Demonstrate an understanding of several key issues in drug therapy for the older person specifically adverse drug reactions polypharmacy and compliance.

the ways that older people may present with health problems as compared with younger adults.
Identify distinctive aspects of quality care in assessing and managing the health needs of older people.
Demonstrate an understanding of several key issues in drug therapy for the older person specifically adverse drug reactions polypharmacy and compliance.
Discuss a number of strategies to promote the safe use of medications.
Recognise the main problems that older people may encounter as inpatients in hospital.
Identify several key strategies to help older people maintain their function and independence if they are admitted to hospital.
present some of the practical implications that arise from the disease processes that may be associated with the biology of ageing. The module begins by exploring some of the important ways that health problems may be different in older people than in younger age groups. It then discusses the particular area of drug therapy in older people. It concludes by examining the special care needs of older people who require treatment in hospital.It examines ageing from the practical viewpoint of care providers. No matter what area of gerontology you are involved in it is certain that those you care for will be
receiving some sort of medical care. It is essential that you understand the principles governing medical care of the aged. This topic identifies how biological changes associated with age impact on the practice of geriatric medicine.The ageing of the population has major health care implications. In Australia half of all acute care hospital beds are occupied by people aged over 60 years. People more than 65 yrsrepresent 12% of the population but account for 35% of total health care expenditure. Expenditure per person aged 65 or more is 3.8 times higher than younger people. It is estimated that the fraction of GDP spent on health will double in 40 years as a result of ageing.Many health care workers express difficulty with geriatric medicine because of its complexity the chronic nature of many common conditions and the lack of evidence to which to base decisions.The medical assessment of older people requires special skills and attitudes. Issues that need consideration include frailty and potential difficulties in communication (e.g. deafness dysphasia cognitive impairment). Patience gentleness and courtesy will be rewarded with a wealth of clinical information as well as development of a therapeutic relationship with the patient.The following issues are important in approaching medical problems of older people.
1. Atypical presentation of disease. The typical signs and symptoms of disease (e.g. chest pain in heart attack) are not seen frequently in older people. More commonly older people present with non-specific symptoms: confusion incontinence failure to cope immobility and falls. These are sometimes called the geriatric giants and in some ways parallel symptoms such as failure to thrive and irritability in paediatric medicine. In the acute hospital setting these problems are often precipitated by infection (e.g. urinary tract infection pneumonia) or the adverse effects of drugs so called drugs and bugs. However inevitably the acute illness often has a multifactorial aetiology.
2. Comorbidity. Older people often have several acute and chronic health problems. In developed countries in people over the age of 70 years the prevalence of common diseases include arthritis (50-60%) hypertension (40-50%) heart disease (20-25%) cancer (20%) diabetes (10-15%) dementia (5-10%). It is important to identify all underlying health problems in every patient because in order to achieve a good functional outcome each problem (not necessarily each disease) usually needs to be addressed and treated. Because of the high prevalence of cognitive impairment and mood disorder in older hospitalized people every older patient should have an assessment of cognition (e.g. MMSE) and mood (e.g. Geriatric Depression Scale) performed.
3. Iatrogenic contributions to health problems. Because older people often do have multiple problems it is vital that all the issues are considered and that problems are not treated in isolation. If this happens it is very easy for one form of treatment tolead onto other often more serious problems. For example a patient with dementia who has been causing carer stress because of wandering is prescribed a sedative. As a result he aspirates and develops pneumonia. He is brought to the Emergency Department with worsening confusion.
4. Holistic assessment of the persons situation. Assessment of the health status of the older person should not be restricted to medical problems. It is also important to get an understanding of other aspects of the persons life such as their social support systems financial constraints affecting their care accommodation and transport needs.
5. The goals of therapy. Quality of life and independence are often paramount for an older person. In a study of older people in hospital it was found that the majority had returning to their own home as their main goal. This often did not correlate with the wishes of family members. In general an older person is admitted to hospital because they cannot manage independently and should be returned home once independence has been achieved. In this setting other medical goals such as the treatment and investigation of specific diseases need to be undertaken as an outpatient or by the general practitioner.CARE OF THE OLDER PERSON IN HOSPITAL
The greatest users of hospitals are older people. Therefore all people working within the hospital system should have an appreciation of some of the special management issues in this age group. These include the following.
1. Team approach. Older people often have multiple problems that need to be addressed therefore special input is required for the assessment and management of each problem.
2. Early discharge planning. Ideally all members of the team should have a long-term plan in place from the day of admission. This is required so that all members of the team have a consistent goal and so that organizational issues (such as completion of Form 26/24 for residential care placement) can be completed ahead of time. For many older people hospitalization is a harbinger of the need for permanent residential care. Discharge planning should involve communication with the persons general practitioner and relevant health and support services in the community.
