Identify the clinical findings from the case that support a diagnosis of Alzheimer’s disease.

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1. Compare and contrast the pathophysiology between Alzheimer’s disease and frontotemporal dementia.

The exact cause of Alzheimer’s Disease is unknown. Failure to process and clear amyloid beta protein leads to the formation of diffuse neuritic plaques, disruption of nerve impulse transmission, and death of neurons. Misfolded and aggregated proteins trigger immune responses with activation of glial cells and release of cytokines leading to neuroinflammation. Neuritic plaques and neurofibrillary tangles are more concentrated in the cerebral cortex and hippocampus. The loss of neurons results in brain atrophy with decreases in weight and volume. Loss of synapse, acetylcholine, and other neurotransmitters contributes to decreased memory and attention and loss of other cognitive functions associated with AD. With frontotemporal dementia, there is a familial association with an age onset of less than 60 years. The majority of cases involve mutations of genes encoding tau protein or progranulin. The specific pathogenesis is unknown (Heuther & McCance, 2019).

2. Identify the clinical findings from the case that support a diagnosis of Alzheimer’s disease.

Clinical findings from the case that support the diagnosis of Alzheimer’s are reports of worsening memory and how he has been found wandering in the neighborhood where he has lived for 35 years. His wife is concerned about his ability to make decisions as he was convinced to buy a home security system, which they already have. The patient has trouble dressing himself and balancing the checkbook. There is a family history of Alzheimer’s; his father died at 78 from AD. The patient scored a baseline MMSE score of 12 out of 30, suggesting moderate dementia. The MRI shows hippocampal atrophy.

3. Explain one hypothesis that explains the development of Alzheimer’s disease.

One hypothesis that explains the development of AD is the excitotoxic hypothesis. Glutamate is the excitatory neurotransmitter in the brain that is responsible for synaptic plasticity and processes related to memory and learning. It is produced over several signaling pathways within the CNS and the hippocampus. This neurotransmitter has two types of receptors, inotropic and metabotropic, and they play an essential role in the development of cognitive disorders, especially with AD, since they participate in the process of formation of modulation of memory. In patients with AD, there is a hyperexcitability of the channels of these receptors caused by deficient recycling of glutamate released in the synaptic cleft. This causes the neurotransmitters to keep acting on the receptors, chronically activating them and triggering an influx of excessive calcium ions in the neuronal cell. This increase in calcium damages the cell, causing cell degeneration and death (Schwab et al., 2022).

4. Discuss the patient’s likely stage of Alzheimer’s disease.

Based on the case, the patient’s likely stage of Alzheimer’s Disease would be the moderate stage. In this stage, behavioral disturbances can include wandering, outbursts of anger, and aggression towards caregivers. The patient may struggle with independent eating, dressing, and bathing (Olczak et al., 2022). The wife reports that the patient has difficulty dressing himself. She also reports that the patient becomes angry and defensive when asked about wandering in the neighborhood. In the general physical exam, the patient is alert and angry but cooperative.

1. INSTRUCTION-

2. Sources are published within the last 5 years (unless it is the most current CPG); AND

3. Reference list is provided and in-text citations match; AND

All answers are fully supported with an appropriate EBM argument. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND

· Evidence from appropriate scholarly sources are included; AND

· Reference list is provided and in-text citations match

· Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*

Compare and contrast the pathophysiology between Alzheimer’s disease and frontotemporal dementia.

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1. Compare and contrast the pathophysiology between Alzheimer’s disease and frontotemporal dementia.

The exact cause of Alzheimer’s Disease is unknown. Failure to process and clear amyloid beta protein leads to the formation of diffuse neuritic plaques, disruption of nerve impulse transmission, and death of neurons. Misfolded and aggregated proteins trigger immune responses with activation of glial cells and release of cytokines leading to neuroinflammation. Neuritic plaques and neurofibrillary tangles are more concentrated in the cerebral cortex and hippocampus. The loss of neurons results in brain atrophy with decreases in weight and volume. Loss of synapse, acetylcholine, and other neurotransmitters contributes to decreased memory and attention and loss of other cognitive functions associated with AD. With frontotemporal dementia, there is a familial association with an age onset of less than 60 years. The majority of cases involve mutations of genes encoding tau protein or progranulin. The specific pathogenesis is unknown (Heuther & McCance, 2019).

