NR 508 Week 3 Discussions Essay

discussion part one

elliot is a 74 year-old male who presents to your clinic with complaints of frequent nosebleeds (4 in the past week) and several severe bruises scattered variously throughout his anatomy. the patient is also complaining of a runny nose, cough, and head/chest congestion. he has a history of chronic atrial fibrillation and is currently prescribed and taking warfarin. approximately 3 weeks previously, he started taking over-the-counter cimetidine for heartburn he was experiencing. below is a list of the patient’s medications, his physical examination, and his laboratory findings:

medications

digoxin 0.25 mg qd cimetidine otc bid

pseudoephedrine sr 120 bid warfarin 7 mg qd

allergies: nkda

physical examination

vs: bp: 180/95, hr 75, irregularly irregular, rr 17

weight: 95 kg

heent: wnl

abd: + bowel sounds ext: bruising on arms and legs

neuro: alert & oriented x 3 gen: well developed, well-nourished male

ecg: atrial fibrillation

laboratory

na 143 meq/l k 4.5 meq/l

cl 99 mmol/l co2 25 meq/l

bun 18 mg/dl scr 0.9 mg/dl

inr 4.8 hct 42%

hbg 15 mg/dl digoxin 3.8 ng/ml

what problems should be identified in this patient? NR 508 Week 3 Discussions Essay

what are the precise mechanisms of action of each drug?

what do you think is contributing to the patient’s hypertension?

are there any drug interactions that you can identify as associated with this current drug regimen, and if so how, mechanistically, are they occurring?

what is the clinical significance of these interactions?

discussion part three

he returns a month later complaining of increased fatigue, visual disturbances, weakness, and nausea; however, his ecg is normal. NR 508 Week 3 Discussions Essay

based on this information, what is occurring in this patient? include precise mechanism(s) of how it is occurring.

additionally, please include any drug interactions associated with any new medications initiated keeping in mind the current regimen.

discussion part one

barbara is a married 39-year-old woman with no children, smokes 1 pack/day, and weighs 180 pounds who has scheduled an appointment with you to discuss feelings of anhedonia that she has been experiencing for the past few months. she has a history of depression as a teenager, but has not needed or received therapy for ~20 years. at the appointment, she relays that she has been experiencing chronic fatigue/loss of energy, feelings of worthlessness, appetite disturbances, weight gain, inability to concentrate, psychomotor disturbances, and insomnia. NR 508 Week 3 Discussions Essay

please provide a list of differential diagnoses, as well as an indication of your primary diagnosis.
once this has been completed, please indicate and describe your chosen pharmacological treatment with inclusion of dose and mechanism of action of your chosen prescription.

Description

Feedback Questions for Peer Presentation Reviews

Consider the following points when composing your review of a classmate’s presentation:

- How effective was the presentation?
- What did the classmate do well? NR 508 Week 3 Discussions Essay
- What elements of the presentation could be improved for future work?
- Is the material presented in a clear and concise manner?
- If there is one thing that you could learn from this person’s presentation and apply to your own future work, what would it be? Why did you pick that element?
- Does the color scheme really work for the presentation or against it? Why?
- How strong is the audio recording that accompanies the presentation? Is there anything you would suggest to improve next time?
- Does the presentation make a strong first impression? Why or why not?
- Does the presentation leave a solid lasting impression? Why or why not? NR 508 Week 3 Discussions Essay
- Summarize your general thoughts on the presentation and applaud the best parts of the work.

Description

Answer the following BOLD questions. Answer does not need to exceed more than a couple of paragraphs.

What do you think of Chinua Achebe’s claim that the racism of works like Heart of Darkness precludes us from considering them great works of literary art?

Note that there are several ways of addressing Achebe’s claim. One might agree with it, and then explore its implications for our evaluation of other works in the traditional canon. One might agree with it, and then explore its implications for other “isms,” like sexism, heterocentrism, etc. Or one might contest Achebe’s claim, for example by arguing that the artistic merit of a work’s “technical” qualities can outweigh any moral/ethical problems with its plot/characters (as, for example, is sometimes argued on behalf of Nabokov’s novel Lolita), or even that our literary judgement should not depend on moral/ethical considerations at all. NR 508 Week 3 Discussions Essay

Whichever way you choose to answer, your essay should at least mention the arguments of Edgar Allan Poe in “The Poetic Principle” and Walter Pater in Studies in the History of the Renaissance.