APA Paper on Medication Insulin Lispro

/in /by

Medication Insulin Lispro

Due July 2, 2017

Document APA Format

Note any additional references used

(See Attached information from the FDA-Food & Drug Administration)

Include information in the paper that is in Bold

(see information noted from my initial research)

Pharmacokinetics of Lispro

(Information to use) Used in management of Diabetes mellitus, types 1 and 2: Treatment of type 1 diabetes mellitus (insulin dependent, IDDM) and type 2 diabetes mellitus (noninsulin dependent, NIDDM) to improve glycemic control

Onset of action

Peak

Rapid acting: insulin lispro (Humalog)

              0 to 15 minutes (Peak)

30 to 90 minutes (Onset of Action)

Half-life

Duration of action

Pharmacodynamics of Lispro insulin

Pharmacotherapeutics of Lispro

Include Drug-to-drug interactions,

Drug-to-food interactions,

Drug-to-herb interactions

Routes and dosage ranges

For Children

For Adults

(Information to consider in writing paper)

Type 1 Diabetic : Note: Multiple daily doses or continuous subcutaneous infusions guided by blood glucose monitoring are the standard of diabetes care. Combinations of insulin formulations are commonly used. The daily doses presented below are expressed as the total units/kg/day of all insulin formulations combined.

Initial total insulin dose: 0.2 to 0.6 units/kg/day in divided doses. Conservative initial doses of 0.2 to 0.4 units/kg/day are often recommended to avoid the potential for hypoglycemia. A rapid-acting insulin may be the only insulin formulation used initially.

Usual maintenance range: 0.5 to 1 units/kg/day in divided doses. An estimate of anticipated needs may be based on body weight and/or activity factors as follows:

Nonobese: 0.4 to 0.6 units/kg/day

Obese: 0.8 to 1.2 units/kg/day

Adverse effects of Lispro

·       Cardiovascular: Peripheral edema

·       Central nervous system: Headache (type 1 diabetes: 30%; type 2 diabetes: 12%), pain (11% to 20%)

·       Endocrine & metabolic: Hypoglycemia, hypokalemia, weight gain

·       Gastrointestinal: Diarrhea (type 1 diabetes: 9%), nausea (type 1 diabetes: 6%)

·        

·       Genitourinary: Urinary tract infection (type 1 diabetes: 6%)

·        

·       Hypersensitivity: Hypersensitivity reaction

·        

·       Immunologic: Antibody development

·        

·       Infection: Infection (10% to 14%)

·        

·       Local: Hypertrophy at injection site, injection site reaction, lipoatrophy at injection site

·        

·       Neuromuscular & skeletal: Myalgia (type 1 diabetes: 7%; most likely secondary to excipient metacresol)

·        

·       Respiratory: Flu-like symptoms (type 1 diabetes: 35%; type 2 diabetes: 6%), pharyngitis (type 1 diabetes: 33%; type 2 diabetes: 7%), rhinitis (type 1 diabetes: 25%; type 2 diabetes: 8%)

• Glycemic control: The most common adverse effect of insulin is hypoglycemia. The timing of hypoglycemia differs among various insulin formulations. Hypoglycemia may result from changes in meal pattern (eg, macronutrient content or timing of meals), changes in the level of physical activity, increased work or exercise without eating or changes to co-administered medications. Hyperglycemia is also a concern; may occur with CSII pump or infusion set malfunctions or insulin degradation; hyper- or hypoglycemia may result from changes in insulin strength, manufacturer, type or administration method. Use of long-acting insulin preparations (eg, insulin detemir, insulin glargine) may delay recovery from hypoglycemia. Patients with renal or hepatic impairment may be at a higher risk. Symptoms differ in patients and may change over time in the same patient; awareness may be less pronounced in those with long standing diabetes, diabetic nerve disease, patients taking beta-blockers or in those who experience recurrent hypoglycemia. Profound and prolonged episodes of hypoglycemia may result in convulsions, unconsciousness, temporary or permanent brain damage or even death. Insulin requirements may be altered during illness, emotional disturbances or other stressors. Instruct patients to use caution with ethanol; may increase risk of hypoglycemia.

