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  • [Solved] Unit 6 response adv psych

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    – ## unit6response.docx **## unit6response.docx** Instructions: Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers: · Compare and contrast your initial posting with those of your peers. · How are t…

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    Assignment Prompt & Instructions

    – ## unit6response.docx

    **## unit6response.docx**

    Instructions:

    Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

    · Compare and contrast your initial posting with those of your peers.

    · How are they similar or how are they different?

    · What information can you add that would help support the responses of your peers?

    · Ask your peers a question for clarification about their post.

    · What most interests you about their responses?

    Please be sure to validate your opinions and ideas with citations and references in APA format.

    [**April Williams**\
    **_(She/Her)_**](https://herzing.instructure.com/courses/48814/users/88791)

    Oct 9 12:59am| Last reply Oct 10 12:39am

    **Reply from April Williams**

    Sam’s symptoms are most consistent with Bipolar I Disorder, current episode manic (National Institute of Mental Health [NIMH], 2024):

    · “resounding moment,”

    · grandiosity “I should be teaching my professors.”

    · long hours awake, energized

    · engaging strangers in philosophical conversations

    · alcohol, sexual activity, reckless spending

    · withdrawal from college, legal trouble

    · no hallucinations or delusions

    According to the NIMH (2024), bipolar disorder is a serious mental disability that causes “unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks.”.

    Per NIMH (2024)and clinical guidelines, treatment involves mood stabilization and sometimes adjunctive therapy:

    · Mood stabilizers

    · Lithium (gold standard, reduces suicide risk)

    · Valproate (Depakote).

    · Carbamazepine, Lamotrigine (more for bipolar depression/maintenance).

    For acute mania in a 19-year-old:

    · Lithium carbonate is first-line (unless contraindicated)

    · initial dose: 300 mg orally 2–3 times daily

    · adjust to therapeutic serum level: 0.6–1.2 mEq/L.

    · Monitor: renal function, thyroid function, and lithium levels.

    **Reference**

    National Institute of Mental Health. (2024). Bipolar Disorder. Retrieved from
    [https://www.nimh.nih.gov/health/topics/bipolar-disorderLinks to an external site.](https://www.nimh.nih.gov/health/topics/bipolar-disorder)

    · Reply to post from April Williams
    **Reply**

    ·

    · Expand discussion thread from April Williams

    **1 Reply, 1 Unread**

    **1 Reply (1)**

    [**Makeda Thomas**](https://herzing.instructure.com/courses/48814/users/95107)

    Oct 9 12:52am

    **Reply from Makeda Thomas**

    Makeda Thomas, Discussion Week 6:

    **Probable Diagnosis**

    Based on Sam’s presentation, the most likely diagnosis is Bipolar I Disorder, current episode manic, without psychotic features, as defined by the DSM-5 (Preda, 2024). Sam exhibits hallmark symptoms of mania, including grandiosity, decreased need for sleep, pressured speech, risky behaviors (e.g., impulsive spending, hypersexuality, alcohol use), and flight of ideas. His belief that he is more advanced than his professors and his impulsive shift in academic focus reflect elevated mood and inflated self-esteem. Although he was arrested for a “psychotic break,” there is no evidence of hallucinations or delusions at present, which supports a manic episode without psychotic features.

    Importantly, Sam has a prior diagnosis of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), which may have represented early manifestations of bipolar spectrum illness. Bipolar disorder often emerges in late adolescence or early adulthood, and misdiagnosis as unipolar depression is common in early stages (Yang et al., 2023).

    **Medication Classifications for Bipolar I Disorder**

    Pharmacologic treatment of acute mania typically involves one or more of the following classes:

    ·
    **Mood stabilizers**: Lithium, valproate, carbamazepine (Marzani & Price, 2021)

    ·
    **Second-generation antipsychotics (SGAs)**: Olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone (Marzani & Price, 2021)

    ·
    **Anticonvulsants**: Valproic acid, lamotrigine (more effective for bipolar depression than mania) (Marzani & Price, 2021)

    ·
    **Adjunctive benzodiazepines** (e.g., lorazepam) for agitation or insomnia in acute settings (Marzani & Price, 2021)

    Combination therapy is often required in moderate to severe mania, especially when functional impairment or risk behaviors are present (Marzani & Price, 2021).

    **Recommended Medication and Dose**

    **Medication**:
    _Risperidone_ **Class**: Second-generation antipsychotic

    **Starting Dose**:
    _1–2 mg orally once daily_

    **Rationale**: Risperidone is FDA-approved for the treatment of acute manic or mixed episodes in Bipolar I Disorder. It has demonstrated rapid efficacy in reducing manic symptoms, including grandiosity, impulsivity, and sleep disturbance (McNeil et al., 2024). Compared to other SGAs, risperidone has a relatively favorable side effect profile in young adults and is less sedating than olanzapine or quetiapine, which may help preserve daytime functioning. It also has a lower risk of metabolic side effects when used short-term.

