Physical Assessment Discussion Reply Danger Gonzalez

 Below is the post of another student please reply . 

Vascular supply to the breast is primarily through branches of which two arteries? Thoracoacromial artery and internal mammary artery.

What is thelarche? The onset of secondary breast development. (during puberty).

The upper arm drains into which area of lymph nodes? Begins in the hand and runs upwards in the axillary direction, reaching the cubital nodes.

 what changes occur when axillary lymph nodes are removed. Lymphedema can happen any time after lymph nodes are removed.

The mother of a girl at Tanner stage 2 asks whether her daughter will start menses early. What is the correct response to give this mother? This would be a normal finding to start early. The menstrual cycle normally appears or happens during stage III.

 Name the three methods commonly used for ensuring palpation of the entire breast. Chest wall palpation, lymph node palpation and bimanual digital palpation.

What do retractions and dimpling signify? Dimpling of the breast tissue can be a sign of a serious form of cancer known as inflammatory breast cancer. (i.e.) Carcinoma. Dimpling as a sign of breast cancer tends to occur in only one breast. If dimpling affects both breasts, the person probably does not have breast cancer. 

A patient who is in her first trimester of pregnancy asks you what changes she should expect in her breasts. What information and important instructions should you give to this patient? Surging hormones and a shift in breast structure mean your nipples and breasts may feel sensitive and tender from as early as three or four weeks.

Describe the appearance of the breasts in postmenopausal women. Three is significant change in size and shape. Low level of estrogen makes the breast tissue to begin to become less elastic and dry.

C reate a chart that compares and contrasts the following conditions:

  1. Fibrocystic disease
  2. Fibroadenoma
  3. Malignant breast tumor
  • Name the disease of the breast that is a surface manifestation of underlying ductal carcinoma.  Paget’s disease of the breast.   What is the peak incidence of breast malignancy?  During the premenopausal years.      4  Fibrocystic disease 5  Fibroadenoma 6  Malignant breast tumor7  Non-cancerous condition. Occurs in breast. Breast have tendency to feel lumpy. 8  Non-cancerous condition. Occurs in breast. Results in benign tumors, usually found in younger women. (i.e.) 15-35 yrs. 9  Cancerous condition. Occurs in breast. Results in lumps in breast as well as bloody nipple discharge. Change of shape & texture of breast.Explain the kidneys role in fluid and electrolyte homeostasis. They help maintain electrolyte concentrations by filtering electrolytes and water from blood, returning some to the blood, and excreting any excess into the urine. Maintains balance.

    How soon after birth bowel sounds should be heard. 1-2 hours after birth.

    What is the function of the alimentary tract? To nourish the body. Ingestion and digestion.
    Which organ plays an important role in the metabolism of carbohydrates, fats, and proteins? The liver.
    Generate a list of relevant data to gather when assessing abdominal pain. Vital signs, location of palpation, tenderness, murphy sign, mcburney and psoas. Assessment and evaluation of present bowel sounds.
    How do you would assess for masses in the abdomen and how they would document such findings. Inspection, auscultation and palpation are the techniques used to locate any masses present. Patient position is supine on the examination table.
    Name the sign that appears as a bluish peri-umbilical discoloration and suggests intra-abdominal bleeding. Cullens sign.

    What could a single umbilical artery alert you to in a newborn? Risk of congenital malformations, especially genitourinary malformations and chromosomal anomalies.

    Which type of hernia is common in infants? Umbilical hernias. These hernias are common in newborns and babies younger than 6 months.

     Define Crohns disease. Crohn’s disease is an inflammatory bowel disease (IBD). ) It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. 

     If a sudden onset of severe epigastric pain is continuous, unrelieved, and radiating to the groin and back, what problem should be considered? This is a classic sign of a renal calculi.
    MB is a 44-year-old white female patient. She is obese, with a past medical history of hypertension, hyperlipidemia, and diabetes. She admits that she does not exercise. She is being evaluated today for right upper quadrant abdominal pain.
    1- Differentiate between the three types of cholecystitis. Acute cholecystitis is inflammation in the gallbladder which accompanies nausea fever and abdominal pain. Chronic cholecystitis is chronic inflammation in the gallbladder is less severe than AC, less lasting. Acute cholescystitis with formation of renal calculi stone.

