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In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.(assignments 2, 3 attached)

Refer to “Research Critiques and PICOT Guidelines – Final Draft.”(see attachment). Questions under each heading should be addressed as a narrative in the structure of a formal paper.

(Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Mr. Jones is a 78- year old gentle man who presents to the clinic with a chief complaint of fever, chills and cough. He also reports some dyspnea. He has a history of right sided CVA, COPD, dyspnea. He has a history of right sided CVA, COPD, dyslipidemia, and HTN. Current medications include atorvastatin 40 mg po qhs, lisinopril,and fluticasone/salmeterol. He reports more use of his albuterol rescue inhaler. Vital signs Temp 101.8 F, pulse 108, respirations 21. PaO2 on roomair 86% and on O2 4 L nasal canula 94%. CMP WNL, WBC 18.4. Physical exam reveal thin,anxious gentle man with mild hemiparesis on left side due to CVA. HEENT WNL except for diminished gag reflex and uneven elevation of the uvula, CV-HR 108 RRR without murmurs, rubs, or click, no bruits. Resp-coarse rhonchi throughout lung fields. CXR reveals consolidation in right lower lobe.He was diagnosed with community acquired pneumonia (CAP).

Question:

Patient was hypoxic as evidenced by the low PaO2. Explain the pathologic processes that caused this patient’s hypoxemia.

In a dispute between Cloud Computing Corporation and Digital Enterprises, Inc., the court applies the doctrine of stare decisis. What is this doctrine? What does this doctrine have to do with the American legal system? Can this doctrine ever be overruled or overturned? If so, how? Lastly, do you believe most businesses in the United States agree with stare decisis or disagree with the concept? Why?

Select one genetic development influence and one environmental development influence on fetal development and think about how these influences might impact each other. ( I was thinking for the environmental-mother drinking while pregnant?)

Post a description of the genetic influence and the environmental influence you selected. Then, explain how the environmental influence might positively or negatively affect the development of a fetus with the genetic influence you selected.

· Locate a peer-reviewed journal article (2015-present) on memory related to one of the following topics:

o Improving memory         o Amnesia

o Aging                                   o Cognitive mapping

· Consider how the article you selected relates to cognition and cognitive neuroscience.

          Post a response to the following:

Briefly describe the article you found on memory. Explain how the article informs our understanding of cognition and cognitive neuroscience.

Miss Winters, age 25, comes to the emergency department with severe wheezing, dyspnea, and anxiety. She was in the ED only 6 hours ago with an acute asthma attack, which resolved with nebulized albuteral treatments.

Subjective Data:

-Admits to use of albuterol inhaler several times weekly for the last few months

-Asthma symptoms occasionally awaken her at night (about 3 times a week), and she has cancelled several outings with her family due to her symptoms

-Can now only speak in one to three word sentences

-Is allergic to cigarette smoke

-Began to experience increased shortness of breath and chest tightness when she returned home

-Used albuterol inhaler repeatedly at home without relief

-History of pruritic skin lesions that have come and gone since childhood.

Objective Data:

           Physical Examination:

-Using accessory muscles to breath

-Audible inspiratory and expiratory wheezing to auscultation with no air movement in lower lobes of l

lungs

-HR = 126/min; Resp = 40/min

-Areas of dry, scaling skin in antecubital areas bilaterally with evidence of scratching

Diagnostic Studies:

ABGs: PO2  = 80 mm Hg

PCO2  = 35mm Hg

HCO3  = 24 mEq/L

pH = 7.48

PEFR: 150 L/min (Personal best: 400 L/min)

Continuous pulse oximetry: 82-85

CRITICAL THINKING QUESTIONS:

1. Why did Ms. W. return to the      ED? Explain the pathophysiology of this second exacerbation of asthma.
2. Describe the progression of breath sounds auscultated      from early in an asthma attack through very severe respiratory impairment.      How do the sounds change as the patient improves?
3. What is the significance of her dry, scaling, pruritic      skin lesions? What is your diagnosis (no nursing dx please)? How do these      types of lesions relate to asthma? What is their physiologic cause ?
4. Analyze the ABG. What type of acid-base disorder is      present? Why? Is there any compensation?
5. Discuss the four categories of asthma diagnosis      advocated in the Guidelines for the Diagnosis and Management of      Asthma from the National Heart, Lung, and Blood Institute of the      National Institutes of Health. Which classification best describes Ms.      W.’s asthma?
6. According to the asthma treatment guidelines from #5:      the “Step up-Step down” approach, what is the recommended treatment      strategy for a patient currently at Ms. W.’s classification level once      this current exacerbation is controlled? When would it be appropriate to      reevaluate the interventions and possibly adjust the medications?
7. She lost her Peak Flow meter during a recent house      move. Why would you want to order a new one for her? How is it used and      how can it help increase her ability to control her asthma? Explain the      red, yellow, and green zones. What is the significance of her PEFR level      on her return to the Emergency Room?

MD5 and SHA Functions have been used for years to verify files and messages. Discuss how they have used it. What is the difference between a one-way hash value and other cryptographic functions? Why is “salt” important?

1. After reading the article Think Twice About Being First to Market, evaluate emerging trends and/or products that were introduced to the market too soon. What would you have done differently? If a product is introduced to market and then fails, does this have an impact on another product being reintroduced? Illustrate examples by providing specific details as to how the reintroduction of another product can impact consumer perception and/or intent to buy. Here is a thought-starter: Would you purchase a Mercedes-Benz after the recall of all of the previous year’s same line of cars? Keep in mind that the new model is using the same engine as the previous year’s model.
2. Research Apple Company – What is its mission, philosophy of business, philosophy of customer service, etc.? What are its size and its scope of merchandise? What is its corporate structure? Who does the organization own? Who owns it? What is the internal organization of the retail unit you are assessing?

Topic 1- How might we work to address the issue of violence against women on our campuses or in our community?

Topic 2-Look at the following images and provide an analysis – How do these images contribute to rape culture? Use what you’ve learned from this week’s readings to form your answer. Also, what can we as a society do to eliminate rape culture? (Attached are the images and this week’s readings).