    Given Sam’s age and lack of prior antipsychotic exposure, a starting dose of 1 mg daily is appropriate, with titration to 2–4 mg/day based on clinical response and tolerability. Monitoring should include assessment for extrapyramidal symptoms, sedation, and metabolic changes (McNeil et al., 2024). If symptoms escalate or do not respond adequately, adjunctive mood stabilizers such as valproate may be considered.

    **Clinical Considerations**

    ·
    **Avoid antidepressant monotherapy**: SSRIs or SNRIs may worsen mania if used without a mood stabilizer or antipsychotic (Preda, 2024).

    ·
    **Psychoeducation and psychotherapy**: Cognitive behavioral therapy (CBT) and family-focused therapy can improve insight, adherence, and relapse prevention (Özdel et al., 2021).

    ·
    **Safety planning**: Given Sam’s impulsivity and legal involvement, risk assessment and structured follow-up are essential.

    **References**

    Marzani, G., & Price Neff, A. (2021). Bipolar Disorders: Evaluation and Treatment.
    _American family physician_,
    _103_(4), 227–239.
    [https://www.aafp.org/pubs/afp/issues/2021/0215/p227.htmlLinks to an external site.](https://www.aafp.org/pubs/afp/issues/2021/0215/p227.html)

    McNeil, S., Gibbons, J.R., Cogburn, M. (2024). Risperidone
    _. StatPearls_.
    [https://www.ncbi.nlm.nih.gov/books/NBK459313/Links to an external site.](https://www.ncbi.nlm.nih.gov/books/NBK459313/)

    Özdel, K., Kart, A., & Türkçapar, M. H. (2021). Cognitive Behavioral Therapy in Treatment of Bipolar Disorder.
    _Noro psikiyatri arsivi_,
    _58_(Suppl 1), S66–S76.
    [https://doi.org/10.29399/npa.27419Links to an external site.](https://doi.org/10.29399/npa.27419)

    Preda, A. (2024). What are bipolar disorders?
    _American Psychiatric Association_.
    [https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders#:~:text=These%20behaviors%20must%20represent%20a,hallucinations%2C%20known%20as%20psychotic%20featuresLinks to an external site.](https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders).

    Yang, R., Zhao, Y., Tan, Z., Lai, J., Chen, J., Zhang, X., Sun, J., Chen, L., Lu, K., Cao, L., & Liu, X. (2023). Differentiation between bipolar disorder and major depressive disorder in adolescents: From clinical to biological biomarkers.
    _Frontiers in Human Neuroscience_,
    _17_, 1192544.
    [https://doi.org/10.3389/fnhum.2023.1192544](https://doi.org/10.3389/fnhum.2023.1192544)

    **## unit6response.docx**

    Instructions:

    Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

    · Compare and contrast your initial posting with those of your peers.

    · How are they similar or how are they different?

    · What information can you add that would help support the responses of your peers?

    · Ask your peers a question for clarification about their post.

    · What most interests you about their responses?

    Please be sure to validate your opinions and ideas with citations and references in APA format.

    [**April Williams**\
    **_(She/Her)_**](https://herzing.instructure.com/courses/48814/users/88791)

    Oct 9 12:59am| Last reply Oct 10 12:39am

    **Reply from April Williams**

    Sam’s symptoms are most consistent with Bipolar I Disorder, current episode manic (National Institute of Mental Health [NIMH], 2024):

    · “resounding moment,”

    · grandiosity “I should be teaching my professors.”

    · long hours awake, energized

    · engaging strangers in philosophical conversations

    · alcohol, sexual activity, reckless spending

    · withdrawal from college, legal trouble

    · no hallucinations or delusions

    According to the NIMH (2024), bipolar disorder is a serious mental disability that causes “unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks.”.

    Per NIMH (2024)and clinical guidelines, treatment involves mood stabilization and sometimes adjunctive therapy:

    · Mood stabilizers

    · Lithium (gold standard, reduces suicide risk)

    · Valproate (Depakote).

    · Carbamazepine, Lamotrigine (more for bipolar depression/maintenance).

    For acute mania in a 19-year-old:

    · Lithium carbonate is first-line (unless contraindicated)

    · initial dose: 300 mg orally 2–3 times daily

    · adjust to therapeutic serum level: 0.6–1.2 mEq/L.

    · Monitor: renal function, thyroid function, and lithium levels.