    2- Describe the method for palpating the gallbladder. Gently place the palpating hand below the right lower rib margin at the mid-clavicular line and ask the patient to exhale as much as possible. As the patient exhales, slowly push your hand deeper. Then ask the patient to inhale deeply. A positive Murphy sign is the sudden cessation of inspiration with pain

  • 3- Differentiate between the common symptoms of cholecystitis pain and the associated symptoms. Severe pain in your upper right or center abdomen. Pain that spreads to your right shoulder or back. Tenderness over your abdomen when it’s touched.
  • References
  • Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidels guide to physical examination (p. 351-415) St. Louis, MI: Elsevier Mosby
     

SOCW 6361 Week 1

 

Week 1: Social Work in the Policy Arena

Policies designed to enhance peoples’ welfare or well-being are known as social policies. These policies are concerned with many aspects of social welfare, including health, housing, education, income, and nutrition, to name but a few. Social policies have also been formulated to meet the needs of groups of people such as needy children, people with disabilities, low-income families, and elderly people.
Midgley & Livermore, 2008, pp. xxi

From Midgley’s synopsis on social policy, it is clear that as a professional social worker and an advocate of social change, you will be working closely with populations and groups of people that will need your talent and dedication to affect a positive change in the quality of life for these people. Social Policy: Advocacy and Analysis will prepare you for the role of social worker in the policy arena.

In Week 1, you examine ethical reasons and obligations for engaging in social work policy practice, and you explore historical influences on social action in contemporary practice. You also introduce yourself to your colleagues with an introductory video that you will upload in this first week.

Learning Objectives

Students will:
  • Analyze ethical reasons social workers engage in policy practice
  • Analyze historical influences on social action in current practice

Learning Resources

Required Readings

Jansson, B. S. (2018). Becoming an effective policy advocate: From policy practice to social justice. (8th ed.). Pacific Grove, CA: Brooks/Cole Cengage Learning Series.
Chapter 1, “Joining a Tradition of Social Reform” (pp. 331)

Required Media
Optional Resources

Discussion 1: Video Introduction

A large part of social work involves building relationships. To be effective, you must build relationships with clients, colleagues, and community and organizational representatives. Being able to share appropriate amounts of personal information is the first step in building those relationships as you seek to recognize common goals with these individuals. Feeling comfortable with sharing an appropriate amount of personal information requires practice and is an ongoing process as you encounter new people. What would you like others to know about you as an individual who is a social worker? How would you like others to perceive you? The relationships you build rely on those perceptions as much as they rely on what you say. There is no better time than now to plan or revisit your approach to building these relationships.

For this ungraded, but required, Discussion, record a 2-3 minute video introducing yourself to your colleagues. Your video should include and address these items:

  • Introduce yourself (your name, your geographic location, and an interesting, fun fact about yourself related to hobbies, personal interests or experiences)
  • What does being an advocate mean to you?
  • Describe a policy that has impacted your life

Discussion 2

 

Discussion 2: Historical Divides and Ethical ObligatiWork

The National Association of Social Workers (NASW) specifies the ethics and values of the profession in their Code of Ethics. Section 6.04 of the Code of Ethics (1999) states:

Social workers should engage in social and political action that seeks to ensure that all people have equal access to the resources, employment, services, and opportunities they require to meet their basic human needs and to develop fully. Social workers should be aware of the impact of the political arena on practice and should advocate for changes in policy and legislation to improve social conditions in order to meet basic human needs and promote social justice.(Preamble, p. 8)

With the requirement of social and political action among social workers, there is little political activity among clinical social workers. Why? What barriers exist that prevent social workers from fulfilling this ethical obligation?

