Please read post-   The pulmonary system is a system that comprises of the mouth, larynx, pharynx, trachea, bronchus, bronchioles, lungs and alveoli. The purpose is to provide gas exchange of oxygen and carbon dioxide during inhalation and exhalation. Many different disorders arise from the pulmonary system that causes difficulties with ventilation. Asthma is one disorder that results from an obstructed airway. Allergies, air pollutants, airway infections and mucus are just some causative factors. This leads to bronchospasms and airway constriction that limits air to pass. Mr. D.R. presented to the nurse practitioner with a moderate persistent asthmatic episode. His asthma is classified as moderate due to complaints of nighttime symptoms 3 nights a week and a peak expiratory flow rate between 65%-70% (Dlugasch & Story, 2021, p.224).

            Triggers are factors that initiate asthma to exacerbate that include allergic, non-allergic and/or infections. These triggers are described as: pollen, pets, cigarette smoke, cool weather, stress, common cold, and physical exercise just to name a few (Kansen et al., 2019). Women also have experienced triggers prior to menstruation due to hormonal changes (Dlugasch & Story, 2021). The triggers start the inflammatory process in the airway which in then increases mucus production. Based on the symptoms presented by Mr. D.R., he developed worsening of the disease due to an infectious process. During any upper respiratory infection (more specifically viral), patient’s display coughing, watery eyes, stuffy nose, runny nose and fatigue in which Mr. D.R. manifested.

            As stated previously, Mr. D.R. exhibited signs of an asthmatic patient that had an upper respiratory infection. The infection allowed inflammatory mediators to be released in the cells in response to the antigen. The process is branched into two phases that is called an early and late response (Dlugasch & Story, 2021). The early response is linked to bronchospasm and bronchoconstriction and the late response will result in airway edema and mucus production (Dlugasch & Story, 2021). Subsequently Mr. D.R. will then and has revealed symptoms that affect his airway such as wheezing, cough and SOB.          

                                                                         Fluid, Electrolyte and Acid-Base Homeostasis Case Study

            Fluid and electrolytes within the body is found within the intracellular, extracellular and intravascular compartments of the body. Ms. Brown is an elderly woman with type 2 diabetes mellitus and she has been feeling ill for the past two days. Based on her electrolyte laboratory findings, I can conclude that she has several electrolyte imbalances. The imbalance goes as follows: hyperglycemia, hypernatremia, hyperkalemia, and hyperchloremia. From the arterial blood gas findings the results show that she has metabolic acidosis with hypoxemia.

Electrolyte imbalances cause a disruption in homeostasis within the body. Symptoms of hyperglycemia include the three P’s (polydipsia, polyphagia and polyuria). With chloride being bound to sodium, it also mimics the behavior of sodium. All things considered, hypernatremia and hyperchloremia may display the same symptoms, which include lethargy, headache, confusion, hypovolemia and decreased urine output (Dlugasch & Story, 2021). Hyperchloremia also manifests metabolic acidosis that may contribute to the ABG results. Ms. Brown has a potassium level of 5.6 mEq/L which she may exhibit signs such as anxiety, parasthesias, respiratory depression, nausea/vomiting, diarrhea and cramping (Dlugasch & Story, 2021).

The treatment for Ms. Brown’s condition would be to correct the underlying issue. She is in a diabetic ketoacidosis state and her blood glucose level is 412 mg/dl. Insulin therapy and IV fluids to correct the hyperglycemia and metabolic acidosis is the recommended treatment (Laliberte et al., 2017). Insulin will not only decrease the glucose but it will also decrease the potassium by shifting it back into the cells. A hypotonic IV solution is also necessary to correct the hypernatremia and a diuretic is necessary to correct the elevated chloride levels that will be excreted via the kidneys.

The anion gap is a tool to measure the difference between cations and anions in the blood when metabolic acidosis is presented (Ruiz-Ramos et al., 2021). Normally the cations and anions are equal in the extracellular fluid however in an acidotic state they will be unmeasured (Dlugasch & Story, 2021).

Instruction- extending, refuting/correcting, or adding additional nuance to their posts. must be constructive and use literature where possible. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors. Please provide references for reply

• Read about the development of responsibilities and competencies of health educators as presented in Chapter 6 of the Cottrell, Girvan, and McKenzie course text, and the “Health Education Credentialing: Health Educator Job Analysis Projects” reading found in this week’s Learning Resources.
• Review the resources on certifications
• Consider how individual certification relates to quality assurance within a profession.
• Explore the various settings of public health education as presented in Chapter 7 of the Cottrell et al. course text and consider how the seven areas of responsibility are applied to these settings.             To complete this Assignment, write a 2- to 3-page paper that addresses the following:
• Summarize how the responsibilities and competencies of health educators have evolved over time and how the Competencies Update Project (CUP) of 2010 has helped to shape current professional standards in the field.
• Describe and compare and contrast individual certification opportunities available in the field of public health education (CPH, CHES & MCHES).
• Explain the significance of individual certification and program accreditation in the field of public health education. Include in your explanation potential barriers to obtaining both individual certification and program accreditation.
• Select any public health education setting from Chapter 7 of the Cottrell et al. course text and provide specific examples of how a public health educator working in that setting would fulfill all seven responsibilities.

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

Address the following in your initial post:

• How can a shared service delivery model benefit the employees and management of an organization?
• What are some challenges of a shared service delivery model to the employees and management of an organization?
• How do changes in technology affect service delivery, effectiveness, and efficiency?

Provide examples  from your own experience in the workplace to support your responses.

* Work at a care coordinator for a hospital*

1. Respond in the spirit of helpfulness and respect.

2. The best response are ones that are observational; they point directly to the writing in a specific way and observe something without making a judgment.  Share observations of what you notice in the writer’s text, but also share observations you notice of what occurs inside of you as you read the writer’s text.

3. You need not respond in the role of the teacher or fixer of their writing.  Respond as a fellow writer and as a reader.

4. Look to be constructive. Ask meaningful questions of the peer. For instance, asking a “What would you say to ______?” sort of question elicits a critical response. Avoid just being the cheerleader: “Great post. I loved it. Thank you. Good luck.”

5. Offer research and resources. Some of the best peer replies actually go out and share a link or a source from the Keiser e-Library databases with the other person.

 Initial Post Instructions
Choose one of the literary movements that you read about this week and at least one work from that movement. Movements, authors, and famous works are discussed in the lesson as well. You do not have to choose authors or works discussed in the lesson, but you may. For your initial post, address the following : 

 Examine a specific artwork influenced by a literary work and how the artist captured the subject or story. Here are a few examples, but you are not restricted to this list:

• Asher B. Durand’s Thanatopsis (influenced by William Cullen Bryant’s “Thanatopsis”)
• John William Waterhouse’s The Lady of Shalott (influenced by Alfred, Lord Tennyson’s “The Lady of Shalott”)
• Sir John Everett Millais’s Ophelia (influenced by Shakespeare’s Ophelia from Hamlet)
• Gian Lorenzo Bernini’s Apollo and Daphne or The Rape of Prosperina (influenced by ancient myths)
• Ancient Greek vase painting (influenced by various ancient myths)

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