    **Reference**

    National Institute of Mental Health. (2024). Bipolar Disorder. Retrieved from
    [https://www.nimh.nih.gov/health/topics/bipolar-disorderLinks to an external site.](https://www.nimh.nih.gov/health/topics/bipolar-disorder)

    · Reply to post from April Williams
    **Reply**

    ·

    · Expand discussion thread from April Williams

    **1 Reply, 1 Unread**

    **1 Reply (1)**

    [**Makeda Thomas**](https://herzing.instructure.com/courses/48814/users/95107)

    Oct 9 12:52am

    **Reply from Makeda Thomas**

    Makeda Thomas, Discussion Week 6:

    **Probable Diagnosis**

    Based on Sam’s presentation, the most likely diagnosis is Bipolar I Disorder, current episode manic, without psychotic features, as defined by the DSM-5 (Preda, 2024). Sam exhibits hallmark symptoms of mania, including grandiosity, decreased need for sleep, pressured speech, risky behaviors (e.g., impulsive spending, hypersexuality, alcohol use), and flight of ideas. His belief that he is more advanced than his professors and his impulsive shift in academic focus reflect elevated mood and inflated self-esteem. Although he was arrested for a “psychotic break,” there is no evidence of hallucinations or delusions at present, which supports a manic episode without psychotic features.

    Importantly, Sam has a prior diagnosis of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), which may have represented early manifestations of bipolar spectrum illness. Bipolar disorder often emerges in late adolescence or early adulthood, and misdiagnosis as unipolar depression is common in early stages (Yang et al., 2023).

    **Medication Classifications for Bipolar I Disorder**

    Pharmacologic treatment of acute mania typically involves one or more of the following classes:

    ·
    **Mood stabilizers**: Lithium, valproate, carbamazepine (Marzani & Price, 2021)

    ·
    **Second-generation antipsychotics (SGAs)**: Olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone (Marzani & Price, 2021)

    ·
    **Anticonvulsants**: Valproic acid, lamotrigine (more effective for bipolar depression than mania) (Marzani & Price, 2021)

    ·
    **Adjunctive benzodiazepines** (e.g., lorazepam) for agitation or insomnia in acute settings (Marzani & Price, 2021)

    Combination therapy is often required in moderate to severe mania, especially when functional impairment or risk behaviors are present (Marzani & Price, 2021).

    **Recommended Medication and Dose**

    **Medication**:
    _Risperidone_ **Class**: Second-generation antipsychotic

    **Starting Dose**:
    _1–2 mg orally once daily_

    **Rationale**: Risperidone is FDA-approved for the treatment of acute manic or mixed episodes in Bipolar I Disorder. It has demonstrated rapid efficacy in reducing manic symptoms, including grandiosity, impulsivity, and sleep disturbance (McNeil et al., 2024). Compared to other SGAs, risperidone has a relatively favorable side effect profile in young adults and is less sedating than olanzapine or quetiapine, which may help preserve daytime functioning. It also has a lower risk of metabolic side effects when used short-term.

    Given Sam’s age and lack of prior antipsychotic exposure, a starting dose of 1 mg daily is appropriate, with titration to 2–4 mg/day based on clinical response and tolerability. Monitoring should include assessment for extrapyramidal symptoms, sedation, and metabolic changes (McNeil et al., 2024). If symptoms escalate or do not respond adequately, adjunctive mood stabilizers such as valproate may be considered.

    **Clinical Considerations**

    ·
    **Avoid antidepressant monotherapy**: SSRIs or SNRIs may worsen mania if used without a mood stabilizer or antipsychotic (Preda, 2024).

    ·
    **Psychoeducation and psychotherapy**: Cognitive behavioral therapy (CBT) and family-focused therapy can improve insight, adherence, and relapse prevention (Özdel et al., 2021).

    ·
    **Safety planning**: Given Sam’s impulsivity and legal involvement, risk assessment and structured follow-up are essential.

    **References**

    Marzani, G., & Price Neff, A. (2021). Bipolar Disorders: Evaluation and Treatment.
    _American family physician_,
    _103_(4), 227–239.
    [https://www.aafp.org/pubs/afp/issues/2021/0215/p227.htmlLinks to an external site.](https://www.aafp.org/pubs/afp/issues/2021/0215/p227.html)

    McNeil, S., Gibbons, J.R., Cogburn, M. (2024). Risperidone
    _. StatPearls_.
    [https://www.ncbi.nlm.nih.gov/books/NBK459313/Links to an external site.](https://www.ncbi.nlm.nih.gov/books/NBK459313/)

    Özdel, K., Kart, A., & Türkçapar, M. H. (2021). Cognitive Behavioral Therapy in Treatment of Bipolar Disorder.
    _Noro psikiyatri arsivi_,
    _58_(Suppl 1), S66–S76.
    [https://doi.org/10.29399/npa.27419Links to an external site.](https://doi.org/10.29399/npa.27419)

    Preda, A. (2024). What are bipolar disorders?
    _American Psychiatric Association_.
    [https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders#:~:text=These%20behaviors%20must%20represent%20a,hallucinations%2C%20known%20as%20psychotic%20featuresLinks to an external site.](https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders).

