heart attack

A 60-year-old man is brought to the ER by ambulance because of slurred speech and left side weakness. His wife states they went to bed at 11pm and woke up at 5am when she noticed his symptoms. He is right handed with a history of coronary artery disease, hypertension, and hypercholesterolemia and a heart attack at age 50. He currently is unable to move his left arm and leg. He had an episode of amaurosis fugux (blindness)in his right eye one month ago that lasted for 5 minutes. Around 3 months ago his wife states he had bilateral pain in his legs while they were on a walk that lasted about 15 minutes. He is taking a baby aspirin a day an ACE inhibitor, and statin as well. He does have a history of alcohol use and smoking in the past but stopped after his heart attack. His blood pressure is 195/118 Pulse 106, Respiratory rate 18, Temperature 99.8, o2 sat is 97% on room air. Although his pupils are equal and reactive, and the ocular movements are intact, he is unable to turn his eyes voluntarily toward the left side. The neck is supple, there is no jugular vein distension, and there are no bruits. The lungs are clear heart sounds regular without murmurs, and abdomen is normal. The limbs are not well perfused distally. The neurologic examination reveals that he is alert and oriented, although he does not recognize he is sick. He shows loss of awareness and attention with respect to objects or stimuli on his left side. He has mild dysarthria but, his speech is fluent, and he understands and follows commands very well. There is mild weakness on the left side of the face and left sided homonymous hemaianopsia, but there is no nystagmus or ptosis, and no tongue or uvula deviation. He is not able to move his left arm and leg, has hyperreflexia, and the left great toe is upgoing.

  • What are two questions you would ask this patient?
  • Identify the subjective data for this patient.
  • Identify the objective data for this patient.
  • What is the likely diagnosis?

Your response should include evidence of review of the course material, websites, and literature through proper citations using APA format.

King’s Conceptual System Theory.

Part 1:

Discussion Question:

Consider what was happening in nursing in the late 1970’s and early 1980’s with the change from diploma programs to an associate degree program. Martha Rogers believed that nursing is a separate and essential discipline and a unique field of study. She worked hard to establish nursing in higher education. Explain the importance of this shift and how it impacted nursing as a profession.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length. 

Part 2:


This week you will be writing an APA paper to include a title page, level headings, and a reference page

  1. Discuss and explain King’s Conceptual System Theory. 
    1. First explain the 3 systems and provide examples of each system
    2. Explain how the systems influence goal attainment
    3. How could King’s theory help define a clinical quality problem? 
    4. Apply this theory to a potential practice quality improvement initiative within your clinical practice.
    5. How could a quality committee align outcomes with King’s Conceptual System Theory? 
    6. What additional nursing theory from our readings could also align with an improved quality of practice initiative?

This paper should include 2 outside references and the textbook. This paper should be 1250 to 1500 words in length.

Concept Of Nursing Meta paradigm

Nursing Theory

Identify your specialty area of professional practice (Use Family Nurse Practitioner). Select a nursing theory from the list of specialty track specific theories provided in the lesson plan or one of your own findings (Use the Synergy Model of Patient Care). Address the following: (1) briefly identify concepts of the nursing metaparadigm (remember the selected theory may not include all four concepts); (2) provide an example how the theory could be used to improve or evaluate the quality of practice in your specific setting.

Use articles starting 2014 – present

Accounts of Ground-Breaking Cases

Term paper is on Physician Assisted Suicide 

Medical Ethics: Accounts of Ground-Breaking Cases

Author: Pence, G. 

Publisher: Boston McGraw- Hill 

Edition:8th (2017) 


carotid surgery

Please answer the following questions after reading the article:

1. What are the parameters for considering whether to perform carotid surgery? (two conditions)

2. Reduction in the stroke risk in patients with atherosclerotic disease has been attributed to the use of what or which intervention? (three of them)

3. Experts feel which is a safer means of treating carotid stenosis? Medical Management or surgery?

4. What is a carotid endartarectomy? Explain..

5. Name three contraindications to carotid stenting?

6. What is the one most critical factor from studies that increase peri-procedural complications?

The Physiology and Processing of Pain

  • Module 8 Vocabulary- Neurological Assessment
  • Nursing Journal Article: CE: The Physiology and Processing of Pain: A ReviewAttached Files:
    •  Link to file (212 B)
    • Neurological Article Questions
      1. Pain- both acute and chronic-cost on an annual basis in the U.S. approximately how much?
      2. What is the frequency of pain and visits for pain complaints to physicians at the present time?
      3. More than 2/3’s of persons with chronic pain have had it how long?
      4. What is the International Association for the Study of Pain (IASP) definition of pain?
      5. A nociceptor is defined as…?
      6. Name the steps for pain perception from the peripheral tissue nociceptive receptor.
      7. Name three different types of non-nociceptive receptors.
      8. Name the two types of fibers found in the spinal cord.
      9. Describe what you would find in both ventral horns and dorsal horns of the spinal cord (hint: see figure 3).
      10. What is Lissauer’s tract?
      11. What are the three tracts that transmit nociceptive/pain impulses?
      12. Name six supraspinal structures in the brainstem and diencephalon where the nociceptive signal travels?
      13. What is a major component of pain modulation circuit called?
      14. Control of ascending sensory input by tonic inhibitory control of neurons occur where?
      15. Which area of the medulla of the brain exhibits both inhibitory and facilitation of nociceptive transmission?
      16. How do NSAIDS work to modulate the pain network?