2. Identify the clinical findings from the case that support a diagnosis of Alzheimer’s disease.

Clinical findings from the case that support the diagnosis of Alzheimer’s are reports of worsening memory and how he has been found wandering in the neighborhood where he has lived for 35 years. His wife is concerned about his ability to make decisions as he was convinced to buy a home security system, which they already have. The patient has trouble dressing himself and balancing the checkbook. There is a family history of Alzheimer’s; his father died at 78 from AD. The patient scored a baseline MMSE score of 12 out of 30, suggesting moderate dementia. The MRI shows hippocampal atrophy.

3. Explain one hypothesis that explains the development of Alzheimer’s disease.

One hypothesis that explains the development of AD is the excitotoxic hypothesis. Glutamate is the excitatory neurotransmitter in the brain that is responsible for synaptic plasticity and processes related to memory and learning. It is produced over several signaling pathways within the CNS and the hippocampus. This neurotransmitter has two types of receptors, inotropic and metabotropic, and they play an essential role in the development of cognitive disorders, especially with AD, since they participate in the process of formation of modulation of memory. In patients with AD, there is a hyperexcitability of the channels of these receptors caused by deficient recycling of glutamate released in the synaptic cleft. This causes the neurotransmitters to keep acting on the receptors, chronically activating them and triggering an influx of excessive calcium ions in the neuronal cell. This increase in calcium damages the cell, causing cell degeneration and death (Schwab et al., 2022).

4. Discuss the patient’s likely stage of Alzheimer’s disease.

Based on the case, the patient’s likely stage of Alzheimer’s Disease would be the moderate stage. In this stage, behavioral disturbances can include wandering, outbursts of anger, and aggression towards caregivers. The patient may struggle with independent eating, dressing, and bathing (Olczak et al., 2022). The wife reports that the patient has difficulty dressing himself. She also reports that the patient becomes angry and defensive when asked about wandering in the neighborhood. In the general physical exam, the patient is alert and angry but cooperative.

1. INSTRUCTION-

2. Sources are published within the last 5 years (unless it is the most current CPG); AND

3. Reference list is provided and in-text citations match; AND

All answers are fully supported with an appropriate EBM argument. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND

· Evidence from appropriate scholarly sources are included; AND

· Reference list is provided and in-text citations match

· Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*

Leadership and Management Theory

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Leadership and Management Theory

“People may not remember what you said, but they remember the way

you made them feel.” Maya Angelou

Emotional Intelligence (EI)

 

Introduction to Emotional Intelligence Emotions play a big role in our lives; they help to guide decisions for the world around us and influence our interactions with others. Accordingly, emotions are also shaped from the external world. Emotional intelligence brings control to our everyday emotions and will affect every aspect of our lives. The ability to control one’s emotions and use them in a healthy manner can be life-changing. Emotional intelligence combines emotional and social skills to navigate through organizations and relationships, as well as deal with emotional stress. It is a skill that can be learned and strengthened, bringing great success to an individual’s personal and professional life. With an emotionally intelligent team, maximum success can be achieved.

Defining Emotional Intelligence Every day we face situations in which we emotionally react. Emotional intelligence (EI) brings cognition to emotional responses. It involves recognizing, understanding, and managing our own emotions, as well as recognizing, understanding, and influencing the emotions of others. This includes being aware of the emotions that drive specific behaviors. It does not mean denying personal feelings, but rather identifying and reasoning with them. Developing emotional intelligence is especially important in the workplace, as it teaches professional and empathetic communication.