• Hypersensitivity: Hypersensitivity reactions (serious, life-threatening and anaphylaxis) have occurred. If hypersensitivity reactions occur, discontinue administration and initiate supportive care measures.

• Hypokalemia: Insulin (especially IV insulin) causes a shift of potassium from the extracellular space to the intracellular space, possibly producing hypokalemia. If left untreated, hypokalemia may result in respiratory paralysis, ventricular arrhythmia and even death. Use with caution in patients at risk for hypokalemia (eg, loop diuretic use).

Monitoring

·       Monitor serum potassium frequently with IV insulin use and supplement potassium when necessary.

Patient teaching

Medical Research

/in /by

Description:

You are to write an essay which analyses a case study in order to discuss appropriate biopsychosocial factors and nursing management or interventions relevant to that case. Recent and relevant literature must be used to support your discussion.Instructions:

  1. 1)  Select a case study provided.

  2. 2)  Use recent literature to support your discussion:

  1. 2.1)  Discuss biopsychosocial factors that contribute to the development of the selected disorder.

  2. 2.2)  Discuss a nursing management or interventions appropriate for your

selected case study. 2.3) Discuss ethical implications for the selected case study.

Other elements:

  •   Ensure that you use scholarly literature (digitised readings, research articles, relevant Government reports and text books) that has been published within the last 10 years.

  •   Provide a clear introduction and conclusion to your paper.

  •   You may use headings to organise your work if you wish.

      Unless otherwise instructed, write in the third person.

  •   Use academic language throughout.

  •   Refer to the marking guidelines when writing your assignment. This will assist you in calculating the weightings of the sections for your assignment.

  •   State your name, essay title and word count (excluding your reference list) on the Title page.

    Please find the attached document 

this is Pharmacology for Nurse Practitioners

/in /by

Case #1

While seeing patients with your preceptor, you have the opportunity to meet a 46-year-old woman who presents for her yearly physical examination. Her medical history is notable for borderline hypertension and moderate obesity. Last year her fasting lipid profile was acceptable. Her mother and brother have diabetes and hypertension. At prior visits, your preceptor has counseled her on a low calorie, low fat diet and recommended her to start an exercise program. With her full time job and four children, she finds it difficult to exercise, and she eats out most of the time. She is 67” tall and weighs 213lbs today, no current medication, takes fish oil supplements when she remembers. She doesn’t smoke, only drinks juice or soda with each meal, 3-4 cups of coffee per day. Today: BP 145/95mm Hg, TC 230 mg/dL, LDL 132 mg/dL, HDL 38 mg/dL, triglycerides 240mg/dL, fasting plasma glucose is 177 mg/dL; HgbA1C is 8.4mg/dL. Her examination is notable for acanthosis nigricans at the neck but otherwise is normal.

  1. What are your treatment goals for her?
  2. What is your plan for drug therapy? 3. Please give five teaching points for each drug prescribed, use patient centered language.
  3. Would you change your plan if her initial HbgA1C was 10.2mg/dL and her fasting blood glucose was 305mg/dL? If so what would be the alternative plan and what is your rationale? Case #2

MT is a 48 year old diabetic woman who presents with thickened, yellow toenails that are painful when she wears dress shoes. She also has some peeling of the skin on the soles of her feet. MT’s blood sugar levels are well controlled and last HbgA1C was 6.6mg/dL and fasting today 114mg/dL.  BP in office 120/84, P78, R 16, T 98.2, htg 66 inches, weight 165 lbs.  Medications are metformin 1000mg bid, Cimetidine 300mg tid, accupril 10mg po qd. Toenail culture comes back positive for fungus

  1. List specific goals of treatment for her dermatological conditions?
  2. What drug therapy would you prescribe and please explain your rationale.
  1. Do you need to consider any monitoring before, during or after your therapy?
  1. What are 5 patient centered teaching points for MT.