    Yang, R., Zhao, Y., Tan, Z., Lai, J., Chen, J., Zhang, X., Sun, J., Chen, L., Lu, K., Cao, L., & Liu, X. (2023). Differentiation between bipolar disorder and major depressive disorder in adolescents: From clinical to biological biomarkers.
    _Frontiers in Human Neuroscience_,
    _17_, 1192544.
    [https://doi.org/10.3389/fnhum.2023.1192544](https://doi.org/10.3389/fnhum.2023.1192544)

  • [Solved] sft

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  • [Solved] Information Systems VI Aassignment

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    see attached. Course Textbook(s) Lewis, T. G. (2020). Critical infrastructure protection in homeland security: Defending a networked nation (3rd ed.). Wiley. https://online.vitalsource.com/#/books/9781119614562 \ UnitVI.pdf](https://www.sweetstudy.com/files/unitvi-pdf-10422765 "UnitVI.pdf") \ Depa…

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    see attached.
    Course Textbook(s) Lewis, T. G. (2020). Critical infrastructure protection in homeland security: Defending a networked nation (3rd ed.). Wiley. https://online.vitalsource.com/#/books/9781119614562
    \
    UnitVI.pdf](https://www.sweetstudy.com/files/unitvi-pdf-10422765 "UnitVI.pdf")
    \
    DepartmentofHomelandSecurity.docx](https://www.sweetstudy.com/files/departmentofhomelandsecurity-docx-10422771 "DepartmentofHomelandSecurity.docx")

  • [Solved] Integration

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    In-depth study guidance and analytical solution covering Integration.

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  • [Solved] Discussion response unit 6 adv health

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    – ## unit6response2copy.docx **## unit6response2copy.docx** Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least two of these prompts: · Do you agree with your peers’ assessment? · Take an opposing view to a peer and present a logical argumen…

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    Assignment Prompt & Instructions

    – ## unit6response2copy.docx

    **## unit6response2copy.docx**

    Please respond to at least 2 of your peer’s posts.  To ensure that your responses are substantive, use at least two of these prompts:

    · Do you agree with your peers’ assessment?

    · Take an opposing view to a peer and present a logical argument supporting an alternate opinion.

    · Share your thoughts on how you support their opinion and explain why.

    · Present new references that support your opinions.

    Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.

    Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

    [**Mallory Palmer**](https://herzing.instructure.com/courses/48799/users/92503)

    Oct 8 5:43am| Last reply Oct 8 4:32pm

    **Reply from Mallory Palmer**

    **Two questions:**

    1. When is the last time you remember feeling normal before these symptoms started?

    2. Have you had any recent episodes of weakness, numbness, vision loss, or difficulty speaking before this event or have you ever suffered a stroke or TIA before?

    **Subjective Data:**

    **-** Onset of symptoms noticed upon awakening at 5 am (last known normal at 11 PM)

    -Slurred speech and left-sided weakness since waking

    -Amaurosis Fugax (transient right eye blindness) one month ago, lasting five minutes

    -PMH: CAD, Hypertension, Hypercholesterolemia, Myocardial infarction at age 50

    Medications: Baby aspirin daily, ACE inhibitor, statin

    Social History: Former smoker and alcohol user, quit after a heart attack

    No reported chest pain, shortness of breath, or other acute complaints

    **Objective Data:**

    Vital signs: 195/118mmHg, HR: 106bpm, RR 18, Temp 99.8F, SpO2 97% RA

    General: Alert and oriented, but unaware of illness (anosognosia)

    Neurological Findings:

                -Left-sided hemiplegia

                -Left facial weakness

                -Left homonymous hemianopsia

                -Hyperreflexia and upgoing left great toe (Babinski sign)

                -Dysarthria, but fluent and comprehensible speech; good comprehension

                -Loss of voluntary eye movement toward the left (gaze preference to the right)

                -Left-sided neglect and inattention

    Cranial Nerves: Pupils equal and reactive; intact ocular movements; no nystagmus, ptosis, tongue, or uvula deviation

    Cardiovascular: Tachycardic, Regular rhythm, no murmurs, or JVD, or carotid bruits

