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Connecting Systems: PICK ONE OPTION BELOW TO ANSWER.Option 1: Trace the pathway atrial natiuretic peptide would take from its secretion by the heart to target cells in the kidneys. Start with the vein that collects all blood from the cardiac muscle and returns it to circulation.Option 2: Trace the pathway lymph would take from the right axillary lymph nodes to the heart and then to the upper right leg.

Net Present Value is the difference between the [BLANK-1] of the returns and the cost of the original investment. If the answer equals [BLANK-2] it means the returns, at the specified interest rate, exactly recover the cost of the original investment. If the answer is a Positive number the investment is earning the desired rate of return.

Give an example of a real-life annuity payment: [BLANK-1] What is one of the characteristics of this payment that makes it an annuity? [BLANK-2]

Case Study Question 5 of 6 A 23-year-old male with bipolar disorder has a health maintenance appointment with the telehealth nurse. Nurses’ Notes   4/1 Telemedicine visit. Client appeared onscreen in a positive mood, was well groomed; shaved; clothes neat, and non- wrinkled. His speech had a normal cadence, was organized, and logical. No slurring or stuttering. Occasional tongue thrusting noted while speaking that was reported to have started 1 day ago. Fine hand tremor noted when client smoothed hair back during conversation. Client reports that he is still attending school and is doing well. He is working a part time job on weekends for local restaurant.  States that he has been taking his meds as directed, he has no thoughts of self- harm, but he has had difficulty sleeping more than a few hours per night.  He complains that he has gained weight (10 lbs / 4.53 kg) recently and has not had the energy to work out. Self-obtained home vital signs of 128/72, HR 82, RR 20. Medications   Medication Dosage/Frequency/ Route         Time Lithium Carbonate 900 mg twice per day by mouth 0800 1800 Risperidone 2 mg once daily at bedtime by mouth 2100 Discontinued 4/1 Laboratory Report      Lab Results Reference range Cholesterol (Total) 220 240 mg/dL high BUN 15 10-20 mg/dL Creatine (Serum) 1.2 0.9 to 1.4 mg/dL Glucose (fasting) 125 Normal 126mg/dL Preterm infants 40mg/dL-60mg/dL HgbA1C 5.7% Normal 6.5% Hematocrit 44 Males: 42-52%;Females: 35-47% Hemoglobin 15 Males: 13-18 g/dL; Females:12-16 g/dL WBC 6 4.5 – 10.5 x 103 cells/mm3 Platelets 180,000 140,000 to 450,000/ mm3 Potassium(serum) 4.2 3.5 to 5 mEq/L Sodium (serum) 140 135 to 145 mEq/L Lithium level 0.8 0.8-1.2 mEq/L   The prescriber discontinues the risperidone, and the nurse teaches the client about the treatment plan. For each possible action, select if the following client education is indicated or not indicated. 

Case Study Question 6 of 6 A 23-year-old male with bipolar disorder has follow-up health maintenance appointment 2 months later. Nurses’ Notes   4/1 Telemedicine visit. Client appeared onscreen in a positive mood, was well groomed; shaved; clothes neat, and non- wrinkled. His speech had a normal cadence, was organized, and logical. No slurring or stuttering. Occasional tongue thrusting noted while speaking that was reported to have started 1 day ago. Fine hand tremor noted when client smoothed hair back during conversation. Client reports that he is still attending school and is doing well. He is working a part time job on weekends for local restaurant.  States that he has been taking his meds as directed, he has no thoughts of self- harm, but he has had difficulty sleeping more than a few hours per night.  He complains that he has gained weight (10 lbs. / 4.53 kg) recently and has not had the energy to work out. Self-obtained home vital signs of 128/72, HR 82, RR 20.   6/1 In person visit. Vitals 135/72, HR 82, RR 16, temp 98.6 F (37 C).  Appears unkept, wearing a ripped t-shirt. Speech- slurred and slow. No tongue thrusting or other uncontrolled orofacial movements noted. States he has been unable to work for the past 2 weeks and is “taking a break from school and work.” Said, “I really don’t like work anymore and school is a bore.”  Reports taking his meds as directed.  Denies thoughts of self-harm. He has lost 5 pounds(2.27kg) since the last visit. Medications   Medication Dosage/Frequency/ Route         Time Lithium Carbonate 900 mg twice per day by mouth 0800 1800 Risperidone 2 mg once daily at bedtime by mouth 2100 Discontinued 4/1 Laboratory Report      Lab Results Reference range Cholesterol (Total) 220 240 mg/dL high BUN 15 10-20 mg/dL Creatine (Serum) 1.2 0.9 to 1.4 mg/dL Glucose (fasting) 125 Normal 126mg/dL Preterm infants 40mg/dL-60mg/dL HgbA1C 5.7% Normal 6.5% Hematocrit 44 Males: 42-52%;Females: 35-47% Hemoglobin 15 Males: 13-18 g/dL; Females:12-16 g/dL WBC 6 4.5 – 10.5 x 103 cells/mm3 Platelets 180,000 140,000 to 450,000/ mm3 Potassium(serum) 4.2 3.5 to 5 mEq/L Sodium (serum) 140 135 to 145 mEq/L Lithium level 0.8 0.8-1.2 mEq/L   The nurse evaluates the effectiveness of the treatment plan. For each finding, click to specify if the finding indicates that the client’s status has improved, declined, or is unchanged. Finding Improved Declined Unchanged No suicidality noted     X Slovenly appearance   X   No tongue thrusts X     Taking meds as ordered     X Stopped working and going to school   x  