​Osteoporosis

/in /by

Osteoporosis is a bone disease marked by brittle and fragile bones. In this assignment, you will explore this disease in more detail using the scenario below.

Scenario:During a recent visit with a female relative, the relative informs you that she has been diagnosed with osteopenia, a precursor to osteoporosis. In order to help your relative, you decide to research this disease further.

To complete this assignment, do the following:

  1. Research this disease using a minimum of 2 sources. You can use your textbook for one of the sources. Choose the remaining source(s) from the GALE Virtual Reference Library provided on the Structure and Function of the Human Body library guide page.
  2. In a minimum of 2 pages (not counting the references page), address the following:
    • Explain how osteoporosis develops and the potential causes.
    • Describe the ways that your relative can prevent the onset of osteoporosis.
  3. Include a references page at the end of your document, formatted using the APA guidelines, that lists your research sources.

For help with formatting your references page, see the Structure and Function of the Human Body library guide page linked to above.

Submit your completed assignment by following the directions linked below. Please check the Course Calendarfor specific due dates.

Save your assignment as a Microsoft Word document

Nursing

/in /by

A 25-year-old Arab American man is one day post op following a thoracotomy. There have been no post-surgical complications. He tells his family that he is “in terrible pain”, yet he reports ratings of 2 to 3 on 0-10 numeric rating scale to the nursing staff. He requests pain medication every two to three hours, and will not get out of bed or ambulate.

  1. Identify and state a priority nursing diagnosis label for your assigned patient related to pain.
  2. Develop and state three (3) nursing interventions for this nursing diagnosis label or patient problem. When planning individualized nursing interventions, consider the patient’s type of pain and cultural perspective.
  3. Provide your rationale or reasoning for each intervention chosen.
  4. Base your initial post on your readings and research of this topic.Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.

The Impact of Chronic IllnessIdentify one person from the illness group you chose in Week 1. The person should not be a patient at the facility in which you work. You can use friends, family members,

/in /by

The Impact of Chronic Illness

Identify one person from the illness group you chose in Week 1. The person should not be a patient at the facility in which you work. You can use friends, family members, or coworkers. Do not use the person’s name in the paper but only initials. Administer the questionnaire you created in Week 1 to that person. Compile the data and analyze the responses to better illustrate where this person, his or her family, and friends are in relation to accepting the diagnosis in relation to the standard health or illness definitions. The analysis should also include coping skills, treatment, and support aspects of the illness. Identify how this will direct care plan development for the chosen illness group.

Compile a report of your interview with the questions you created, the responses you received, your analysis, and your interpretation of how it will affect planning care for the group in a 4- to 5-page Microsoft Word document.

Support your responses with examples.

On a separate references page, cite all sources using APA format.

comment from post 6

/in /by

As the lecture discusses, advancements in medical technology, procedures, and practices has created a new meaning of death. With these changes in medicine, death and dying has also been modified according to scientific and sociological meaning (GCU. 2015). Modern futility has evolved over the years in response to the changes of medicine. In years gone by, the belief was to engage in “the complete removal of the distress of the sick, the alleviation of the more violent diseases and the refusal to undertake to cure cases in which the disease has already won the mastery, knowing that everything is not possible to medicine” (Delisser and DeLisser. 2009). Debates in healthcare have continued to morph and adapt to the recent changes in medical treatment. However, at what point do these changes and so-called advancements then defeat the plan created by God? In terms of suicide and euthanasia, we are changing these paths and disobeying His ways. Meilaenders writing discusses a case of assisted suicide of an elderly woman, which in turn resulted in manslaughter charges upon her husband for the continued acts beyond what she intended to ensure her death. This case aligns with similar rationale and purpose of numerous other medical cases around the world where a critically ill patient has chosen to end their suffering through the use of lethal doses of medication. Though as the discussion ensues, he notes that all who perform suicide or euthanasia have sinned against God. As healthcare workers, our mission is to reduce suffering and ease pain, but is not our decision to end a life.