    Respiratory: Clear breath sounds bilaterally

    Peripheral Vascular: Poor distal perfusion in limbs

    Abdomen: Soft, non-tender, normal exam

    **Social Determinants of Health:**

    This patient presents with multiple vascular risk factors, including hypertension, hyperlipidemia, coronary artery disease, and prior transient ischemic events. All of the vascular risk factors are strongly influenced by social determinants of health. Safford et al. (2021) found that the number of adverse social determinants of health significantly increased the risk of both fatal and nonfatal coronary heart disease in adults who participated in the REGARDS study. This supports the understanding that factors such as socioeconomic instability, limited access to quality healthcare, and environmental stressors can compound biological risks and exacerbate cardiovascular outcomes. Regarding this patient, previous lifestyle behaviors (smoking, alcohol use), potential barriers to timely medical care, and health literacy levels may have contributed to disease progression and delayed stroke recognition. Addressing social determinants of health through targeted education, community resources, and access to preventive services could reduce recurrent events and improve long-term recovery (Safford et al., 2021).

    **References:**

    Safford, M. M., Reshetnyak, E., Sterling, M. R., Richman, J. S., Muntner, P. M., Durant, R. W., … & Pinheiro, L. C. (2021).
    _Number of social determinants of health and fatal and nonfatal incident coronary heart disease in the REGARDS study._ _Circulation, 143_(3), 244–253. https://doi.org/10.1161/CIRCULATIONAHA.120.048026

    · Reply to post from Mallory Palmer
    **Reply**

    ·

    · Expand discussion thread from Mallory Palmer

    **3 Replies, 3 Unread**

    **3 Replies (3)**

    **Reply from Jennifer Poulson**

    Unit 6 Discussion: Neuro Case Study – Jennifer Poulson

    Two questions that you can ask this patient are:

    · Do you take your medication as prescribed?

    · The patient’s BP is 195/118 indicating that his blood pressure is not controlled.

    · High blood pressure is a risk factor for stroke.

    · When did you first notice the slurred speech and left side weakness?

    · The wife noticed the symptoms at 5 am. The patient may have been up throughout the night experiencing symptoms.

    · Patients experience better clinical outcomes with early diagnosis and treatment and it is critical to diagnose the subtype of stroke rapidly and accurately (Patel et al., 2022).

    · Fast, accurate diagnosis of stroke is vital for selection of appropriate acute stroke treatment, such as tissue plasminogen activator (tPA) or endovascular mechanical thrombectomy treatment (Patel et al., 2022).

    **Subjective Data**:

    Wife states they went to bed at 11pm and woke up at 5am when she noticed his symptoms-slurred speech and left side weakness.

    Right-handed.

    History of coronary artery disease, hypertension, hypercholesterolemia and a heart attack at age 50.

    Patient had an episode of amaurosis fugux (blindness) in his right eye one month ago that lasted for 5 minutes.

    History of alcohol use and smoking-stopped after his heart attack.

    Medications: Baby aspirin daily, ACE inhibitor and statin.

    **Objective Data**:

    Vitals: BP 195/118, HR 106, RR 18, T 99.8, O2 sat 97% RA.

    Unable to move his left arm and leg.

    Hyperreflexia left arm and leg.

    Upgoing left great toe.

    Mild dysarthria, speech is fluent.

    Alert and oriented, does not recognize he is sick. Understands and follows commands.

    Neck is supple, there is no jugular vein distension, and there are no bruits.

    The lungs are clear.

    Heart sounds regular without murmurs.

    Abdomen is normal.

    The limbs are not well perfused distally

    Pupils are equal and reactive, ocular movements are intact, unable to turn eyes voluntarily toward the left side.

    Mild weakness on the left side of the face.

    Left-sided homonymous hemianopsia, no nystagmus or ptosis, no tongue or uvula deviation.

    Loss of awareness and attention with respect to objects or stimuli on his left side.

    **Social Determinants of Heath**:

    According to (Yadav et al., 2022), The World Health Organization has defined social determinants of health as “the circumstances in which people are born, grow, live, work, and age, and the systems put in place to deal with illness”. Social determinants determine how health is affected, how they play a significant role in influencing health, and how we can improve health for all (Chelak & Chakole, 2023). A patient’s socioeconomic status influences their incidence of stroke and the outcome. Heart disease prevalence, blood pressure medication nonadherence and age-adjusted obesity are associated with high stroke hospitalization rate (Yadav et al., 2022). The following social determinants of health would be relevant for this patient: availability of nutritious food, access to healthcare services, ability to afford medications along with employment status.