The Importance of Emotional Intelligence Emotional intelligence is incredibly valuable to many major aspects of our lives, our mental and physical health, professional success, and personal relationships. There are many positive traits that come from emotional intelligence. In business, emotional intelligence will cultivate motivation, change, and leadership. It encourages us to step away from an autopilot mode and become better at navigating through the many social complexities in life. Respectively, emotional intelligence will help us to create a healthy and balanced lifestyle. Signs of low emotional intelligence include: • Having a victim mentality • Being unaccepting of feedback • Dwelling on mistakes • Difficulty listening and connecting • Often quick to make judgments

 

 

Leadership and Management Theory

Who Needs It?

Humans are wired for connection; these connections consist of social interactions full of emotions. Essentially, identifying and building emotional intelligence is important for everyone. High emotional intelligence is a hiring trait desired by leading corporations, and to some extent, more important than IQ. Emotional intelligence provides a strong foundation for humans to reflect on their emotional responses, including when managing feelings of stress or overwhelm, creating a collaborative environment, and having difficult conversations with others. It is the key to achieving success in any leadership role. When emotional intelligence is lacking from one individual in the workplace, it affects everyone else within the organization. These repercussions can include a lower company morale, and decrease in productivity and performance. A positive work environment requires employees who are willing to coach and motivate one another, in which emotional intelligence is the foundation.

What Are Emotions?

Since emotional intelligence is all about the management and control of emotions, it is advantageous to understand what emotions are and why they matter. Although we all share the same emotions, we do not all experience these emotions the same way. Emotions are natural reactions that we experience, in response to a situation, mood, or connection. They signal a change that has occurred within us, or in our environment. The six basic human emotions, also known as primary emotions, are happiness, sadness, surprise, fear, disgust, and anger. Emotions may be momentary or long-lived. There are three key elements of emotions, including the subjective experience (how someone experiences an emotion), the physiological response (how their body reacts to this emotion), and the behavioral/expressive response (how they behave in response to this emotion). Emotions will guide decisions, help us to avoid danger, and motivate action. Our daily lives are influenced on whether we are feeling happy, sad, or bored.

Practical Illustration Shawn was in charge of hiring the new marketing analyst. He was looking for an employee who was knowledgeable in this field, along with great social skills and emotional control. After reading a few resumes, he had two strong prospects that he chose to interview. The first candidate, Hunter, had many years of experience. Although he had a lot of knowledge to bring to the team, he did not demonstrate strong leadership and interpersonal skills. Shawn’s second prospect, Leah, did not have many years of experience. Leah understood the essentials for the position, and assured Shawn that she was willing to learn and transition with the company. She was confident, empathetic, and professional. The positive impact that Leah left on Shawn had helped to guide his decision. He believed that Leah was perfect for the position, and would share her enthusiastic attitude with the rest of the team.

Alzheimer’s type dementia.

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A 76-year -old man is brought to the primary care office by his wife with concerns about his worsening memory. He is a retired lawyer who has recently been getting lost in the neighborhood where he has lived for 35 years. He was recently found wandering and has often been brought home by neighbors. When asked about this, he becomes angry and defensive and states that he was just trying to go to the store and get some bread.

His wife expressed concerns about his ability to make decisions as she came home two days ago to find that he allowed an unknown individual into the home to convince him to buy a home security system which they already have. He has also had trouble dressing himself and balancing his checkbook. At this point, she is considering hiring a day-time caregiver help him with dressing, meals and general supervision why she is at work.

Past Medical History: Gastroesophageal reflux (treated with diet); is negative for hypertension, hyperlipidemia, stroke or head injury or depression

Allergies: No known allergies

Medications: None

Family History

· Father deceased at age 78 of decline related to Alzheimer’s disease

· Mother deceased at age 80 of natural causes

· No siblings

Social History

· Denies smoking

· Denies alcohol or recreational drug use

· Retired lawyer

· Hobby: Golf at least twice a week

Review of Systems

· Constitutional: Denies fatigue or insomnia

· HEENT: Denies nasal congestion, rhinorrhea or sore throat.

· Chest: Denies dyspnea or coughing

· Heart: Denies chest pain, chest pressure or palpitations.

· Lymph: Denies lymph node swelling.