What does it mean to be a macro social worker? A micro social worker? Do these differentiations have any real meaning? If not, why is this language used when referring to the social work profession?

In this Discussion, you will look at the obligation of social workers to engage in political action in their practice and discuss why there appear to be different perceptions of the responsibility for political action among social work professionals.

By Day 4

Post an analysis of historical divides (such as the schism between Jane Addams and Mary Richmond) and historical influences on current social work practice with respect to policy advocacy and action. Do such schisms exist in contemporary social work? If you think these divides exist, how do they prevent social workers from fulfilling their ethical obligation(s)? Are they important differentiations?

By Day 6

Respond to a colleague with a suggestion about how to address these schisms, both historical situations and current but yet unidentified ones. Does social action need to be separate from social work practice?

 

History8A-Question(S) – This Post Must Be At Least 200 Words.

Question(s)

–This chapter (and lecture) talked about colonial administration. What did you find unusual, strange, or even infuriating about how the Spanish crown organized society?

(optional)– in “Scandal at the Church”, What is surprising? What is not surprising? What are the elements of calidad?

lecture—–

It didn’t take long after arriving in the Americas that the Spanish and Portuguese governments began trying to organize the hemisphere– at least their parts of it. 

Of course, it is important to remember that even though the violent portion of the conquest was mainly over, other forms of conquest began. Therefore, although the larger military conquest of indigenous folks had pretty much ended (there were regions in Latin America where it almost never ended, keep in mind– but those were smaller conflicts, nothing on the scale of the larger conquest), the spiritual conquest continued (the church!), and the political conquest began to get more serious and organized.

Before we talk about the different offices and the Spanish and Portuguese administration of the colonies in Latin America, it is important to restate something that your reading points out at the beginning of the chapter:

Traveling to Latin America was a pain in the backside. 

(of course, your book puts it a bit differently, maybe more nicely, but still…)

Just to emphasize this, I want to post the Table from your reading:

Sailing Time Table

Days from Andalusian port to                         Days to Andalusian Port from

   Canary Island                       18                                  Azores                      31

   Hispaniola                            51                                  Florida                       65

   Havana                                 64                                  Havana                      67

   Cartagena                             51                                  Cartagena                  110

   Vera Cruz                             75                                  Vera Cruz                  128

   Isthmus of Panama              75                                Isthmus of Panama   137

The distance and time that it took to get from the Iberian peninsula (Spain and Portugal) to the colonies in Latin America is important, because it meant a few things (and I’ll say it my way, thank you very much!):

1) What happened in Latin America, stayed in Latin America (technically it didn’t, but the time lag between the two places meant that it effectively did)

2) The church became powerful– even more powerful than they were in Spain and Portugal. The reason for this, of course, was that they were the ones in charge of converting indigenous folks, making sure they remained Christians, forced “Christian” values on them, etc. In many ways, the church was what organized indigenous life in Latin American cities, either explicitly or implicitly. On top of all that, they tended to govern– not directly, mind you– not only the natives, but the Spanish and Portuguese settlers in their respective regions, because remember– Portugal and Spain were still Catholic kingdoms!!!

3) Spanish and Portuguese settlers acknowledged the crowns’ established governments in their given regions, but ultimately, their connection to the crown became more theoretical as time passed. (For example, in Colonial Mexico, after some time had passed, a famous saying developed whenever there were new laws passed down directly from the crown: “Obedezco pero no cumplo” [“I obey, but I do not comply”]. Complicated, I know, but it demonstrates that over time, settlers in particular found their ties to the Spanish monarchy weakening, even as the colonial government became stronger. 

That being said, in the early period, there were serious efforts by the Spanish crown to ensure that they had power over everyone else. Government in Spanish America was, after all, very much a top-down affair (this means that all of the power in government was held at the top (Spanish officials), and very little power was held at the bottom (Indians, peasants). City life was punctuated by reminders of the centrality of the king and his representative, the viceroy. Across the whole colonial period, city dwellers were called out from their homes by noisy processions to welcome a new viceroy, celebrate the birth of a royal heir or mourn the death of their king. These eventssurprising and irregularwere extravagantly commemorated and they also afforded spectators a visual lesson on politics.