    References

    Chelak, K., & Chakole, S. (2023). The Role of Social Determinants of Health in Promoting Health Equality: A Narrative Review. Cureus, 15(1), e33425.
    [https://doi.org/10.7759/cureus.33425Links to an external site.](https://doi.org/10.7759/cureus.33425)

    Patil, S., Rossi, R., Jabrah, D., & Doyle, K. (2022). Detection, Diagnosis and Treatment of Acute Ischemic Stroke: Current and Future Perspectives. Frontiers in medical technology, 4, 748949.
    [https://doi.org/10.3389/fmedt.2022.748949Links to an external site.](https://doi.org/10.3389/fmedt.2022.748949)

    Yadav, R. S., Chaudhary, D., Avula, V., Shahjouei, S., Azarpazhooh, M. R., Abedi, V., Li, J., & Zand, R. (2022). Social Determinants of Stroke Hospitalization and Mortality in United States' Counties. Journal of clinical medicine, 11(14), 4101.
    [https://doi.org/10.3390/jcm11144101Links to an external site.](https://doi.org/10.3390/jcm11144101)

    **## unit6response2copy.docx**

    Please respond to at least 2 of your peer’s posts.  To ensure that your responses are substantive, use at least two of these prompts:

    · Do you agree with your peers’ assessment?

    · Take an opposing view to a peer and present a logical argument supporting an alternate opinion.

    · Share your thoughts on how you support their opinion and explain why.

    · Present new references that support your opinions.

    Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.

    Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

    [**Mallory Palmer**](https://herzing.instructure.com/courses/48799/users/92503)

    Oct 8 5:43am| Last reply Oct 8 4:32pm

    **Reply from Mallory Palmer**

    **Two questions:**

    1. When is the last time you remember feeling normal before these symptoms started?

    2. Have you had any recent episodes of weakness, numbness, vision loss, or difficulty speaking before this event or have you ever suffered a stroke or TIA before?

    **Subjective Data:**

    **-** Onset of symptoms noticed upon awakening at 5 am (last known normal at 11 PM)

    -Slurred speech and left-sided weakness since waking

    -Amaurosis Fugax (transient right eye blindness) one month ago, lasting five minutes

    -PMH: CAD, Hypertension, Hypercholesterolemia, Myocardial infarction at age 50

    Medications: Baby aspirin daily, ACE inhibitor, statin

    Social History: Former smoker and alcohol user, quit after a heart attack

    No reported chest pain, shortness of breath, or other acute complaints

    **Objective Data:**

    Vital signs: 195/118mmHg, HR: 106bpm, RR 18, Temp 99.8F, SpO2 97% RA

    General: Alert and oriented, but unaware of illness (anosognosia)

    Neurological Findings:

                -Left-sided hemiplegia

                -Left facial weakness

                -Left homonymous hemianopsia

                -Hyperreflexia and upgoing left great toe (Babinski sign)

                -Dysarthria, but fluent and comprehensible speech; good comprehension

                -Loss of voluntary eye movement toward the left (gaze preference to the right)

                -Left-sided neglect and inattention

    Cranial Nerves: Pupils equal and reactive; intact ocular movements; no nystagmus, ptosis, tongue, or uvula deviation

    Cardiovascular: Tachycardic, Regular rhythm, no murmurs, or JVD, or carotid bruits

    Respiratory: Clear breath sounds bilaterally

    Peripheral Vascular: Poor distal perfusion in limbs

    Abdomen: Soft, non-tender, normal exam

    **Social Determinants of Health:**

    This patient presents with multiple vascular risk factors, including hypertension, hyperlipidemia, coronary artery disease, and prior transient ischemic events. All of the vascular risk factors are strongly influenced by social determinants of health. Safford et al. (2021) found that the number of adverse social determinants of health significantly increased the risk of both fatal and nonfatal coronary heart disease in adults who participated in the REGARDS study. This supports the understanding that factors such as socioeconomic instability, limited access to quality healthcare, and environmental stressors can compound biological risks and exacerbate cardiovascular outcomes. Regarding this patient, previous lifestyle behaviors (smoking, alcohol use), potential barriers to timely medical care, and health literacy levels may have contributed to disease progression and delayed stroke recognition. Addressing social determinants of health through targeted education, community resources, and access to preventive services could reduce recurrent events and improve long-term recovery (Safford et al., 2021).

    **References:**

    Safford, M. M., Reshetnyak, E., Sterling, M. R., Richman, J. S., Muntner, P. M., Durant, R. W., … & Pinheiro, L. C. (2021).
    _Number of social determinants of health and fatal and nonfatal incident coronary heart disease in the REGARDS study._ _Circulation, 143_(3), 244–253. https://doi.org/10.1161/CIRCULATIONAHA.120.048026

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    **Reply from Jennifer Poulson**

    Unit 6 Discussion: Neuro Case Study – Jennifer Poulson

    Two questions that you can ask this patient are:

    · Do you take your medication as prescribed?

