. Select any one (1) individual from the list below and write a 2 page summary of their influence on statistics. Be specific in detail to explain the concepts they developed and how this advanced our understanding and application of statistics.
Florence Nightingale
Francis Galton
Thomas Bayes
Part B (50 Points):
Select any one statistical concept you learned in this course and explain how it can be applied to our understanding of the Covid-19 pandemic (2 pages). You should use a specific example and include at least one diagram to illustrate your answer.
Please note: Your work must be original and not copied directly from other sources. No citations are needed. Be sure to submit this assignment in Blackboard on the due date specified.
.
Part A:
1. K
2. D
3. N
4. C
5. A
6. O
7. F
8. Q
9. H
10. M
11. S
12. Y
13. I
14. U
15. X
Part B:
1.
A. UTI is short form for Urinary tract infection. Means infection which affects organs of urinary tract. Such as urethra, urinary bladder and kidney. This are main organ for formation of urine and helps to expel it out of body.
B. Kidneys, urethra and urinary bladder gets affected during Urinary tract infection. Generally infection begins with urethra then travels to kidney.
When only lower part gets affected which is called lower UTI also cystitis because involves bladder
And when infection spread to upper side involving kidneys known as pyelonephritis.
2.
A. Microorganism in UTI
Escherichia coli
Klebsiella pneumoniae
B. Coli bacteria lives in intestine. So they also seen near anal canal. From which gets transferred to urethra.
C. Bacteria enters urinary tract from urethra. In very less cases kidney gets infected by blood stream.
3.
Signs and symptoms:
A) Pain with urination:
The infection cause inflammation of urinary tract, the urine from the inflammed urinary tract cause pain in urination.
B) orange or red colour urine:
The inflammation of urinary tract may cause a orange or red colour urine. It is common sign in UTI due to inflammation of urinary tract.
4.
UTI:
Urinary tract infection (UTI) any infection on the urinary tract causing difficult in urination. It most commonly affects the woman because thet are more prone to it.
Diagnosis And treatment:
A) The diagnostic test for UTI:
The two major diagnostic test for UTI are:
Urinalysis:
Urine is collected from the patient who came for test. This test shows the bacterial or any infectious organism in the urine.
The collected urine sample is added to the substance which promotes the growth of the organism in the urine.
If the growth is organism doesn't takes place then the test is negative.
If the organism growth in the urine takes place then the test is positive.
Ultra sound:
The sound waves from the transducer of ultra produce a imaging of the internal organs.
Patient lower abdomen is scanned by ultra sound to detect any abnormality in the organs and structures of urinary tract.
B) The medications for UTI are antibiotics or antimicrobial.
The two drugs are amoxicillin, sulfasulfamethaxazole.
Both of these drugs act on UTI by fighting against the microorganisms in the UTI. By assisting the immune system, it fight against the microorganisms and that relieves the symptoms of UTI.
5.
answer. a) In women at the time of pregnancy the drainage system from the kidney towards bladder become wide, hence, urine does not pass out as quickly. This makes it easier to get an infection. Similarly women has shorter urethra than a man have, the shorter distance make the way easy to bacteria to travel into the bladder.
b) There are no of ways by which women can reduce the risk of getting UTI. Like women should drink plenty of water this will help of getting rid from UTI, a women should protect their urethra .
Part A Develop an original age-appropriate activity for your .docxsmile790243
Part A:
Develop an original age-appropriate activity for your preschool class using
one
of the following.
Froebel’s cube gift
Froebel’s parquetry gift
Lincoln Logs
Describe the activity that you have developed.
Identify at least two (2) skills that the activity would help develop.
Part B:
Develop an original age-appropriate activity for your preschool class promoting the same skill(s) as the activity above, but develop the activity based on the Montessori method.
Describe the activity that you have developed.
What are at least two key differences between the two activities you developed?
.
Part 3 Social Situations2. Identify multicultural challenges th.docxsmile790243
Part 3: Social Situations
2. Identify multicultural challenges that your chosen individual may face as a recent
refugee.
