M. K. is a 45-year-old female measuring 5’5″ and weighing 225 lbs. M. K. has a history of smoking about 22 years along with a poor diet. She has a history of type II diabetes mellitus along with primary hypertension. M. K. has recently been diagnosed with chronic bronchitis. Her current symptoms include chronic cough, more severe in the mornings with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increased urination at night. Her current medications include Lotensin and Lasix for the hypertension along with Glucophage for the type II diabetes mellitus. The following are lab findings that are pertinent to this case:

Vitals

BP

158/98 mm Hg

CBC

Hematocrit

57%

Glycosylated hemoglobin (HbA1c)

7.3 %

Arterial Blood Gas Assessment

PaCO₂

52 mm Hg

PaO₂

48 mm Hg

Lipid Panel

Cholesterol

242 mg/dL

HDL

32 mg/dL

LDL

173 mg/dL

Triglycerides

184 mg/dL

For your signature assignment, compose a 3- to 4-page case analysis, written in APA format with a title page and at least 3 references, with one non-Internet reference. Organize your analysis with headings that thoroughly answer the following prompts. Support your opinions with evidence from your readings and research. Review the rubric for complete grading criteria.

1. In your introduction, summarize the case.
2. What clinical findings correlate with M. K.’s chronic bronchitis? What type of treatment and recommendations would be appropriate for M. K.’s chronic bronchitis?
3. Which type of heart failure would you suspect with M. K.? Explain the pathogenesis of how this type of heart failure develops. Include an overview of the disease and it’s effects in the U.S. population.
4. According to the BP. value, what stage of hypertension is M. K. experiencing? Explain the rationale for the current medications for her hypertension.
5. According to the lipid panel, what other condition is M. K. at risk for? According to this case study, what other medications should be given and why? What additional findings correlate for both hypertension and type II diabetes mellitus?
6. Interpret the lab value for HbA1c and explain the rationale for this value in relation to normal/abnormal body function.
7. Provide a conclusion that summarizes your findings and discusses the effects of this disease in the U.S. population.

Points possible: 60

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Purpose: To investigate & integrate knowledge of advanced nursing practice, scholarly inquiry, & leadership by examining a policy at the level of clinical practice, health care systems, or public/social health policy.Submit a paper between 5-8 pages long excluding title page and reference pages. Paper must be organized according to the guidelines below and should include all the identified sections as required. Paper must be completed in APA format and contain current scholarly sources dated from 2014 until current.

· Introduction: Generally define & describe the policy issue to be addressed. Identify the purpose of analysis, the targeted level of policy (i.e., clinical practice, health care systems, or public/social health) & significance of topic. Identify questions the policy analysis is intended to address.

· Background: Provide details of the issue or problem, including its nature/scope, relevant literature & history, & the context within which the issue exists. Describe existing policy addressing the issue, if any. Discuss strengths & shortcomings in existing policy. Identify & describe key stakeholders (individuals & groups) that are or will be affected by the policy & why.

· Analysis: Identify alternative policies to achieve objectives. Establish/identify criteria that will be used for selection of “best” policy. Evaluate each alternative & its potential impact relative to the healthcare & patient outcomes.  Assess the trade-offs between alternatives.

· Recommendations: Based on the analysis, identify the “best” alternative to address the current issue & policy situation.  Provide rationale for selection.  Describe possible strategies to implement selected alternative. Identify barriers to implementation of selected alternative. Describe methods to evaluate policy implementation.

· Discussion: Discuss analysis & recommendations relative to the original questions identified, & the level of policy it is intended to address (i.e., clinical practice, health care systems, or public).  Identify limitations of analysis. Discuss implications for practice, education, research, & policy-making.

· Conclusion: Summarize findings & recommendations of analysis  Identify questions to be addressed in future studies or policy analyses.

· References: List all references cited in paper. Must be completed in APA format.

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Comment in this .

For this assignment I have chosen to use a qualitative research analysis. This approach is best for my area of interest because the PICo question will be answered with patient’s personal life experiences, views, and opinions. The PICo question I have created asks, “In sickle cell patient’s experiences(P) how effective are non-opioid medications and non-pharmacological interventions compared to opioid medications (I) in decreasing sickle cell disease pain (Co)?” My practice questions seeks to find best practices for managing pain in patients with sickle cell disease. Currently in the

For this assignment I have chosen to use a qualitative research analysis. This approach is best for my area of interest because the PICo question will be answered with patient’s personal life experiences, views, and opinions. The PICoquestion I have created asks, “In sickle cell patient’s experiences(P) how effective are non-opioid medications and non-pharmacological interventions compared to opioid medications (I) in decreasing sickle cell disease pain (Co)?” My practice questions seeks to find best practices for managing pain in patients with sickle cell disease. Currently in the United States there is only one medications approved by the FDA formanagement of sickle cell pain, Hydroxyurea. Unfortunately, only about 25% of adults diagnosed with sickle cell disease are using this medication, either for reasons such as poor adherence or lack of prescribing (American Society of Hematology, 2016). Many rely on opioid medications. The phenomena I have chosen to research relates to sickle cell patients views, experiences, and opinions on the use of Hydroxyurea and non-pharmacological interventions such as hydration, warmth, rest, diversion techniques, and aromatherapy compared to the use of opioid pain medications at managing their pain. This analysis does not include the opinions of sickle cell patients during a crisis in which opioid pain medication along with non-pharmacological interventions is almost always necessary. Therefore, the group or population of interest is that of patients living with sickle cell disease. There are four major qualitative research designs; phenomenological, ethnography, grounded theory, and case study (Astalin, 2013). I have chosen to use thephenomenological qualitative research design for this study. Phenomenological design translated means the study of a phenomena (Astalin, 2013). This research approach explores the real life experiences of a group or population of interest (Astalin, 2013). The phenomena in this situation is the experience of what works best for pain within this population.

American Society of Hematology (2016). State of Sickle Cell Disease; 2016 Report. Retrieved from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=7&cad=rja&uact=8&ved=2ahUKEwiPueuN8bzjAhWVcc0KHTgACPAQFjAGegQIBhAC&url=http%3A%2F%2Fwww.scdcoalition.org%2Fpdfs%2FASH%2520State%2520of%2520Sickle%2520Cell%2520Disease%25202016%2520Report.pdf&usg=AOvVaw1W1nAxpkRyYd8bIFlq6j01

Astalin, P.K. (2013). QUALITATIVE RESEARCH DESIGNS: A CONCEPTUAL FRAMEWORK. International Journal of Social Science & Interdisciplinary Research. Vol.2 (1). pp. 2.

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