    · The patient’s BP is 195/118 indicating that his blood pressure is not controlled.

    · High blood pressure is a risk factor for stroke.

    · When did you first notice the slurred speech and left side weakness?

    · The wife noticed the symptoms at 5 am. The patient may have been up throughout the night experiencing symptoms.

    · Patients experience better clinical outcomes with early diagnosis and treatment and it is critical to diagnose the subtype of stroke rapidly and accurately (Patel et al., 2022).

    · Fast, accurate diagnosis of stroke is vital for selection of appropriate acute stroke treatment, such as tissue plasminogen activator (tPA) or endovascular mechanical thrombectomy treatment (Patel et al., 2022).

    **Subjective Data**:

    Wife states they went to bed at 11pm and woke up at 5am when she noticed his symptoms-slurred speech and left side weakness.

    Right-handed.

    History of coronary artery disease, hypertension, hypercholesterolemia and a heart attack at age 50.

    Patient had an episode of amaurosis fugux (blindness) in his right eye one month ago that lasted for 5 minutes.

    History of alcohol use and smoking-stopped after his heart attack.

    Medications: Baby aspirin daily, ACE inhibitor and statin.

    **Objective Data**:

    Vitals: BP 195/118, HR 106, RR 18, T 99.8, O2 sat 97% RA.

    Unable to move his left arm and leg.

    Hyperreflexia left arm and leg.

    Upgoing left great toe.

    Mild dysarthria, speech is fluent.

    Alert and oriented, does not recognize he is sick. Understands and follows commands.

    Neck is supple, there is no jugular vein distension, and there are no bruits.

    The lungs are clear.

    Heart sounds regular without murmurs.

    Abdomen is normal.

    The limbs are not well perfused distally

    Pupils are equal and reactive, ocular movements are intact, unable to turn eyes voluntarily toward the left side.

    Mild weakness on the left side of the face.

    Left-sided homonymous hemianopsia, no nystagmus or ptosis, no tongue or uvula deviation.

    Loss of awareness and attention with respect to objects or stimuli on his left side.

    **Social Determinants of Heath**:

    According to (Yadav et al., 2022), The World Health Organization has defined social determinants of health as “the circumstances in which people are born, grow, live, work, and age, and the systems put in place to deal with illness”. Social determinants determine how health is affected, how they play a significant role in influencing health, and how we can improve health for all (Chelak & Chakole, 2023). A patient’s socioeconomic status influences their incidence of stroke and the outcome. Heart disease prevalence, blood pressure medication nonadherence and age-adjusted obesity are associated with high stroke hospitalization rate (Yadav et al., 2022). The following social determinants of health would be relevant for this patient: availability of nutritious food, access to healthcare services, ability to afford medications along with employment status.

    References

    Chelak, K., & Chakole, S. (2023). The Role of Social Determinants of Health in Promoting Health Equality: A Narrative Review. Cureus, 15(1), e33425.
    [https://doi.org/10.7759/cureus.33425Links to an external site.](https://doi.org/10.7759/cureus.33425)

    Patil, S., Rossi, R., Jabrah, D., & Doyle, K. (2022). Detection, Diagnosis and Treatment of Acute Ischemic Stroke: Current and Future Perspectives. Frontiers in medical technology, 4, 748949.
    [https://doi.org/10.3389/fmedt.2022.748949Links to an external site.](https://doi.org/10.3389/fmedt.2022.748949)

    Yadav, R. S., Chaudhary, D., Avula, V., Shahjouei, S., Azarpazhooh, M. R., Abedi, V., Li, J., & Zand, R. (2022). Social Determinants of Stroke Hospitalization and Mortality in United States' Counties. Journal of clinical medicine, 11(14), 4101.
    [https://doi.org/10.3390/jcm11144101Links to an external site.](https://doi.org/10.3390/jcm11144101)

  • [Solved] wk 6 wk 7

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    I need assistance – ## Professionalbusinessletter.docx **## Professionalbusinessletter.docx** **Chapter 6 – Written Assignment (Professional Business Letter)** **Due Date:** See Lesson Schedule for all assignment due dates **Purpose**: The purpose of this assignment is to familiarize you with the va…

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    I need assistance

    – ## Professionalbusinessletter.docx

    **## Professionalbusinessletter.docx**

    **Chapter 6 – Written Assignment (Professional Business Letter)**

    **Due Date:** See Lesson Schedule for all assignment due dates

    **Purpose**:  The purpose of this assignment is to familiarize you with the various costs of production and to practice writing a professional letter.

