Environmental Factors and Health Promotion Presentation.

The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to caregivers. Create a 12 slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan for the presentation of your PowerPoint. Include an additional slide for the Loom link at the beginning,(the Loom link https://www.loom.com/).  and an additional slide for references at the end. In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored Include the following in your presentation: 

1)Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants.

2)Create a health promotion plan that can be presented to caregivers to address the environmental factor and improve the overall health and well-being of infants.

3)Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.

4)Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly resources are required. Two of the three resources must be peer-reviewed and no more than 6 years old.

5)Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide.

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 LopesWrite. 

How K–12 Schools Can Intentionally or Unintentionally Enforce Gender Roles

Evaluates how K–12 schools can intentionally or unintentionally enforce gender roles.

How Colleges and Universities Either Support or Disregard Gender Issues on Campus

Analyzes how colleges and universities either support or disregard gender issues on campus.

The Role of Gender in The Student–Instructor Dynamic

Evaluates the role of gender in the student–instructor dynamic.

How to Reduce or Eliminate Gender Bias in The Classroom

Outlines how to reduce or eliminate gender bias in the classroom.

Minimum of 300 words with at least 2 peer review referenc in 6th edition APA style.

  What symptoms and exam findings would prompt you to perform a pituitary workup? What laboratory and neuroimaging studies would you order and why? A 24-year-old postpartum patient presents with vague symptoms of fatigue, weight fluctuation, brittle nails, and a lump in her throat. From an endocrine standpoint, what are your potential diagnoses based on symptoms without knowing lab findings? Include the potential workup you would attempt.

  Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples. 

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Knowing how to diagnose and treat complex patient illnesses is important to understand as an advanced practice provider.  The case study provided this week is about a 66 year old women with a history of MI, HTN, Hyperlipidemia, and diabetes mellitus who presents with sudden onset of diaphoresis, nausea, vomiting, dyspnea, followed by a bandlike upper chest pain that she rates 8/10 and radiates down her left arm.  With the health history and her current symptoms, I am immediately worried about another cardiac event for this patient.  This patient has many risk factors for cardiac events. Not only does she have previous heart history, she has HTN, Hyperlipidemia and Diabetes, all of which increase her risk for cardiac events significantly. Brewer et al. (2015) state that the number of men and women who are affected by and die from CAD outnumber all other conditions including all forms of cancer in the US.  Women present differently when having cardiac events.  Brewer et al. (2015), points out that there is significant evidence that adverse outcomes in women with IHD may be fueled by underestimation of cardiovascular disease risk, leading to underdiagnosis and undertreatment.

Due to the acute presentation of this patient, treating her quickly to prevent further heart damage is imperative. An EKG needs to be done within 10 minutes of the patients’ arrival to review for ST elevation and blood sent to lab to evaluate cardiac enzymes.  Oxygen would be my first medication intervention.  The patient complains of dyspnea and chest pain with radiation on a scale of 8/10.  Anytime there is pain we assume there is damage being done to the heart.  Oxygen will help with the dyspnea and provide extra oxygen to the tissues in the heart and hopefully prevent damage.  ASA 4 chewable 81mg tablets would also need to be administered to this patient.  Aspirin suppresses platelet aggregation, producing an immediate antithrombotic effect.  It has been identified as causing a substantial reduction in mortality.

Morphine to treat the pain is the treatment of choice in acute STEMI situations.  In addition to treating the pain, it improves hemodynamics by promoting venodilation and reducing cardiac preload.  It can also reduce modest arterial dilation and in so reduce afterload as well.  This reduction in preload and afterload help by lowering cardiac oxygen demand, helping to preserve the ischemic myocardium.  Beta blockers are also important in treating acute STEMI. The reduce cardiac pain, infarct size, and short-term mortality.  They also reduce recurrent ischemia and reinfarction.  They reduce myocardial wall tension and may decrease the risk for myocardial rupture. Continued use of oral beta-blockers increases long term survival rates.  They work by blocking preventing beta receptor activation.  Ultimately this reduces heart rate and contractibility, reducing oxygen demands and blood pressure. They increase coronary blood flow and myocardial oxygen supply.  This patient is already taking Metoprolol 50mg BID at home so this step has already been taken.

The patient’s cardiac enzymes are positive which verifies an acute cardiac event.  The rest of her labs and vital signs are normal. My next drug of choice would be nitroglycerin, which according to Rosenthal et al. (2018), acts directly on vascular smooth muscle to promote vasodilation.  This works by increasing the blood flow to the ischemic areas of the heart.  Educating the patient that this medication cause headache, orthostatic hypotension, and reflex tachycardia are important, along with the benefits of this medication for her current condition.  Nitroglycerin should be avoided in patients with hypotension, bradycardia, and suspected right ventricular infection.

I work in a small critical access hospital so at this point I would be contacting a tertiary care center for cardiology recommendations and transfer of cares for this patient.  Sometimes the cardiologist will recommend reperfusion therapy with fibrinolytics prior to transfer for PCI therapy.  Fibrinolytic drugs resolve clots by converting plasminogen into plasmin, a proteolytic enzyme that digests the fibrin meshwork that holds a clot together.  The common drugs used for this is alteplase, reteplase, and tenecteplase.  These drugs are most effective when presentation is early.  When given in a timely manner they can open the occluded artery in 80% of patients.  The major complications of this therapy are bleeding, which occurs in 1-5% of patients.  Intercranial hemorrhage is the greatest concern.  Patients undergo an intense screening process to make sure they are appropriate candidates for therapy and reduce the risk of these complications.  Patients who receive this therapy are also treated with anticoagulants such as heparin and antiplatelets such as aspirin or Plavix.  These are proven to decrease mortality in acute cardiac events.

The patient at this time is ready to be transferred to a cardiac unit for further evaluation and treatment by a cardiologist.  Making sure the patient is educated and understands each treatment and why it is important along with the risks is an important part of treating acute cardiac events.  It is a scary time for the patient and knowing what is going on can help to ease anxiety and fears.

                                                References

Anderson, J. L., & Morrow, D. A. (2017). Acute Myocardial Infarction. The New England Journal of Medicine. doi: 10.1056/NEJMral606915

Brewer, L. C., Svatikova, A., & Mulvagh, S. L. (2015). The Challenges of Prevention, Diagnosis and Treatment of Ischemic Heart Disease in Women. Cardiovascular Drugs and Therapy, 29(4), 355–368. doi: 10.1007/s10557-015-6607-4

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.