Genetic Factor – Savvy Essay Writers | savvyessaywriters.net

Respond to at least two of your colleagues who selected a different factor than you, in one of the following ways:

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Share insights based on your own experience and additional research.

Main Post

A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.

Heart Murmurs

Heart murmurs can be common in healthy infants, children, and adolescents. These murmurs are often innocent and result from normal patterns of blood flow through the heart. “Although most are not pathologic, a murmur may be the sole manifestation of serious heart disease” (Frank, J., Jacobe, K. 2011). If a murmur is detected, a thorough evaluation is needed.

Scenario

In this scenario, I would most likely have referred this patient out to a pediatric cardiologist. I would be hesitant because he has no family history and exam is negative. Only reason I would like to send him to a pediatric cardiologist is because he is young, even though he has no signs of symptoms, I could be missing something. The cardiologist would be able to do a more in-depth examination. The cardiologist could order an echo, ECG, and chest X-Ray. This 16-year-old male has a high-grade murmur, which can be heard at the apex of the heart, which could suggest MVR or MVP or aortic stenosis. “Certain characteristics of the murmur may be considered red flags, prompting stronger consideration for structural heart disease. These include a holosystolic murmur, grade 3 or higher should warrant a referral” (Frank, J., Jacobe, K. 2011).

Genetic Factor

Genetics can play a role in cardiac murmurs. Mostly, murmurs are discovered when a child is just a few days old or younger than 6 months. Usually, there will be signs and symptoms present with genetic murmurs in newborns and young children. Sometimes, in the older child, there will be a murmur present that does not cause symptoms or problems, but other times these asymptomatic murmurs can be deadly. Family history is an important factor and can be helpful when diagnosis an older child with a murmur. If during the scenario the mother had stated a family history of cardiac issues, I would not hesitate to send this patient to a cardiologist.

References

Frank, J., Jacobe, K. (2011). Evaluation and Management of Heart Murmurs in Children. American Family

Physician. 1;84(7):793-800. Retrieved from https://www.aafp.org/afp/2011/1001/p793.html

Mayo Clinic. (2019). Heart Murmurs. Retrieved from https://www.mayoclinic.org/diseases-

conditions/heart-murmurs/symptoms-causes/syc-20373171

Stanford Children’s Health. (2019). Heart Murmurs in Children. Retrieved from

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Assignment: Types Of Oral Medication

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Question 71

The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?

Question 72

A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?

Question 73

What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?

Question 74

A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough?

Question 75

A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests:

Question 76

The nurse practitioner is reviewing a patient’s lab report who completed the hepatitis B series 3 months ago. Which of the following lab results would you expect to see in this patient?

Question 77

A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?

Question 78

Which of the following is not a risk factor for coronary arterial insufficiency?

Question 79

A very active elderly patient has a documented diagnosis of arteriosclerosis obliterans. Common expected lower extremity physical exam findings include:

Question 80

Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?

Question 81

John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?

Question 82

A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:

Question 83

Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?

Question 84

A child complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his tonsils. His uvula is deviated to the left. What is the most likely diagnosis?

Question 85

Which intervention listed below is safe for long term use by an adult with constipation?

Question 86

Which of the following is a secondary cause of hyperlipidemia?

Question 87

What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?

Question 88

In order to decrease deaths from lung cancer:

Question 89

Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant abdominal cramping pain, nausea, and vomiting. Your differential diagnosis might be:

Question 90

A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:

Question 91

Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?

Question 92

The differential diagnosis for a patient complaining of a sore throat includes which of the following?

Question 93

Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?

Question 94

Diagnosis of Crohn’s disease is made considering signs, symptoms and:

Question 95

A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to:

Question 96

A false-positive result with the fecal occult blood test can result from:

Question 97

Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

Question 98

A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:

Question 99

Which antibiotic would be the most effective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions?

Question 100

A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free?

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Tsunami

Case Study to read uploaded
rubric to follow uploaded
Questions to answer are listed below, this should be written in APA format and at the end of the questions please write a summary of the answers.

1. Whats the difference between a tsunami and a tidal wave?

2. Give three examples of how you would lead when preparations are insufficient and when core values are threatened? How would you respond to unanticipated situations when time is of the essence, and planned approaches dont work?

3. Reputations are made or lost in crises is a core observation from almost all major past disasters. Please give three examples in the recent history of natural or human generated disasters where this was a particular outcome.

4. How might the nuclear reactor disaster have been prevented or repaired more quickly with proper planning and tools and more effective media relations? What is the meaning of the word Tomodachi?

5. What preparedness activities mitigated the impact of the earthquake and tsunami?

6. What environmental controls were destroyed and what was the impact on the community?

7. What activities did public health do to help restore environmental controls?

8. How did the Japanese people respond?

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Assignment-Development of Mental Illness

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Question Description
Many variables, such as work, family, friends, and/or lifestyle, may influence the development of mental illness. Along with these variables, a client’s individual variables, such as age and maturity, may also play a role in this development. Although such variables may increase a client’s level of risk in the development of mental illness, conversely, they may also assist in a client’s level of resilience. As a future professional in the field, it is essential to understand how variables influence the development of mental illness.

For this Discussion, select a variable that contributes to risk and resilience for a client. Think about why this variable might be considered in client diagnosis. Consider how this variable may interact with one individual variable.

With these thoughts in mind:

Post a brief description of one variable that contributes to risk and resilience of clients. Then explain why this variable is important to client diagnosis. Finally, explain how this variable might interact with one individual variable in the development of psychopathology. Provide an example and justify your response using the current literature.

3 Paragraphs. APA Format. In-text Citations to Support Writing.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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