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A term infant was admitted to the NICU with tachypnea, a cleft palate, a pansystolic, left lower sternal border murmur, and hypocalcemia.  An echocardiogram was completed which demonstrated findings consistent with truncus arteriosus.  As the NNP caring for this infant you would also have a high degree of suspicion for which of the following?

An elderly female patient had been admitted for a hip replacement. The patient seemed to be recovering well until she developed redness, increased swelling, and purulent discharge at the surgical site. The wound was cultured and results from microbiological testing revealed that the infection was caused by Staphylococcus aureus. The patient successfully completed the course of antibiotic therapy, and within a few days, all signs of infection had subsided. The patient was progressing well with physiotherapy, and was planning for discharge when the patient suddenly began to experience diarrhea. On the first day, the patient had two loose bowel movements. By the second day, the episodes of diarrhea were occurring every 2 to 3 hours. The stools were watery and foul-smelling and contained large amounts of mucus. The patient complained of mild abdominal pain and cramping, and she subsequently developed a fever. The physician was notified, and a stool specimen was collected for laboratory testing.  The stool culture came back showing that the patient’s diarrhea was actually caused by the Clostridium difficile. The patient was placed on contact isolation and was started on intravenous metronidazole (Flagyl). With this treatment, the diarrhea gradually slowed and finally stopped. Repeat cultures performed after the metronidazole therapy was completed showed that the infection had been successfully cleared. QUESTION:  What are risk factors for this patient to develop Clostridium difficile infection (2.5 points)? Also give the Domain and type of microorganism C. diff  is (2.5 points).

A completar Type (or copy & paste as given) the verb form that best completes each sentence from the choices given.  “ar” Verbs 1. Los lunes y miércoles mis amigos y yo [BLANK-1] inglés. (compramos/estudiamos) 2. La profesora [BLANK-2] literatura y cultura. (viaja/enseña) 3. [BLANK-3] a clase al mediodía. (Descanso/Camino) 4. ¿Cuándo [BLANK-4] a Guatemala? (viajas/trabajas)

Which type of glia generate a myelin sheath?

You have an appointment in the cancer prevention clinic with GC a 32-year-old Caucasian male. He is concerned about his health since he has been told that cancer runs in “the family”. He knows he needs to make some changes in his lifestyle therefore he has an appointment with you today for some suggestions. He played basketball in high school and club sports in college but now feels like there is never enough time to exercise regularly. He describes his job as very stressful causing difficulty with sleep and additionally reports that he has frequently heart burn. However, he states, “it’s time to make some changes”. Ht: 6’ 3”    Wt: 250 lb. (stable)     Blood Pressure: 142/82 Labs: BMP: normal labs     Lipid panel: T cholesterol: 240    LDL: 132    HDL:  42    TGs: 155 Family History: Dad: stage 1 prostate cancer; Mom: osteopenia   Brother: age 48: stage 1 colon cancer Dad’s family: Uncle with colon cancer; Grandfather: prostate cancer and heart disease; Grandma: unknown Mom’s family: Aunt with pancreatic cancer; Grandfather: heart disease; Grandmother died young Diet history: B: Large bowl of corn flakes with whole milk (~1.5 c); 2 large cups of black coffee (~20 oz. total) L: Fast food typically – burgers, Subway, Pizza Hut, etc., Coke (64 oz.) D: Hamburgers, chicken, casseroles, pizza, French fries, 2-3 of beers with dinner on most nights Snack before bedtime: large bowl of ice cream, chips or popcorn and 6 oz. red wine (helps relieve stress) Design 2 PES Statements (10 points) P:                                     E: S: P: E: S:

You have an appointment in the cancer prevention clinic with GC a 32-year-old Caucasian male. He is concerned about his health since he has been told that cancer runs in “the family”. He knows he needs to make some changes in his lifestyle therefore he has an appointment with you today for some suggestions. He played basketball in high school and club sports in college but now feels like there is never enough time to exercise regularly. He describes his job as very stressful causing difficulty with sleep and additionally reports that he has frequently heart burn. However, he states, “it’s time to make some changes”. Ht: 6′ 3″    Wt: 250 lb. (stable)     Blood Pressure: 142/82 Labs: BMP: normal labs     Lipid panel: T cholesterol: 240    LDL: 132    HDL:  42    TGs: 155 Family History: Dad: stage 1 prostate cancer; Mom: osteopenia   Brother: age 48: stage 1 colon cancer Dad’s family: Uncle with colon cancer; Grandfather: prostate cancer and heart disease; Grandma: unknown Mom’s family: Aunt with pancreatic cancer; Grandfather: heart disease; Grandmother died young Diet history: B: Large bowl of corn flakes with whole milk (~1.5 c); 2 large cups of black coffee (~20 oz. total) L: Fast food typically – burgers, Subway, Pizza Hut, etc., Coke (64 oz.) D: Hamburgers, chicken, casseroles, pizza, French fries, 2-3 of beers with dinner on most nights Snack before bedtime: large bowl of ice cream, chips or popcorn and 6 oz. red wine (helps relieve stress) List his current risk factors for developing cancer (10 points):

You are meeting with Mr. Adams in the medical oncology outpatient clinic today. Mr. Adams is a 49-year-old Hispanic male who is currently receiving chemotherapy and radiation for lung cancer. He received a PEG for tube feedings when diagnosed 6 weeks ago because of dysphagia as the tumor was pressing on his esophagus. He has had 3 weeks of radiation and 2 rounds of chemo, which has resulted in the tumor shrinking enough for Mr. Adams to start taking some oral nutrition. He and his wife have an appointment with you today because they would like to know how to best manage his nutrition now. He will have radiation for at least 3 more weeks and will have his last chemo treatment in 4 days – he has been tolerating chemo well. He reports tolerating his tube feedings ok; no problems with nausea, diarrhea or constipation. He doesn’t really get hungry in between feedings. Ht: 5′ 7″     Current Wt: 125 lb.     Wt before starting treatment: 148 lb. (2 months ago) Labs: reportedly WNLs Meds: none besides the chemo. PEG feedings: 4 cans per day providing ~1420 calories & 50 grams of protein; he flushes his feeding tube with 60 mL of water before and after each feeding. The formula is 76% free water. He also drinks about 3-4 oz. of juice in the morning without too much difficulty – it just takes him about 10 minutes to get it all down. He is not experiencing any coughing or difficulties with swallowing when he drinks the juice. He is just cautious because if he drinks it too fast he thinks he might aspirate. Labs: not available but reportedly WNLs. What are your MNT recommendations (formatted in SMART goal format) and plan for follow-up? (10 points)

Mr. Jackson is having surgery in 2 weeks for a hip replacement. Based on the following information, which of the following would you recommend? Ht: 6′    Wt: 188 lb. (stable)   B.P.: 124/80      Lipid panel: Total cholesterol: 182  LDL: 144  TG: 400 HDL: 45    Medications: BP medication, statin, MVM, vitamin E, ginseng & garlic

According to the National Center for Complementary and Integrative Health, art and music therapy would be classified as

A goal of nutrition therapy during palliative care is to