• What are some of the issues that can arise for someone who has recently
immigrated to a new country?
• Explain how these multicultural challenges could impact your chosen individual’s
four areas of development?
3. Suggest plans of action or resources that you feel should be provided to this family to
assist them in proper develop
Part 3: Social Situations
• Proposal paper which identifies multicultural challenges that your chosen individual may face as a recent refugee.
• Suggested plan of action and/or resources which should be implemented to address the multicultural challenges.
• 2-3 Pages in length
• APA Formatting
• Submission will be checked for plagiaris
.
Part A (1000 words) Annotated Bibliography - Create an annota.docxsmile790243
Part A
(1000 words): Annotated Bibliography - Create an annotated bibliography that focuses on ONE particular aspect of current Software Engineering that face a world with different cultural standards. At least seven (7) peer-reviewed articles must be used for this exercise.
Part B
(3000 words):
Research Report
- Write a report of the analysis and synthesis using the
(Part A
) foundational
Annotated Bibliography
.
Part C (500 words): Why is it important to try to minimize complexity in a software system.
Part D (500 words): What are the advantages and disadvantages to companies that are developing software products that use cloud servers to support their development process?
Part E (500 words): Explain why each microservice should maintain its own data. Explain how data in service replicas can be kept consistent?
.
Part 6 Disseminating Results Create a 5-minute, 5- to 6-sli.docxsmile790243
Part 6: Disseminating Results
Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project:
· Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
Points Range: 81 (81%) - 90 (90%)
The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project.
The narrated presentation accurately and clearly explains in detail how to disseminate the results of the project to an audience, citing specific and relevant examples.
The narrated presentation accurately and clearly provides a justification that details the selection of this dissemination strategy that is fully supported by specific and relevant examples.
The narrated presentation provides a complete, detailed, and specific synthesis of two outside resources related to the dissemination strategy explained. The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
Points Range: 5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Evidenced Based Change
Leslie Hill
Walden University
Introduction/PurposeChange is inevitable.Health care organizations need change to improve.There are challenges that need to be addressed(Baraka-Johnson et al. 2019).Challenges should be addressed using evidence-based research.These changes enhance professionalism therefore improving quality of care and quality of life.The purpose of this paper is to identify an existing problem in health care and suggest a change idea that would be effective in addressing the problem. The paper also articulates risks associated with the change process, how to distribute the change information and how to implement change successfully.
Organizational CultureThe Organization is a hospice facilityOffers end of life care for pain and symptom managementThe health care providers cu.
Part 3 Social Situations • Proposal paper which identifies multicul.docxsmile790243
Part 3: Social Situations • Proposal paper which identifies multicultural challenges that your chosen individual may face as a recent refugee. • Suggested plan of action and/or resources which should be implemented to address the multicultural challenges. • 2-3 Pages in length • APA Formatting • Submission will be checked for plagiarism
Part 3: Social Situations 2. Identify multicultural challenges that your chosen individual may face as a recent refugee. • What are some of the issues that can arise for someone who has recently immigrated to a new country? • Explain how these multicultural challenges could impact your chosen individual’s four areas of development? 3. Suggest plans of action or resources that you feel should be provided to this family to assist them in proper development.
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Part 3 Social Situations 2. Identify multicultural challenges that .docxsmile790243
Part 3: Social Situations 2. Identify multicultural challenges that your chosen individual may face as a recent refugee. • What are some of the issues that can arise for someone who has recently immigrated to a new country? • Explain how these multicultural challenges could impact your chosen individual’s four areas of development? 3. Suggest plans of action or resources that you feel should be provided to this family to assist them in proper development.