3. Appreciation of rehabilitation and palliative care needs. A rehabilitative approach should be undertaken from the day of admission and not left until the acute illness has been treated in order to prevent the complications of immobility. If medical treatment is futile palliative care can be instituted. In this setting consideration of resuscitation orders adequate analgesia and communication with the patient and family are important.
4. Prevention and management of iatrogenic disease. There are seven common complications of immobility and hospitalization in older people:
a. venous thrombosis
b. pressures sores
c. malnutrition
d. deconditioning
e. depression
f. bronchopneumonia and
g. constipation.
These all contribution to morbidity mortality and length of hospital stay but ideally are all preventable.DRUG THERAPY IN THE OLDER PERSON
Drug therapy is the main intervention of modern medicine. The efficacy and safety of medications are well established in younger populations with disease. Older people who have greater susceptibility to disease would be expected to benefit even more. However the issue is more complex. Older people have increased risk of adverse effects and in many cases there is limited evidence for efficacy in frail older people. In this setting a careful risk:benefit analysis may preclude use of medications that are routine in the management of disease in younger adults.Adverse drug reactions are a major cause of morbidity and mortality in older people. Thus whenever an older person develops new symptoms particularly falls or confusion the first diagnosis to consider is an adverse drug reaction because these are common and easy to treat.
Adverse drug reactions have taken over from syphilis and tuberculosis as the great mimic of systemic disease. As a rule of thumb it is useful to consider adverse drug reactions for every presenting problem in older people partly because they are common and partly because they are simple to manage (ie by ceasing the medications). Although adverse drug reactions can present with any symptoms there are two special areas of concern in older people: falls and confusion.When making a decision to commence drug therapy the higher prevalence of adverse drug reactions in older people needs to be considered in the risk to benefit ratio.Polypharmacy defined as the use of five or more medications occurs in 20-40% of older people. Part of the risk of polypharmacy may be the unintentional practice of prescribing additional drugs for the adverse effects of other drugs the so-called prescribing cascade.
The risks and negative aspects of polypharmacy include increased risks of adverse drug reactions drug interactions cost and compliance errors. Medication errors can occur easily during hospitalization of older people taking complex medication regimes.
It is important to determine the potential benefits of polypharmacy before dismissing it as inappropriate. As yet there is limited information on the usefulness of treating multiple conditions in the same patient.Evidence based medicine The evidence base for prescribing to older people is small and clearly disproportionate to the amount of prescribing in this group. In the year
2000 only 3.45% of 8945 randomized controlled trials and 1.2% of 706 meta-analyses were for people over 65 years. Much of geriatric practice with respect to drug usage is reduced to being anecdotal and at best based on extrapolation from studies in younger patients or healthy older people.Pharmacodynamics and pharmacokinetics. Age related changes in liver and kidney function lead to impaired clearance of drugs from the body. This means that standard doses of drugs used in younger adults are likely to lead to increased concentrations in older people and hence increased risk of adverse drug reactions. Age-related changes in receptors for drugs can lead to increased or decreased drug activity.READINGSAssessing the health status of the older person
1. Pal SK. Katheria V. Hurria A. (2010) Evaluating the older patient with cancer: understanding frailty and the geriatric assessment. CA: a Cancer Journal for Clinicians. 60(2):120-32.
2. Inouye SK. Studenski S. Tinetti ME. Kuchel GA. (2007) Geriatric syndromes: clinical research and policy implications of a core geriatric concept. Journal of the American Geriatrics Society. 55(5):780-91.Care of the older person in hospital
1. Callahan E.H. Thomas D.C. Goldhirsch S.L. and Leipzig R.M. (2002). Geriatric hospital medicine. Medical Clinics of North America 86(4):707-29.
2. Australian and New Zealand Society for Geriatric Medicine. Position Statement No 15 Discharge Planning. http://www.anzsgm.org/documents/PositionStatement15DischargePlanningDec08.pdf
3. Rothschild J.M. Bates D.W. Leape L.L. (2000) Preventable medical injuries in older patients. Archives of Internal Medicine 160(18):2717-2728
4. Wright L Hill KM Bernhardt J Lindley R Ada L Bajorek BV Barber PA Beer C Golledge J Gustafsson L Hersh D Kenardy J Perry L Middleton S Brauer SG and Nelson MR (2012) Stroke management: updated recommendations for treatment along the care continuum. Internal Medicine Journal 42 562569.
5. Kortebein P (2009) Rehabilitation for Hospital-Associated Deconditioning. American Journal of Physical Medicine& Rehabilitation 88: 66-77.
7. Young JInouye SK (2007). Delirium in older people. British Medical Journal 334: 842-846.
8. Saxena S. Lawley D. (2009) Delirium in the elderly: a clinical review. Postgraduate Medical Journal. 85(1006):405-13.
9. Covinsky KE; Pierluissi E; Johnston CB (2011) Hospitalization-Associated Disability She Was Probably Able to Ambulate but Im Not Sure JAMA-Journal of ohe American Medical Association. 306: 1782-1793.
10. Amador LF Loera JA (2007) Preventing Postoperative Falls in the Older Adult. Journal of the American College of Surgeons 204: 447-453.Pain
1. Karp JF. Shega JW. Morone NE. Weiner DK. (2008) Advances in understanding the mechanisms and management of persistent pain in older adults. British Journal of Anaesthesia. 101(1):111-20.Drug therapy in the older person
1. Dingwall L. (2007) Medication issues for nursing older people (part 1). Nursing Older People. 19:25-9.
2. Shi S; Morike K; Klotz U (2008). The clinical implications of ageing for rational drug therapy European Journal of Clinical Pharmacology 64 (2): 183-199.Aids
1. Thirugnanachandran T Bateson A (2012). Seating for improving function in older people. European Geriatric Medicine 3:6772.
2. Clegg A Smith S (2010). Bedding aids. European Geriatric Medicine 1:385390.
3. Stowe S Hopes J Mulley G (2010) Walking Aids. European Geriatric Medicine 1:122127.