· Musculoskeletal: denies falls or loss of balance; denies joint point or swelling

General Physical Exam  

· Constitutional: Alert, angry but cooperative

· Vital Signs: BP-128/72, T-98.6 F, P-76, RR-20

· Wt. 178 lbs., Ht. 6’0″, BMI 24.1

HEENT

· Head normocephalic; Pupils equal and reactive to light bilaterally; EOM’s intact

Neck/Lymph Nodes

· No abnormalities noted

Lungs 

· Bilateral breath sounds clear throughout lung fields.

Heart 

· S1 and S2 regular rate and rhythm, no rubs or murmurs.

Integumentary System 

· Warm, dry and intact. Nail beds pink without clubbing.

Neurological

· Deep tendon reflexes (DTRs): 2/2; muscle tone and strength 5/5; no gait abnormalities; sensation intact bilaterally; no aphasia

Diagnostics

· Mini-Mental State Examination (MMSE): Baseline score 12 out of 30 (moderate dementia)

· MRI: hippocampal atrophy

· Based on the clinical presentation and diagnostic findings, the patient is diagnosed with Alzheimer’s type dementia.

Advanced pharmacology and Pharmacotherapeutics, for the APRN program

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Your introduction should cover the following details:

  • Your name
  • Geographical area in which you live (state and/or time zone is fine)
  • Your work experiences as an RN
  • Two objectives you hope to achieve throughout this course.
  • Your thoughts on how knowledge of pharmacology enhances the function of the nurse practitioner.

Instructions: This is a discussion post. Ill provide all of the answers. The last two bullet points, you may elaborate as you wish.

Name: Mauricio Pereyra

Geographical Area: Florida

Work experience: worked in the emergency department, went travel nursing during the covid period.

course name: MN553 Advanced pharmacology and Pharmacotherapeutics, for the APRN program. pick any to objectives related to this course.

The last bullet point elaborate as you wish.

describe how you might advise stakeholders to manage a real-world conflict you have witnessed in the workplace.

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Organizations are made up of people. People do not always agree. When they disagree conflict results. The challenge with conflict is that both sides are often sure they are right (and sometimes both are). For this assignment, you will take what we have learned this week and describe how you might advise stakeholders to manage a real-world conflict you have witnessed in the workplace.

General Requirements

· This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· Doctoral learners are required to use APA style for their writing assignments. Refer to the Publication Manual of the American Psychological Association for specific guidelines related to doctoral-level writing. The manual contains essential information on manuscript structure and content, clear and concise writing, and academic grammar and usage.

· You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Directions

Write a paper of 2,250-2,500 words in which you discuss an actual workplace conflict you have witnessed but of which you were not a part. Include the following:

1. Describe the conflict (change names of people and organizations to protect the “guilty”).

2. Describe at least two different theories or frameworks that would explain the parameters of the conflict. Consider stakeholders, leaders, and organizational politics in determining which approach to use.

3. Provide at least two different strategies you would recommend to the stakeholders to manage this conflict, and the pros and cons of each approach.

4. Identify any ethical risks that might need to be considered.

concept map to plan care

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Please use the concept map to plan care for Mr. Jackson. Mr. Jackson is a 38-year-old African American that presents with an altered level of consciousness (ALOC). He has been having headaches for the last three months but due to a hectic work schedule he has not been able to go to see his medical practitioner. During his last visit two years ago, his blood pressure was slightly elevated, but he never followed up. Upon arrival to the ED a CT scan is completed and it shows a large bleed near the frontal lobe. What should Mr. Jackson’s plan of care include?

Biliary cholic without cholecystitis

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Biliary colic without acute cholecystitis Essay

 

A 42 year old male, obese with a history of GERD presented to the clinic complaining of moderated abdominal pain in the right upper quadrant. The pain started after he consumed a large fatty meal. The pain radiated to his back. Denied fever, chest pain, diarrhea or any change in his bowel movements. Admitted vomiting. She took medications for the pain with proton pump inhibitors but did not relieved his pain. He consumes alcohol on the weekends. Quite smoke since 10 years ago. Physical examination is normal. Murphy’s sign was negative

Introduction

Should be a paragraph that provides a brief overview of the case and main diagnosis:

 

1-Biliary colic without cholecystitis:

:

 

Differential Diagnoses

Differential Diagnosis:

Provide EACH ( 3 of them) differential diagnosis with the rationale and supporting evidence with the REFERENCE for each one. Also explain why differentials (2&3) were not the primary diagnosis.