Part 3: Social Situations • Proposal paper which identifies multicultural challenges that your chosen individual may face as a recent refugee. • Suggested plan of action and/or resources which should be implemented to address the multicultural challenges. • 2-3 Pages in length • APA Formatting • Submission will be checked for plagiarism
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Part 2The client is a 32-year-old Hispanic American male who c.docxsmile790243
Part 2
The client is a 32-year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to the PMHNPs office for an initial appointment for complaints of depression. The client was referred by his PCP after “routine” medical work-up to rule out an organic basis for his depression. He has no other health issues except for some occasional back pain and “stiff” shoulders which he attributes to his current work as a laborer in a warehouse. the “Montgomery- Asberg Depression Rating Scale (MADRS)” and obtained a score of 51 (indicating severe depression). reports that he always felt like an outsider as he was “teased” a lot for being “black” in high school. States that he had few friends, and basically kept to himself. He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in “trouble” at work.
· Decision #1: start Zoloft 25mg orally daily
· Which decision did you select?
· Why did you select this decision? Support your response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
· Decision #2: Client returns to clinic in four weeks, reports a 25% decrease in symptoms but concerned over the new onset of erectile dysfunction
*add Augmentin Wellbutrin IR 150mg in the morning
· Why did you select this decision? Support y our response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
· Decision #3: Client returns to clinic in four weeks, Client stated that depressive symptoms have decreased even more and his erectile dysfunction has abated
· Client reports that he has been feeling “jittery” and sometimes “nervous”
*change to Wellbutrin XL 150mg daily
· Why did you select this decision? Support your response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Explain how ethical considerations might impact your treatment plan and communication with clients.
Conclusion.
Part 2For this section of the template, focus on gathering deta.docxsmile790243
Part 2:
For this section of the template, focus on gathering details about common, specific learning disabilities. These disabilities fall under the IDEA disability categories you researched for the chart above. Review the textbook and the topic study materials and use them to complete the chart.
Learning Disability Definition Characteristics Common Assessments for Diagnosis Potential Effect on Learning and Other Areas of Life Basic Strategies for Addressing the Disability
Attention Deficit Hyperactivity Disorder (ADHD)
Auditory Processing Disorder (APD)
Dyscalculia
Dysgraphia
Dyslexia
Dysphasia/Aphasia
Dyspraxia
Language Processing Disorder (LPD)
Non-Verbal Learning Disabilities
Visual Perceptual/Visual Motor Deficit
.
Part 2 Observation Summary and Analysis • Summary paper of observat.docxsmile790243
Part 2: Observation Summary and Analysis • Summary paper of observation findings for each area of development and connection to the observed participant. • Comprehensive description of the observed participant. • Analyzed observation experience with course material to determine whetherthe participant is developmentally on track for each area of development. • 4 Pages in length • APA Formatting • Submission will be checked for plagiarism
Part 2: Observation Summary and Analysis 1. Review and implement any comments from your instructor for Part 1: Observation. 2. Describe the participant that you observed. • Share your participant’s first name (can be fictional name if participant wants to remain anonymous), age, physical attributes, and you initial impressions. 3. Analyze your observation findings for each area of development (physical, cognitive, social/emotional, and spiritual/moral). • Explain how your observations support the 3-5 bullets for each area of development that you identified in your Development Observation Guidefrom Part 1: Observation. • Explain whether or not your participant is developmentally on track for each area of development. 4. What stood out the most to you about the observation? 5. Include at least 2 credible sources
.
Part 2 Observation Summary and Analysis 1. Review and implement any.docxsmile790243
Part 2: Observation Summary and Analysis 1. Review and implement any comments from your instructor for Part 1: Observation. 2. Describe the participant that you observed. • Share your participant’s first name (can be fictional name if participant wants to remain anonymous), age, physical attributes, and you initial impressions. 3. Analyze your observation findings for each area of development (physical, cognitive, social/emotional, and spiritual/moral). • Explain how your observations support the 3-5 bullets for each area of development that you identified in your Development Observation Guidefrom Part 1: Observation. • Explain whether or not your participant is developmentally on track for each area of development. 4. What stood out the most to you about the observation? 5. Include at least 2 credible sources
Part 2: Observation Summary and Analysis • Summary paper of observation findings for each area of development and connection to the observed participant. • Comprehensive description of the observed participant. • Analyzed observation experience with course material to determine whetherthe participant is developmentally on track for each area of development. • 4-6 Pages in length • APA Formatting • Submission will be checked for plagiarism
.