 

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Select a topic relevant to drugs and behavior and write a 5-page paper on this topic. This assignment is relevant to learning more about research in the field of substance use disorders and addiction medicine.

Select a topic relevant to drugs and behavior and write a 5-page paper on this topic.
This assignment is relevant to learning more about research in the field of substance use disorders and addiction medicine.

This assignment is relevant to learning more about research in the field of substance use disorders and addiction medicine. You will select a topic relevant to drugs and behavior and write a 5-page paper on this topic. It is required that you have a thesis statement or research question that you support or answer with peer reviewed articles. All references must be included, citing all works used. you will hand in a thesis statement and reasons for your interest in the subject area chosen
For this assignment, you can find peer-reviewed articles on the following websites:
Google Scholar
PubMed
PsychInfo
PsycArticles
Here are some topics that you can choose from:
Drugs and the brain
Medication assisted treatment
Drugs and crime
Medications for ADHD
LSD and violence
Medical marijuana
The Gateway Hypothesis
Designer drugs
Alcohol withdrawal syndrome
Smoking cessation techniques
Intensive outpatient therapy
Inpatient rehabilitation
Performance enhancing drugs in sports
Post-acute withdrawal syndrome
Medications for schizophrenia, bipolar disorder, or depression
Safety of prescription drugs/FDA approval process
Inhalant abuse
Substance abuse prevention
Drug/alcohol abuse and liver disease
12-step programs


 

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Which of the following choices is NOT a common injury in sports? A. concussion and muscle strains B. hemorrhage and arthritis C. ligament strains and tears D. bone fractures and ankle sprains.

Which of the following choices is NOT a common injury in sports? A. concussion and muscle strains B. hemorrhage and arthritis C. ligament strains and tears D. bone fractures and ankle sprains.

Which of the following choices is NOT a common injury in sports? A. concussion and muscle strains B. hemorrhage and arthritis C. ligament strains and tears D. bone fractures and ankle sprains


 

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demand curve and the supply curve for Belgium cocoa beans.

Unless specified differently by your course instructor

Unless specified differently by your course instructor

Question

.0/msohtmlclip1/01/clip_image002.jpg” alt=”Description: kulogo”>Unit 3 Assignment Template:

Name: –

Course Number: –

Section Number: –

Unit Number: –
3

Date: –

———————————- General Instructions for all Assignments———————————–

1.
Unless specified differently by your course instructor, save this assignment
template to your computer with the following file naming format:

Course
number_section number_LAST_FIRST_ unit number

2. At the top of the template, insert the
appropriate information: Your Name, Course Number, Section Number and Date

3.
Insert your answers below, or in the appropriate space provided for in the
question. Your answers should follow the
APA format with citations to your sources and, at the bottom of your last page,
a list of references. Your answers should also be in Standard English with
correct spelling, punctuation, grammar, and style (double spaced, in Times New
Roman, 12-point, black font). Respond to
questions in a thorough manner, providing specific examples of concepts,
topics, definitions, and other elements asked for in the questions.