Case Study Question 4 of 6 A 23-year-old male with bipolar disorder has a health maintenance appointment with the telehealth nurse. Nurses’ Notes   4/1 Telemedicine visit. Client appeared onscreen in a positive mood, was well groomed; shaved; clothes neat, and non- wrinkled. His speech had a normal cadence, was organized, and logical. No slurring or stuttering. Occasional tongue thrusting noted while speaking that was reported to have started  1 day ago. Fine hand tremor noted when client smoothed hair back during conversation. Client reports that he is still attending school and is doing well. He is working a part time job on weekends for local restaurant.  States that he has been taking his meds as directed, he has no thoughts of self- harm, but he has had difficulty sleeping more than a few hours per night.  He complains that he has gained weight (10 lbs / 4.53 kg) recently and has not had the energy to work out. Self-obtained home vital signs of 128/72, HR 82, RR 20. Medications   Medication Dosage/Frequency/ Route         Time Lithium Carbonate 900 mg twice per day by mouth 0800 1800 Risperidone 2 mg once daily at bedtime by mouth 2100   Laboratory Report        Lab Results Reference range Cholesterol (Total) 220 240 mg/dL high BUN 15 10-20 mg/dL Creatine (Serum) 1.2 0.9 to 1.4 mg/dL Glucose (fasting) 125 Normal 126mg/dL Preterm infants 40mg/dL-60mg/dL HgbA1C 5.7% Normal 6.5% Hematocrit 44 Males: 42-52%;Females: 35-47% Hemoglobin 15 Males: 13-18 g/dL; Females:12-16 g/dL WBC 6 4.5 – 10.5 x 103 cells/mm3 Platelets 180,000 140,000 to 450,000/ mm3 Potassium(serum) 4.2 3.5 to 5 mEq/L Sodium (serum) 140 135 to 145 mEq/L Lithium level 0.8 0.8-1.2 mEq/L   The nurse concludes the client is most likely experiencing tardive dyskinesia. Which (2)  interventions should the nurse anticipate to be included in the plan of care?

Case Study Question 1 of 6  A 23-year-old male with bipolar disorder has a health maintenance appointment with the telehealth nurse. Nurses’ Notes   4/1 Telemedicine visit. Client appeared onscreen in a positive mood, was well groomed; shaved; clothes neat, and non-wrinkled. His speech had a normal cadence, was organized, and logical. No slurring or stuttering. Occasional tongue thrusting noted while speaking that was reported to have started 1 day ago. Fine hand tremor noted when client smoothed hair back during conversation. Client reports that he is still attending school and is doing well. He is working a part time job on weekends for local restaurant.  States that he has been taking his meds as directed, he has no thoughts of self-harm, but he has had difficulty sleeping more than a few hours per night.  He complains that he has gained weight (10 lbs /4.53 kg) recently and has not had the energy to work out. Self-obtained home vital signs of 128/72, HR 82, RR 20. Medications   Medication Dosage/Frequency/ Route         Time Lithium Carbonate 900 mg twice per day by mouth 0800 1800 Risperidone 2 mg once daily at bedtime by mouth 2100   Laboratory Report      Lab Results Reference range Cholesterol (Total) 220 240 mg/dL high BUN 15 10-20 mg/dL Creatine (Serum) 1.2 0.9 to 1.4 mg/dL Glucose (fasting) 125 Normal 126mg/dL Preterm infants 40mg/dL-60mg/dL HgbA1C 5.7% Normal 6.5% Hematocrit 44 Males: 42-52%;Females: 35-47% Hemoglobin 15 Males: 13-18 g/dL; Females:12-16 g/dL WBC 6 4.5 – 10.5 x 103 cells/mm3 Platelets 180,000 140,000 to 450,000/ mm3 Potassium(serum) 4.2 3.5 to 5 mEq/L Sodium (serum) 140 135 to 145 mEq/L Other     Lithium level 0.8 0.8-1.2 mEq/L Select the 4 clinical findings that need follow-up. (Select All That Apply)

What element must nurses integrate with best evidence when applying evidence-based practice to ensure appropriate patient care?

What focus characterized Florence Nightingale’s environmental theory as the foundation of modern nursing?

What components combine with the cognitive skills in Layer 3 to inform a nurse’s clinical judgment according to the NCSBN-CJM?