December 8, 2019

In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.

Details: The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, their specific care discipline, and their local communities. As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics. Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes. In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform. A minimum of three scholarly references are required for this assignment. In addition to submitting this assignment in the LoudCloud dropbox, email a copy of your submission to RNBSNclientcare@gcu.edu. While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 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.
December 8, 2019

Describe two specific aspects about the great Wall of China, such as facts about its sizes,length,purposes,varied materials, labor force, and it’s phases of construction.

Describe two specific aspects about the great Wall of China, such as facts about its sizes,length,purposes,varied materials, labor force, and it’s phases of construction. Consider the various purpose of such a wall and its impact for good or bad, compare the wall in this respect to some specific wall of more modern times
December 8, 2019

What is Multiple Myeloma?

Running Header: 73587018 Multiple myeloma MULTIPLE MYELOMA What is Multiple Myeloma? Multiple Myeloma is the cancer of plasma cell in the bone marrow.The plasma cells are important components in the body since they provide an immune system which fights diseases. These cells are found in the bone marrow and they fight body infections by producing proteins known as antibodies. In the case of multiple myeloma the plasma cells in the bone marrow grow out of control and become abnormal thus forming tumors around the solid bones. The development of the tumor makes it difficult for the bone marrow to make healthy blood cells and platelets, thus weakening the body. Multiple myeloma mainly affects the older adults and causes anemia which leads to abnormal bleeding. If the bones in the spine are affected by the disease, it can put pressure on the nerves resulting to weakness of legs and arms. Symptoms of Multiple myeloma One the symptom of multiple myeloma is anemia which develops at an early stage thus making a person to get infections and have abnormal bleedings in the body. Another symptom of multiple myeloma is back pains which develop as the cancer cells grow in the bone marrow. Other symptoms include; fevers, broken bones, fatigue, shortness of breath and bleeding problems that come about as a result of anemia. Therapy and treatment These symptoms of multiple myeloma can be noted and prevented by conducting blood tests in order to check for calcium levels, protein levels and the kidney function. Antibodies and proteins in the body are identified by conducting blood and urine tests. However, some people have a slow developing form of multiple myeloma that takes long to cause symptoms. Such people require some close observation in order to prevent the spread of the disease. The treatment of multiple myeloma is grouped into the following categories; – Induction chemotherapy, consolidated therapy, maintenance therapy and salvage therapy. Multiple myeloma can be treated by: Bexametasone,melphlan,cyclophosphamid,doxil,thalidomide,lenalidomide(Revlimid),and bortezomib (Velcade)can be used alone/combined together. Bisphosphonates (Pamidronate) to reduce bone pain and prevent fractures. Radiation therapy is done to the patients in order to make them comfortable and relieve them of the back pains and also to treat a bone tumor. In addition to the different types of therapies done to the patients, some nursing care is needed to the patients so as to provide them with a prolonged life by encouraging them to exercises and eat a balanced diet. Multiple myeloma patients should drink plenty of water to prevent dehydration and maintain proper kidney function. However the stress of illness may be eased by joining a support group whose members share common experiences and problems. Patient prognosis The possibility of survival and cure for people with multiple myeloma largely depends on the stage of the disease and also the age of the patient. Since the disease is mostly common among the old people, it is sometimes difficult for the patients to survive the therapies due to the weakness of their bodies. Some cases of multiple myeloma are so aggressive while take sometimes before they get worse. However, some patients survive the cancer when the disease is addressed at the early stages and it is advised that patients should identify the early symptoms and seek medical to avoid complications in the future. The patients with lower stages have a better prognosis than the ones with higher stages. Nevertheless, sometimes it depends with a patient’s response to chemotherapy for them to survive the disease. Pathological etiology There are various stages that a cancer disease develops before it reaches its optimum stage where it gets serious. Multiple myeloma is staged using two systems and they include the Durie-Salmon staging system or the International staging system. The Durie-Salmon staging system involves measuring of blood levels of calcium and hemoglobin, blood and urine levels whereby they check for the proteins. Evaluation of the bone damage is done through x-rays and the regular check ups. In the International staging system multiple myeloma is based on the levels certain proteins in the blood such as albumin. Technical information and positions performed in x-ray to demonstrate the multiple myeloma On x-ray multiple myeloma appears as a decreased bone density whereby it shows a lot of holes in the bone. A bone scan shows the bones that are involved with multiple myeloma by showing the destructive lesions that are not surrounded with the white rim like in other bones. The cancer cells of multiple myeloma have a unique appearance when seen under a microscope and they look like a clock face. In x-ray these cells look like punched out holes on the bone thus making the bone appear hollow. The multiple myeloma cells are not usually confined to a specific location or bone when seen through the x-rays, since they tend to involve the entire skeleton. Reference healthcommunities. (2010, September 14). multiple myeloma staging. Retrieved 7 7, 2011, from www.healthcommunities.com Mayo clinic. (2010, July 8). multiple myeloma. Retrieved 7 7, 2011, from www.mayoclinic.com
December 8, 2019

Examine the sources of evidence that contribute to professional nursing practice.

Role of Research Research is a fundamental role that every nurse and healthcare practitioner plays but in different ways. How can you use evidence to improve nursing care as a new nurse? In evidence-based nursing, an effective clinical question engages a topic of interest that is relevant to nursing. This issue of concern must have a basis in the literature and be measurable or describable. The Course Outcomes (CO) we will apply in our first week of discussion includes: Examine the sources of evidence that contribute to professional nursing practice. Recognize the role of research findings in evidence-based practice. Please Answer the Questions Carefully. Let’s open our conversation about research. Research is a fundamental role that every nurses plays but in different ways. How do you fulfill the research role now? Once you graduate from this program, how do you envision yourself fulfilling the research role in the future? Again, please support your rationales with professional resources. Please write at least 250 words and include 1 professional source (Reference) it has to be within the last five years.
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