failure of LGBT to use health care services

What biological, psychological, environmental, socio-cultural, behavioral, and health system factors might be contributing to the failure of LGBT to use health care services? What population health nursing interventions might promote more effective use of services? 400 words in length and utilize at least one scholarly source 



Number of Pages: 1 (Double Spaced)

Number of sources: 1

Writing Style: APA

Type of document: Essay

Academic Level:Master

Category:   Healthcare

VIP Support: N/A

Language Style: English (U.S.)

Order Instructions: Attached

Health care systems


Understanding the health care system at the local level is important when planning an EBP implementation because the health care systems may differ depending on the location. One must take into account the demographics, such as region, population, access to resources, etc. One must also take into account the socioeconomic status of the population being treated. For example, some places may have more access to resources to other places, such as urban areas compared to rural areas. In regards to population one must take into account the age groups, their ethnicity, culture and spiritual beliefs, and values. All of those factors play a significant role in determining if the EBP implementation is effective or not.


Health care systems in various countries have different accountabilities. One cannot just bring change by implementing any Evidence-Based Research Project directly without having understood the implications of the health care system. It is imperative to carry thorough studies to gain knowledge about the extent to which health care systems have developed and what level of changes and advancements that are needed in this regard. For proper implementation of evidence-based practice, it is essential to examine care related to individuals and how the local staff is performing from monetary and technological resources provided to the organization (Stokke, 2017). The flow of information at the hospital also has to be analyzed depending upon which are a more considerable part of the practical implementation. The medical caretakers have the heavy responsibility of implementing and devising strategies to eliminate healthcare-associated risks, answer the clinical inquiries and work on them if they are needed for the betterment of the healthcare system. One should focus on giving knowledge on the importance of EBP to the whole staff and make them aware of evidence-based practices. All individuals including medical attendants should be taught to take an essential role in the implementation.


The two most essential change theories, in my opinion, are Lewin’s model and Social Learning theory. Lewin’s model has remained very useful in explaining the role of power in advancement or no advancement and implication of change. Change can only take place if the joined quality of one constraint becomes noteworthy than the consolidated quality of the restricting arrangement of powers. The social cognitive theory which was initially known as social learning theory considers that the change in behavior has been primarily impacted by individual variables and some properties of behavior. In comparison to both models, Lewin is more valid and reasonable. It disregards all components related to individuals that affect change. In contrast to this, the social cognitive theory is more influenced by what flows are drawn naturally and focuses on individual components. Lewin model is also more preferred because it takes into consideration, the outer and inner ecological conditions (Moses, 2015).


The two most commonly recognized change theories are Lewin’s and  Lippitt’s change models. The two are both very similar to one another in that they both look to evaluate when change in needed, initiated, and ultimately evaluated. The differences with each  are  how the creator ultimately expands further with these three stages.  

Lewin’s Model consists of three stages: unfreezing, moving, and refreezing. The unfreezing stage ultimately looks at status quo, and increase driving forces for change; moving stage is the action stage in which the changes are implemented and involve people; and the final stage refreezing establishes the change as the new way of doing things with the reward of desired outcomes (Mitchell, 2013). Though Lewin’s model is simple and straight forward, as we all know now, change does not just happen as simple,  st raight  to the point stages. This is where Lippitt’s change model may work better not only for changes but changes to be done within the nursing field.  

Lippitt’s model directly reflects change in a way  nurses  already know how. This is true because the language used to establish the model mimics that of the nursing process (Mitchell, 2013). Lippitt’s model is broken down into 7 phases, as follows: diagnose the problem (phase 1), a ssess motivation and capacity for  change ( phase 2), assess change agent’s motivation and resources (phase 3), select progressive change objective (phase 4), choose appropriate role of the change agent (phase 5), maintain change (phase 6), and terminate the helping relationship (phase 7) (Mitchell, 2013). Use of Lippitt’s model though it may not be as direct can help create a  clearer  and outlined  way of implementing change within the health care system. This is primarily why I would more likely use Lippitt’s model because  it  acknowledges more specific areas where change can either be a halted because oversight.

Youth Physical Activity Guidelines

 hi dear,

 can help me to finish this assignment with good quality and be on time please?

School Physical Activity Policy

· Review the CDC Youth Physical Activity Guidelines

Reflect on your personal experiences regarding physical activity while you were in elementary, middle, or high school. Explain how your experience differed or was similar to what is outlined in the document. Specifically, compare/contrast:

· Amount, frequency, intensity

· Curriculum

· Student Assessment

· Extracurricular sports, clubs, and activity

Cite and reference your sources.