My personal opinion aligns with the above lectures and writings. The act of suicide is identified as some to be cowardly, selfish, and rebellious. These individuals are seen as taking the easy way out of life, only to leave behind greater suffering to one’s family and friends. I have had my share of difficult days, but fortunately not the extreme of wanting to end my life. However, I am indeed aware that countless people in the world feel pain and emotional distress which has often led them to this contemplation. For them, I feel great sadness at hope that they are able to find strength through faith and opening up their hearts to God for his healing hands. Overall, I do agree that these acts of suicide and euthanasia are sins against God.

I NEED YOU TO COMMENT FROM THIS POST, 150 WORDS NEEDED AND A REFERENCE PLEASE

Milestone 3: Educating Staff

/in /by

Purpose

The purpose of this assignment is to create the Educating Staff: Implementing Change ProjectPowerPoint presentation. Your plan is to educate the staff that will be involved in the pilot program. You will need to educate them on the problem, show the supporting evidence, and how your pilot plan will be implemented.

Course Outcomes

This assignment enables the student to meet the following Course Outcomes.

  • CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO2)
  • CO3: Communicates effectively with patient populations and other healthcare providers in managing the healthcare of individuals, families, aggregates, and communities. (PO3)
  • CO7: Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings. (PO7)             
  • Directions
    1. A tutorial with tips on completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=8912a4b3268463312e115abf9e73efd6 (Links to an external site.)Links to an external site.
    2. Create an educational presentation for staff before the launch of your change project. This should inform the staff of the problem, your potential solution, and their role in change project.
    3. The format for this proposal will be a PowerPoint presentation.
    4. Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.)Links to an external site. The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found under the Special Courses list in eCollege.
    5. The length of the PowerPoint presentation should be 15-20 slides; excluding the title and reference slides.
    6. Below are the main topics or bullet points for your slides:
    1. Title slide
    2. Description of the Ace Star change model that you have used for this project.
    3. Practice Issue
    4. Scope of the problem—use basic statistics from what you know of the problem in your work area.
    5. Your team/stakeholders
    6. Evidence to support your need for change—from your Evidence Summary
    7. Action Plan
    8. Timeline for the plan
    9. The nurse’s role and responsibility in the pilot program
    10. Procedure (what steps are to be taken to complete this change process, from start to finish?)
    11. Forms that will be used (if applicable)
    12. Resources available to the staff—including yourself
    13. Summary
    14. References
    1. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. Citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means choose peer-reviewed journals and credible websites.

    Guidelines

    • Application: Use Microsoft PowerPoint 2010 or later.
    • Length: The PowerPoint slide show is expected to be between 15-20 slides in length (not including the title slide and reference list slides).
    • Submission: Submit your by 11:59 p.m. Sunday by the end of Week 6.
    • Late Submission: See the Policies on late submissions.
    • Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.)Links to an external site. The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found under your course list in the student portal.

    Best Practices in Preparing a PowerPoint Presentation

    The following are best practices in preparing this presentation.

    1. Be creative.
    2. Incorporate graphics, clip art, or photographs to increase interest.
    3. Make easy to read with short bullet points and large font.
    4. Use speaker notes (found under the section View and “Notes” in the PowerPoint template you choose. These are for your personal use to use as a reference if you are giving your presentation to an audience and they help faculty identify what you will speak to your audience about.
    5. Review directions thoroughly.
    6. Cite all sources within the slides with (author, year) as well as on the Reference slide.
    7. Proofread prior to final submission.
    8. Spell check for spelling and grammar errors prior to final submission.

UNIT 7ISH

/in /by

DUE IMMEDIATELY One of the ways that the NP can manage risk of being successfully sued for malpractice or negligence is by utilizing evidence practice guidelines. Explain how these guidelines affect the “standard of care” and discuss with your classmates how utilizing this guideline can be a major strategy to significantly reduce risk to the provider. REFER TO THE STATE OF ALABAMA 

MUST BE 300 WORDS OR MORW WITH 3 INTEXT CITATIONS NO OLDER THAN 3 YEARS DUE NOW