Part 2Data collectionfrom your change study initiative,.docxsmile790243
Part 2:
Data collection
from your change study initiative, sample, method, display of the results of the data itself, process, and method of analysis (graphs, charts, frequency counts, descriptive statistics of the data, narrative)
Part 3: Interpretation of the results of the Data
Collection and
Analysis, address likely resistance, and provide recommendations for continuing
the study
or evaluating your change study/initiative.
.
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!
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Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
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The Art Pastor's Guide to Sabbath | Steve Thomason
Learning Objectives Covered1. Explain Respiratory Failure and th.docx
1. Learning Objectives Covered
1. Explain Respiratory Failure and the two types of respiratory
failure: hypoxemic and hypercapnic respiratory failure
2. List and describe the indications and objectives for ventilator
support
3. Explain the advantages and disadvantages of volume and
pressure ventilation>
Background
Mechanical Ventilation is indicated to assist the patient who
cannot maintain adequate oxygenation, alveolar ventilation or
lacks the ability to protect his or her own airway.The inability
of a patient to maintain either the normal delivery of oxygen to
the tissues or the normal removal of carbon dioxide from the
tissues is referred to as acute respiratory failure. Though the
three common indications for mechanical ventilation includes
inability to maintain adequate oxygenation, inability to maintain
adequate alveolar ventilation and/or inability to protect one’s
own airway. There are more specific indications for mechanical
ventilation and can be found in the table below.
Indications
Definition
Example
Apnea
Absence of breathing
Cardiac Arrest
Acute
Respiratory Failure (ARF)
Inability of a patient to maintain adequate: PaO2, PaCO2,
and, potentially, pH.
Hypoxemic RF
Hypercapnic RF
Impending
Respiratory Failure
2. Respiratory failure is immi-nent in spite of therapies.
Commonly defined as: Pt is barely maintaining
(or gradually deteriorating) normal blood gases but with
significant WOB.
Neuromuscular
Disease (N-M)
Status Asthmaticus
Chronic
Respiratory Failure
Repeated failures after attempts to liberate from the ventilator
(extubations, Trach Collar trials, etc.)
SEVERE:
Obesity Hypoventilation Syndrome
COPD
Pulmonary Fibrosis
Prophylactic
Ventilatory Support
Clinical indication = high risk of respiratory failure.
Ventilatory support is instituted to ↓
WOB,minimize O2consumption and hypoxemia,
reduce cardiopulmonary stress, and/or control airway
with sedation.
Brain injury
Heart muscle
Injury
Major surgery
Shock (prolonged)
Smoke injury
Trauma (some)
3. Hyperventilation Therapy
Ventilatory support is instituted to control and
manipulate PaCO2 tor lower than normal level
Acute head injury
(↑ ICP)
(not immediately
after injury)
*respiratoryupdate.com
Respiratory failure can be acute or chronic and is classified as
either hypoxemic or hypercapnic. During hypoxemic respiratory
failure, the patient’s ventilatory demands exceed the lung's
ability to provide blood oxygenation resulting in muscle fatigue.
Hypoxemic respiratory failure is defined as a PaO2 below the
predicted normal range for the patient’s age under ambient
conditions. A normal PaO2 for a patient that is 60 years or
younger on room air is 80-100mmHg. When a patient is
hypoxemic their body naturally responds to the low PaO2by
increasing respiratory rate and/or tidal volume (an increase in
minute ventilation). An increase in minute ventilation leads to
hyperventilation. During hyperventilation, a greater than normal
amount of CO2 is exhaled resulting in a low
PaCO2 (hypocapnia).
Hypercapnic respiratory failure is defined as a PaCO2 level
above 50mmHg and a rising and a falling pH of 7.25 or less.
Hypercapnic respiratory failure may be accompanied by a
normal or low PaO2. A patient who is experiencing hypercapnic
respiratory failure is in imminent danger of cardiopulmonary
arrest and mechanical ventilation is essential.
Once the need for mechanical ventilation has been established
and the airway is secured the practitioner must select the type of
ventilator, breath type and ventilator mode that is most
appropriate for the patient.
