Joshi Kamakani – 70 year old male with metastatic prostate cancer. Joshi is a retired engineer that the Palliative Care home care team and the NP has been looking after him at home for the last two months. Joshi was diagnosed with inoperable prostate cancer three years ago and has been treated with ablative hormone therapy.
His wife called you yesterday stating that he is in a lot of pain and therefore spends most of his time on the couch. He cannot get around on his own and is very fatigued.
Past medical History:
HTN
GERD
Medications:
Prednisone 5mg PO BID
Leuprorelin 22.5 mg IM every 3 month
Hydrocholorthiazide 25mg daily
Pantoprazole 40mg PO daily
Morphine slow release 100 mg q12h
You are a home health nurse taking care of Joshi. Use the resources available in your community to create the following care plan.
1. What are the 3 priority questions you will ask Joshi and his wife during the patient interview? (You may only ask 3 questions, so make sure you are focusing on the priority of care)
2. What are your 3 priority safety concerns for Joshi?
3. Create a plan of care to address the needs of Joshi and his wife.

Priority questions for Joshi and his wife:

Are you experiencing any pain or discomfort that is not being adequately managed with the medication currently prescribed?

Are you experiencing any changes in your appetite or weight?

Are you experiencing any confusion or difficulty with daily activities such as bathing, dressing, and grooming?

Priority safety concerns for Joshi:

The risk of falls due to his fatigue and inability to ambulate

The risk of medication errors due to confusion or difficulty swallowing

The risk of depression or anxiety due to his prognosis and decreased mobility

Plan of care to address the needs of Joshi and his wife:

Conduct regular pain assessments and adjust medication as needed to ensure adequate pain management.

Assess for any changes in appetite or weight and provide appropriate interventions such as tube feeding or oral care.

Assess for any cognitive or functional changes and provide appropriate interventions such as home health aides or adult day care.

Provide education on pain management, medication safety, and wound care.

Provide emotional support and resources for Joshi and his wife, such as counseling or support groups.

Assist with activities of daily living such as bathing, dressing, and grooming to prevent further decline in functional abilities.

Provide support for the family to ensure they are able to provide adequate care and manage their own emotional needs.

Coordinate with the oncology team and community resources for any additional interventions such as hospice care if needed.

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What would you suggest doing in order to reduce the stigma of
opioid use and increase community support?

In class, we learned that the impact of a teratogen depends on the genotype of the individual. Which example best illustrates this:
A. Zika is more likely to cause birth defects during some times of pregnancy than during others.
B. One drug during pregnancy causes deformed limbs but not low birth weight while the use of a different drug during pregnancy is associated with low birth weight but not deformed limbs.
C. the effects of moderate alcohol use while pregnant is not obvious when a child is born, but appears later in the child's life.
D. two women who both drank the same amount during pregnancy, but only one of them gave birth to a child with fetal alcohol syndrome and the other gave birth to a healthy child.

1. Which is a true statement?
A. X-rays are invisible and not very powerful.
B. Exposure to x-rays can harm the eyes, bone marrow and skin.
C. The diagnostic benefits of x-rays usually don’t outweigh the risks.
2. If you are having an asthma attack, you should use _____.
A. an inhaler
B. a nebulizer
C. a peak flow meter
D. either an inhaler or a nebulizer
3. This is a preventative measure to help track your asthma before your symptoms get worse.
A. An inhaler
B. A nebulizer
C. A peak flow meter
D. Either an inhaler or a nebulizer

Mary and Elmer’s fifth child, Melvin, was born 6 weeks prematurely and is 1-month old. Sarah, age 13, Martin, age 12, and Wayne, age 8, attend the Amish elementary school located 1 mile from their home. Lucille, age 4, is staying with Mary’s sister and her family for a week because baby Melvin has been having respiratory problems, and their physician told the family he will need to be hospitalized if he does not get better within 2 days.
Choose two or three areas of prenatal care that you would want to discuss with Mary, and then write brief notes about what you know and/or need to learn about Amish values to discuss perinatal care in a way that is culturally congruent.
Discuss three Amish values, beliefs, or practices to consider when preparing to do prenatal education classes with Amish patients.

Interview an individual between the ages of 38 - 64. ( INTERVIEW) please act like you interviewed someone and answer these questions below
Ask if they have noted any of the physical or cognitive changes as discussed in this week's module.
Ask if they have any chronic diseases then ask about lifestyle habits they have been practicing since adolescence or early adulthood.
This can be behaviors like smoking, drug use, sedentary lifestyle, poor diet, and others. Reflect on this information and discuss how these behaviors could have resulted in this changes in later adulthood.
100 words and no plaragarism

Which federal agency is primarily responsible for responding to public health emergencies?
a. Food and Drug Administration (FDA)
b. Centers for Disease Control and Prevention (CDC)
c. National Institutes of Health (NIH)
d. Centers for Medicare & Medicaid Services (CMS)