Accоrding tо the sоlubility rules, which of the following compound(s) is (аre) soluble in wаter? 1. CdCO3 2. (NH4)2CO3 3. NiCl2 4. Pb3(PO4)2 5. Cu(NO3)2 а. 5 only b. 2, 3, and 5 only c. 3 and 5 only d. 1 and 4 only e. 2 and 3 only Tables.pdf Periodic Table with New Elements.pdf
Accоrding tо the sоlubility rules, which of the following compound(s) is (аre) soluble in wаter? 1. CdCO3 2. (NH4)2CO3 3. NiCl2 4. Pb3(PO4)2 5. Cu(NO3)2 а. 5 only b. 2, 3, and 5 only c. 3 and 5 only d. 1 and 4 only e. 2 and 3 only Tables.pdf Periodic Table with New Elements.pdf
Scenаriо 1: Jоe is а 68 yeаr оld gentleman who attends his practice nurse appointment. The appointment was booked because recently he has had less energy, has lost 3kgs of weight over the last 2 months unintentionally and is unable to quench his thirst. His observations are recorded as follows: Height 180cm Weight 92kg BMI 28 Blood pressure 163/92 Heart rate 88 Oxygen saturations 96% Random blood glucose 12.9mmols Blood work taken in a preparatory appointment shows the following: FBC shows Joe’s Hb is at the lower end of normal Biochemistry shows elevated levels of creatinine and urea suggesting early renal damage Liver panel normal HBA1C level elevated at 6.7% (Normal range 4.5-5.2%) Lifestyle history: Joe has recently retired from his job as an accountant. He lives with his wife who is 10 years younger and is still working as a school teacher. Joe has a passion for woodwork and has recently converted his garage in to a workshop. His retirement gift from his wife was a puppy. Joe shares with you he thinks she did this to keep him company and also encourage him to get out of the house regularly. Joe smokes 20 cigarettes per day for 30 years. He has tried to give up in the past and failed although he would like to be successful as his brother died of a stoke and he was also a smoker. Joe does not drink regularly although he does like an occasional whiskey on special occasions. Family history: Mother had type 2 diabetes, father died of Alzheimer’s Brother died age 62 of a stroke No familial history of cancer Symptom history: Joe initially thought his energy had changed following his retirement because he was exhausted but he is now not been working for 4 months and things have not improved. He has also noticed his sleep is disturbed by needing the toilet multiple times in the night. His digital rectal exam shows slight prostate hypertrophy but no indication for concern. His appetite is okay although he does admit he gets absorbed in his wood projects sometimes and forgets to eat lunch when his wife is at work. He does not feel this is enough to explain his weight loss. Joe’s diet is reasonably balanced, his wife is a good cook and they have a shared allotment in their village and use veg from this most evenings in their meals. They both have a sweet tooth and at the weekends will often visit a garden centre and have a cup of coffee and cake. Outcome: The nurse tells Joe she suspects he has developed type 2 diabetes. She wants to do some more screening of him but initially gives him advice on how to manage this. Scenario 1 questions Describe the condition of type 2 diabetes. You should include the pathophysiological changes that occur, the impact this has on the body’s normal homeostasis and the potential long term effects Joe might experience as a result of his condition (20 marks) Identify 5 different interventions the nurse might give Joe to help manage his condition and explain how these will help (15 marks) Choose a care plan need you think Joe has from this history given and write a care plan using SMART goals as a structure. Remember to include timescales for review and justify each of your interventions (20 marks) Diabetes care is a significant burden on the NHS. Describe the impact of poorly managed diabetes on the health service, giving detail and justification for your points. Then discuss a current health promotion campaign the health service employs which is attempting to reduce people’s risk of diabetes, explain your choice including how the campaign is designed to work. (20 marks) Scenario 2 April is a 22 year-old University student. She currently lives in a shared house with friends. She maintains contact with her mother and stepfather who live over 100 miles away. April was referred to the Early Intervention in Psychosis Team. April has been seen on two occasions for initial screening assessment of current mental health need. She was referred by her local GP practice. She originally attended her GP with a friend and housemate. April reported to the GP that she hears voices and that she sometimes has periods of absence. She has found that scratching her arms and legs with her fingernails helps to manage these absences. She describes the voice she hears as that of an old man. The content of the voice can be range from neutral to threatening. She is unsure of the reasons why she hears the voice but is accepting of the possibility of it being caused by her mental state. There is no indication of paranoia or thought disorder. She is pleasant and amenable in assessment. April has been treated for asthma since childhood. She reports ongoing adherence, as required, to treatment with reliever and preventer inhalers. She reports subjective concerns about her mood being rapidly changing. To date, on assessment, she has presented as slightly flat and slowed in responses. April denies any current thoughts of serious self-harm or suicide. She denied any previous attempts at suicide. When asked, she denies any history of significant trauma. Sleep is reported as a significant concern. Reports initial insomnia and early waking. Estimates sleeping between 3am and 6am most nights. April is not in a relationship. She does not have children. She works in a local supermarket to supplement her income. She does not have any significant debts. April does not smoke. She denies any recent change in diet or weight. She reports “snacking” and “living off junk”. She enjoys spending time with her friends and likes skateboarding. April tells you that she “doesn’t get the buzz out of it like I used to”. She drinks alcohol. She reports drinking 8 units of lager twice a week. She admitted to occasional use of cannabis but denied misuse of other drugs. Her friends have accompanied her previously to the GP. They expressed concerns about her safety to the GP who passed these details to you with the referral. Her GP recently initiated a prescription for mirtazapine at 30mg. April reports current adherence. Alongside salbutamol and ciclenoside inhalers for asthma. There is no identified family history of mental illness. Scenario 2 questions Provide a description of the pathophysiology of a patient with asthma. Your answer should include symptoms that April that may experience with regards to asthma ( 15 marks ) Identify up to 5 care needs for April that are present in the scenario. Provide a summary of suitable nursing interventions for each identified need ( 25 marks ) What concerns would you have with regard to the management of April’s ongoing safety? Identify suitable interventions and approaches to manage these ( 20 marks ) Identify a suitable public health initiative that would be applicable in the management of asthma. What impact would this have on the NHS and outcomes of poorly managed asthma? ( 15 marks )
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