The selection of a ventilatory support strategy is based on the
type of respiratory failure the patient demonstrates. For
4. example, a patient in hypoxemic respiratory failure can be
treated with various oxygen therapy devices to manage the
patient’s oxygenation status. The practitioner must be careful to
identify when a patient is experiencing refractory hypoxemia.
Refractory hypoxemia is a lack of oxygen in the blood that does
not respond to oxygen alone. These patients experience
intrapulmonary shunting, such as with pneumonia, pulmonary
edema, and atelectasis, which requires PEEP along with oxygen.
Patients who experience refractory hypoxemia can be treated
with devices such as high flow oxygen delivery devices and
CPAP.
In a patient presenting with hypercapnic respiratory failure, the
patient must be treated with ventilatory support to mange the
patients PaCO2 levels and acid-base status. For example, a
patient in hypercapnic respiratory failure must be intubated and
placed on mechanical ventilation. However, if hypercapnic
respiratory failure is noticed soon enough then practitioners can
treat these patients with noninvasive ventilatory support
(NIPPV) or Bipap. NIPPV has been proven to be effective when
implemented early and set correctly.
Either noninvasive ventilation or invasive ventilation can be
used as a ventilatory support strategy. Noninvasive ventilation
(NIV or NIPPV) is defined as any mode of ventilation that does
not require an invasive artificial airway (endotracheal tube or
tracheostomy tube). NIV/NIPPV includes CPAP or CPAP in
combination with any mode of pressure limited or volume
limited ventilation (BiPaP).
Invasive mechanical ventilation is defined as positive pressure
ventilation delivered via an endotracheal tube or tracheostomy
tube.
Once it as been determined that the patient should be placed on
noninvasive mechanical ventilation one of two methods can be
chosen:
1. CPAP (continuous positive airway pressure)
2. Noninvasive positive airway pressure (NIPPV) or BiPaP
Once it has been determined that the patient needs invasive
5. mechanical ventilation the practitioner must determine the mode
of ventilation and breath delivery type.
Modes of Ventilation
· Type of breath (mandatory, spontaneous, assisted)
· Targeted control breath (volume or pressure)
· Timing of breath delivery (continuous mandatory ventilation
(CMV), SIMV, or spontaneous
There are three types of positive pressure ventilators.
Volume cycled
a. Pressure is applied to the airway until a preset volume is
delivered.
b. Minute volume will remain constant.
c. Airway pressure will increase or decrease depending on the
patient's compliance and/or airway resistance.
d. Volume cycled ventilators can be used with most patients.
Pressure cycled
a. Apply positive pressure to the airways until a preset pressure
limit is reached.
b. Tidal volume (Vt) is adjusted by increasing or decreasing the
pressure limit.
c. Although peak pressure (PIP) will remain constant, the
volume will change as lung compliance/resistance change.
Time cycled
a. These ventilators provide positive pressure until a preset time
is reached.
b. The peak inspiratory pressure (PIP) is usually limited by an
adjustable pop-off valve.
c. Tidal Volume (Vt) is adjusted by increasing or decreasing the
peak inspiratory pressure, inspiratory time, or flow.
There are three breath delivery techniques aka modes of
ventilation.
1. Continuous Mandatory Ventilation (CMV)
a. All breaths are mandatory and can be volume or pressure
targeted.
b. Breaths can be patient triggered or time triggered.
c. When the breaths are patient triggered, CMV mode is called
6. A/C (assist/control)
d. When the breaths are time triggered the CMV mode is called
control mode.
e. CMV is commonly volume targeted (volume control
continuous mandatory ventilation (VC-CMV)
f. CMV can also be pressure targeted (pressure control
continuous mandatory ventilation (PC-CMV)
2. Synchronized Intermittent Mandatory Ventilation (SIMV)
a. Periodic volume-or pressure-targeted breaths occur at set
intervals.
b. Between mandatory breaths, the patient breaths
spontaneously at any desired pressure without receiving a
mandatory breath.
c. Synchronized Intermittent Mandatory Ventilation (SIMV)
works the same way as IMV except that the mandatory breaths
are time triggered rather than patient triggered.