    **Skills:** This assignment will help improve your communication and professional writing skills and understand the different short run costs of production.

    **Knowledge:** This assignment will sharpen your understanding of the various economic costs of production, the difference between accounting and economic costs, as well as the concepts of diminishing marginal returns and economies of scale.

    **Task:** Please draft the following information into a formal, professional letter that you are sending to your boss or to your local venture capitalist to try and convince them to invest in your business.
    Think
    [Shark TankLinks to an external site.](https://www.youtube.com/watch?v=HpUR7-Oe1ss) if you have watched that program.  You can visit the
    [Purdue Writing LabLinks to an external site.](https://owl.purdue.edu/owl/subject_specific_writing/professional_technical_writing/basic_business_letters/index.html) for a sample business letter.  Put your letter on Letterhead (you can find letterhead templates in Microsoft Word and I'm sure Google Office has them, too).

    Think of a business you may be interested in starting and explain the following in the body of your letter to the Sharks (venture capitalists) (assume the venture capitalist knows nothing about business or economics):

    1. What specific resources (land, labor, capital, entrepreneurship) you will need to acquire to operate this business.
    2. Explain the difference between explicit and implicit costs and which of your resources are implicit costs.
    3. Explain the difference between fixed and variable costs for this business.
    4. Explain which of the resources you need are fixed and which are variable resources.
    5. Explain how this business could experience diminishing marginal returns in the short run.
    6. Explain whether the business will experience economies of scale.

    **Criteria for Success**

    · Type the assignment as a professional letter on letterhead.

    · Include salutations, date, recipient address, etc.

    · Make sure your assignment is at least one page (250+ words long) and includes detailed explanations and examples.

    · Use complete sentences.

    · Use
    **professional grammar and punctuation**– remember, you are trying to persuade someone to invest in your business.

    · Avoid “text” or “twitter speak” when corresponding.

    · Fancy it up by using letterhead and make it look as professional and visually appealing as possible.

    · Do your own work in the class.  The use of AI (including Grammarly) or cheating websites is not allowed in this course.  Students suspected of academic dishonesty will earn a score of zero on this assignment.

    · Be sure to cite any outside resources you use to complete this assignment.

    **## Professionalbusinessletter.docx**

    **Chapter 6 – Written Assignment (Professional Business Letter)**

    **Due Date:** See Lesson Schedule for all assignment due dates

    **Purpose**:  The purpose of this assignment is to familiarize you with the various costs of production and to practice writing a professional letter.

    **Skills:** This assignment will help improve your communication and professional writing skills and understand the different short run costs of production.

    **Knowledge:** This assignment will sharpen your understanding of the various economic costs of production, the difference between accounting and economic costs, as well as the concepts of diminishing marginal returns and economies of scale.

    **Task:** Please draft the following information into a formal, professional letter that you are sending to your boss or to your local venture capitalist to try and convince them to invest in your business.
    Think
    [Shark TankLinks to an external site.](https://www.youtube.com/watch?v=HpUR7-Oe1ss) if you have watched that program.  You can visit the
    [Purdue Writing LabLinks to an external site.](https://owl.purdue.edu/owl/subject_specific_writing/professional_technical_writing/basic_business_letters/index.html) for a sample business letter.  Put your letter on Letterhead (you can find letterhead templates in Microsoft Word and I'm sure Google Office has them, too).

    Think of a business you may be interested in starting and explain the following in the body of your letter to the Sharks (venture capitalists) (assume the venture capitalist knows nothing about business or economics):

    1. What specific resources (land, labor, capital, entrepreneurship) you will need to acquire to operate this business.
    2. Explain the difference between explicit and implicit costs and which of your resources are implicit costs.
    3. Explain the difference between fixed and variable costs for this business.
    4. Explain which of the resources you need are fixed and which are variable resources.
    5. Explain how this business could experience diminishing marginal returns in the short run.
    6. Explain whether the business will experience economies of scale.

    **Criteria for Success**

    · Type the assignment as a professional letter on letterhead.

    · Include salutations, date, recipient address, etc.

    · Make sure your assignment is at least one page (250+ words long) and includes detailed explanations and examples.

    · Use complete sentences.

    · Use
    **professional grammar and punctuation**– remember, you are trying to persuade someone to invest in your business.

    · Avoid “text” or “twitter speak” when corresponding.

    · Fancy it up by using letterhead and make it look as professional and visually appealing as possible.

    · Do your own work in the class.  The use of AI (including Grammarly) or cheating websites is not allowed in this course.  Students suspected of academic dishonesty will earn a score of zero on this assignment.

    · Be sure to cite any outside resources you use to complete this assignment.

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    What is the difference between equity and equality.  At least one reference must be used to support.  300 Words

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