 

1- Biliary cholic without cholecystitis:

2- Acute cholecystitis:

2- Duodenal ulcer:

 

Diagnostics

1- Identify the lab, radiology, or other tests needed for the main diagnosis( Biliary cholic without cholecystitis): and the other 2 possible diagnosis provided ( Acute cholecystitis and Duodenal ulcer) with supporting evidence.

 

Treatment

· Include the initial treatment plan for the main diagnosis. It should include medication names, dosages, and frequencies. (Please use specific treatment plan supported by recent clinical Guidelines treatment as the Reference)

 

Education

Patient/family education:

 

Follow-Up

Appropriate follow up plan.

Please include when will patient follow up: 2 weeks, 1month, 3 months.

What are some follow up labs or test. Referrals

Why are they following up? What outcome do you wish to assess?

Old age is often characterized by depreciating health and general well-being.

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Old age is often characterized by depreciating health and general well-being. For instance, the majority of people affected with chronic infections are usually older individuals due to their reduced immunity and limited activities (Singu et al., 2020). Even though the social determinants of health apply to everyone older individuals are the ones that are greatly impacted by these social determinants especially when they are from lower economic backgrounds. Therefore, this paper will discuss how social determinants of health for senior citizens are influenced by those living in poverty.

The first social determinant is access to quality healthcare. Since senior individuals are prone to be victims of chronic infections and conditions related to accidents, they require frequent and quality healthcare intervention or services to lead a comfortable life. However, medical services are usually expensive in many nations including the United States of America which is among the developed nations with no universal care (Hill-Briggs et al., 2020). Therefore, when older adults are living in poverty they might not have enough disposable income to take care of their medical bills and frequent consultations hence lowering their levels of comfort. Quality care is very essential, especially for older individuals that are why many nations have enacted policies to ensure that older adults living in poverty can easily access these services. For instance, in the United States of America, the Affordable Care Act was enacted to ensure that older adults suffering from certain chronic infections can easily access medical care.

Nutrition or food security is also another social determinant that can significantly influence the well-being of older adults. Food is a very essential component of life, and everyone needs food for the normal metabolic functioning of the body (Hill-Briggs et al., 2020). Older adults, especially those suffering from chronic infections such as diabetes may require foods that are very nutritious and healthy as opposed to junk food. However, a healthy and nutritious diet might be more expensive than a non-nutritious diet hence forcing those older adults living in poverty to consume unhealthy foods that might have adverse effects on their health. Additionally, older adults living in extreme poverty might lack the financial capability to access daily or regular meals, and this can have adverse effects on their already depreciating health.

Social interactions and belonging is also another essential social determinant for the healthy well-being of older adults. Everyone needs a social support system and a sense of belonging to lead a healthy life. Older adults, especially those living in poverty might lack the required social support to enable them to lead a healthy life due to several reasons. For instance, senior adults living in poverty might be abandoned by their families and forced to reside in homes. This might have an adverse impact on their psychological well-being (Singu et al., 2020). Additionally, since senior citizens engage in fewer activities they may lack an opportunity to create a social connection with others. For those older individuals living in poverty, this limited physical activity might be heightened because they might be unable to pay for services such as a caregiver, gym membership, or join a club to help create a social connection

What people or agencies would you work with in facilitating the proposed interventions and why?

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Watch the “Diary of Medical Mission Trip” videos dealing with the catastrophic earthquake in Haiti in 2010. Reflect on this natural disaster by answering the following questions:

Propose one example of a nursing intervention related to the disaster from each of the following levels: primary prevention, secondary prevention, and tertiary prevention. Provide innovative examples that have not been discussed by previous students.

Under which phase of the disaster do the three proposed interventions fall? Explain why you chose that phase.

What people or agencies would you work with in facilitating the proposed interventions and why?