3. Spontaneous
a. Spontaneous breathing - the patient can breathe through the
ventilator circuit (T-piece method). The ventilator monitors the
patient's breathing and can activate an alarm if necessary.
b. CPAP
c. PSV – (pressure support ventilation). The ventilator provides
a constant pressure during inspiration once it senses the patient
has made an inspiratory effort.
There are less frequently used modes such as MMV, APRV and
PAV as well as HFV, which will be later discussed.
Initial Settings for Mechanical Ventilation
1. Ventilation mode
a. Control, assist/control, IMV/SIMV
b. Any mode is acceptable for initial set up
2. Tidal volume, respiratory rate, FiO2 and PEEP
a. Tidal volume - 6-8 ml/kg of ideal body weight
b. Respiratory rate - 12 -18 breaths per minute
c. FiO2 - if patient is on room air or you have no prior
information, start the patient at 40-60%. If the patient is
currently on oxygen, set the ventilator FiO2 to the patient's
7. current setting.
d. PEEP - if the patient is currently on PEEP/CPAP keep it at
the same level. If the patient is not currently on PEEP/CPAP
start at 0-10 cm H2O.
Ventilation Mode
Modes of ventilation
1. Assist Mode
a. Patient initiates all breaths
b. No minimum respiratory rate
2. Control Mode
2. Ventilator will initiate breaths at a preset rate
2. Does not allow patient to initiate breaths
2. Indicated for head trauma/surgery patients
1. Assist/Control
c. Allows patient to set the respiratory rate
c. The ventilator will maintain a minimum rate
c. May be used with most patients
c. Ventilator controls tidal volume for every breath
1. SIMV Mode
d. Allows patient to breath spontaneously
d. Ventilator provides a minimum minute ventilation
1. Pressure Control Ventilation (PCV)
e. Pressure controlled breaths
e. Used when PIP is very high
e. Exhaled Vt will vary
e. Adjust IT or PIP as needed.
1. Pressure Support Ventilation (PSV)
f. Pressure support adds a preset amount of pressure during a
spontaneous breath
f. Helps the patient overcome the resistance of breathing
through an ETT and ventilator circuit
Prompt
For this assignment, you will provide detailed responses to the
following questions.
A 32-year-old man presents to the emergency department with a
2-day history of fever and cough. His chest film shows a right
8. middle lobe infiltrate. His room air ABG showed:
pH: 7.32
PCO2: 32 torr
PO2: 78 torr
HCO3- 18
He was started on antibiotics and admitted to the floor. Four
hours later, the nurse calls because she is concerned he is doing
worse. On your arrival to the room, his blood pressure is 85/60,
his pulse is 120 beats/min and his oxygen saturation, which had
been 97% on 2L oxygen via nasal cannula, is now 78% on a
non-rebreather mask. The patient is obviously laboring to
breathe with use of his accessory muscles and is less responsive
than he was on admission. On the lung exam, he has crackles
throughout the bilateral lung fields. The chest film now shows
increasing bilateral, diffuse lung opacities. An ABG is done
while on the non-rebreather and shows:
pH: 7.17
PCO2: 65
PO2: 58
HCO3- 16
1. Based on the clinical presentation of this patient, discuss how
you would address the treatment. Include in your answer the
following information: possible diagnosis, and what would be
appropriate therapy (invasive vs noninvasive ventilation), and
why?
2. Based on your choice of ventilation for this patient, discuss
appropriate initial settings to properly ventilate this patient.
Include and explain the following information in your answer:
If you choose noninvasive ventilation be sure to include IPAP
and EPAP settings (defend your position). If you choose
invasive ventilation be sure to include Mode of ventilation,
Tidal Volume (VT), respiratory rate (frequency), oxygen
percentage (FI02), Positive End Expiratory Pressure (PEEP) or
any other therapy that may be indicated.
Submit your answers in at least 500 words on a Word document.
You must cite at least three references in APA format and