4. Provide a list of references at the end of
the last page of your assignment.

5.
Upload the completed assignment to the appropriate dropbox.

6.
Any questions about the assignment, or format questions, should be directed to your
course instructor.

——————————————- Career
Competencies —————————————–

In
this assignment, you will engage in developing the following career
competencies:

Analyzing
Quantitative Data

Analyzing
Qualitative Data

Improving
Global Awareness

——————————————- Assignment ——————————————-

1. St Atanagio is a remote island in the Atlantic. The
inhabitants grow corn and breed poultry. The accompanying table shows the
maximum annual output combinations of corn and poultry that can be produced.
Obviously, given their limited resources and available technology, as they use
more of their resources for corn production, there are fewer resources
available for breeding poultry.

Maximum annual output options Quantity of Corn

(pounds)

Quantity of
Poultry
(pounds)
1 1200 0
2 1000 300
3 800 500
4 600 600
5 400 700
6 200 775
7 0 850

Examine the
following production possibility frontier graph with corn on the horizontal
axis and poultry on the vertical axis illustrating these options and showing
points 1–7.

.0/msohtmlclip1/01/clip_image004.png”>

a. Can St. Atanagio produce 650 pounds
of poultry and 650 pounds of corn? Explain. Where would this point lie relative
to the production possibility frontier?

b. What is the opportunity cost of
increasing the annual output of corn from 800 to 1000 pounds?

c. What is the opportunity cost of
increasing the annual output of corn from 200 to 400 pounds?

d. Can you explain why the answers to
parts b. and c. above are not the same? What does this imply about the slope of
the production possibility frontier?

2.Suppose that the supply schedule of
Belgium Cocoa beans is as follows:

Price
of cocoa beans
(per
pound)
Quantity
of cocoa beans supplied
(pounds)
$40 900
$35 700
$30 500
$25 400
$20 200

Suppose that Belgium cocoa beans can be
sold only in Europe. The European demand schedule for Belgium cocoa beans is as
follows:

Price
of Belgium cocoa beans
(per
pound)
European
Quantity of Belgium cocoa beans demanded
(pounds)
$40 100
$35 300
$30 500
$25 700
$20 900

a. Below is the graph of
the demand curve and the supply curve for Belgium cocoa beans. From the supply
and demand schedules above, what are the equilibrium price and quantity of
cocoa beans from Belgium?

.0/msohtmlclip1/01/clip_image006.jpg” alt=”Description: slide1″>

Now suppose that Belgium cocoa beans can be sold in
the U.S. The U.S. demand schedule for Belgium cocoa beans is as follows:

Price
of Belgium cocoa beans
(per
pound)
U.S.
Quantity of Belgium cocoa beans demanded
(pounds)
$40 200
$35 400
$30 600
$25 800
$20 1000

b.
What is the combined (total) demand schedule for Belgian cocoa beans
that European and USA consumers buy?

Price
of Belgium cocoa beans
U.S.
Quantity of Belgium cocoa beans demanded
European
Quantity of Belgium cocoa beans demanded
Total
Demanded
(per
pound)
(pounds) (pounds) (pounds)
$40 200 100
$35 400 300
$30 600 500
$25 800 700
$20 1000 900

Below is the
supply and demand graph that illustrates the new equilibrium price and quantity
of cocoa beans from Belgium.

.0/msohtmlclip1/01/clip_image008.jpg” alt=”Description: slide2″>

c.
From the supply schedule and the combined U.S. and European demand
schedule, what will be the new price at which Belgium plantation owners can
sell cocoa beans?

d.
What price will be paid by European consumers?

e.
What will be the quantity consumed by European consumers?

——————————————–

References:

Unit _3_
PERFORM Assignment Grading Rubric/ Instructor Worksheet
Content Percent Possible Points Possible
Full assignment 100% 80
Overall Writing: 20% 16
correct coversheet information at the top of 1st page 5% 4.00
APA format for answers 3% 2.40
correct citations 3% 2.40
standard English no errors 4% 3.20
At least ONE, or more, references 5% 4.00
Answers: provides complete information demonstrating
analysis and critical thinking:
80% 64
Individual Questions:
1. a. – Can this
quantity be produced, where does point lie?
10% 8.00
1. b. – What is
Opportunity cost from 800 to 1,000?
10% 8.00
1. c. – What is
opportunity cost from 200 to 400?
10% 8.00
1. d. – Why are c
& d not the same, what shape of curve?
5% 4.00
2. a. – What is
equilibrium quantity and price?
5% 4.00
2. b. – What is new
demand schedule?
10% 8.00
2. c. – What is new
price?
10% 8.00
2. d. – What price
will Europeans pay?
10% 8.00
2. e. – What quantity
will Europeans buy?
10% 8.00
Sub-total for Individual Questions: 80% 64.00

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Write a 750-1,000-word paper that analyzes your research and focuses on the population you have chosen.

In this course, you will be complete a 2-part assignment in which you conduct research about a population of focus, develop a PICOT statement, and write a Literature Review. The PICOT statement and Literature Review you write in this course can be used for your evidence-based practice project in the next course so be sure to select an issue you want to continue working on in your next course.

PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting the population of focus. Additionally, the information derived from a good PICOT makes it easier to perform a literature search in order to find translational research sources that can be used to address the clinical problem.

Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT and conduct research on the population.

Write a 750-1,000-word paper that analyzes your research and focuses on the population you have chosen. Describe the population’s demographics and health concerns, and explain how nursing science, health determinants, and epidemiologic, genomic, and genetic data may impact population health management for the selected population. Provide an overview of a potential solution for solving the health issue related to your population and the intended PICOT statement. Describe how the solution incorporates health policies and goals that support health care equity for the population of focus.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.


 

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Based on your understanding of the topic, conduct a research and create a report on the political battle for universal healthcare in the United States.

Based on your understanding of the topic, conduct a research and create a report on the political battle for universal healthcare in the United States.

One of the significant challenges for health policy is not necessarily the implementation of programs but the influence of the political climate in regard to both the financial support and control of the programs.

Based on your understanding of the topic, conduct a research and create a report on the political battle for universal healthcare in the United States.

Your report should include the following elements:

History of the national healthcare reform starting from the early days struggle for a national health plan to the present day.
Political struggle to pass PPACA.
Political impact of Medicare and Medicaid on the push for universal coverage.
Major issues from the legislative and executive (presidential) perspective. Who were the opponents and supporters?
The politics surrounding the national health insurance agenda and its impact on the PPACA.
Note: Your report should include at least four references from reputable sources.

In a Microsoft Word document, create a 3- to 4-page report on your research on the political battle for universal healthcare in the United States.


 

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Cumulative Dose Monitoring – Required for Course Completion.The nurse’s role in monitoring cumulative dose is an expected step in the safe administration verification process, as part of an assessment of the overall treatment plan.

Cumulative Dose Monitoring – Required for Course Completion.The nurse’s role in monitoring cumulative dose is an expected step in the safe administration verification process, as part of an assessment of the overall treatment plan.

The nurse’s role in monitoring cumulative dose is an expected step in the safe administration verification process, as part of an assessment of the overall treatment plan. Yet, many nurses will rely on the dosage checks performed by others (physicians, pharmacists, etc.) or by systems (e.g., electronic health records)


 

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What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention?

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention?

Nursing

The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has high blood pressure, which he tries to control with sodium restriction and sleep apnea. He current works at a catalog telephone center.

Objective Data •Height: 68 inches; Weight 134.5 kg •BP: 172/96, HR 88, RR 26 •Fasting Blood Glucose: 146/mg/dL •Total Cholesterol: 250mg/dL •Triglycerides: 312 mg/dL •HDL: 30 mg/dL

Critical Thinking Questions 1.What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not? 2.Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered: (a) Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime; (b) Ranitidine (Zantac) 300 mg PO at bedtime; and (c) Sucralfate / Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.


 

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Explain what risks do the mentally ill pose to staff and other inmates in the prison facility? Read Chapter-10. This discussion question will be available from 6/19 6/26, midnight CST.

Explain what risks do the mentally ill pose to staff and other inmates in the prison facility?
Read Chapter-10. This discussion question will be available from 6/19 6/26, midnight CST.

Prisoners in state and federal institutions have asked the courts for help in cases involving medical treatment – both for treatment and received and treatment inmates failed to receive. Think about the mentally ill – are they receiving proper care? In 400-600 words explain what risks do they pose to staff and other inmates in the prison facility? Respond to two other students post in at least 100 words each.


 

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It’s not a paper it’s actually an online multiple choice assignment for introduction to macroeconomics. Can you do this one? The questions are posted one week before the due date and once I open he quiz I have 30 mins to finish it.

It’s not a paper it’s actually an online multiple choice assignment for introduction to macroeconomics. Can you do this one? The questions are posted one week before the due date and once I open he quiz I have 30 mins to finish it.


 

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