The point here is that the Spanish crown, aaalllllll the way out in Spain (across an ocean!) recognized the importance of maintaining control over the colonies. Why? Well, if we were to put our finger on something directly, it would be that there was a lot of money in mineral deposits (mainly silver, but other metals as well) in Latin America (cities like Zacatecas in Mexico, and Potos in Peru [which is now Bolivia]) come to mind, but there was also quite a lot of land to make a profit from, especially as people started arriving in this region of the world to settle down!

And because the income was so important to them, they did everything they could to strike a balance between (A) keeping a tight grip on the colonies, and (B) letting them do what they liked. 

Keeping a tight grip on the colonies was done through the creation of institutions like The Council of the Indiesfounded in 1524, to oversee just about everything in the colonies.

The Viceroys were the “executives”, or the direct representative of the king in the colonies (In New Spain, Peru, New Granada, Rio de la Plata)– kind of like the President, if we were to make weird comparisons (it’s a weird comparison because they aren’t really the same, but I wanted you guys to know that this guy was the one who had the most power).

In fact, he had enough power to take whatever new laws and regulations that were passed across the Atlantic ocean from the Spanish crown and say, “obedezco pero no cumplo.” Now, I mentioned this earlier, but check this out– there are two things going on here:

1) When the Viceroy says, “obedezco pero no cumplo” (to himself and his friends, not the crown!), he is basically saying, “I understand what you are saying, but you have no idea what it is like out here! Maybe I’ll implement that law later, but if I do it now, s*&t’s going to get real.” (excuse the mild and censored profanity).

2) The end result of this is what I mentioned earlier in this lecture– the grip that the crown holds on the region begins to weaken, and the administrators (who are still very much European Spaniards and Portuguese) end up wielding more power. The other thing that ends up happening is that the colonial government starts doing their own thing. Obviously, the way it is set up, people who are not from pure Spanish blood are not really eligible for any positions in the colonial government, so they were outside of the sphere of power. But there was another way that they divided people– through creating a social division between people of Spanish blood who were actually born in Spain (Peninsulares), and people of Spanish blood who were born in the Americas. This class division created a lot of tension, and also enabled the folks in the upper levels of colonial government (Peninsulares) to shut out people who were aspiring to get into higher positions within the government (often, Criollos).  Although with the financial problems that the Spanish crown was facing in the late 1500s, the King made it legal to sell higher administrative and political positions to the highest bidder, in an effort to create more revenue. 

This would usually freak out the crown (and in truth, it did!), but the Spanish crown, in many ways, had some good back up: the Catholic Church.

As you know from your earlier readings (and the lectures!), the relationship between the fractured kingdom of Spain and the Catholic Church was very strong. This is mainly because together, over a period of more than 700 years, they fought together to expel Muslims out of what is today called Spain and Portugal. (It was called the “Reconquista”). The Reconquista ended in 1492, just around the time that the Spanish were arriving (“discovering”) the western hemisphere. Upon their arrival, finding people who did not practice Catholicism,the Spanish crown and the Catholic Church made it part of their mission to Christianize everyone– it’s the spiritual conquest! And why wouldn’t they? It worked during the Reconquista! 

Of course, that took over 700 years, but still!

In any case, the relationship between the Spanish crown and the Catholic Church was strong, so even though the viceroy and the different institutions wielded a lot of power, the church also had a lot of power as well, which was almost like an insurance policy for the Spanish crown (and the Portuguese!). The relationship between the Church and the Spanish crown was solidified through the patronato real (or Royal Patronage), which essentially meant that the Spanish crown paid money to the Catholic Church in exchange for being in charge of preaching to and converting the native folks throughout the Americas. 

Sure, there were some issues. As you might have noticed in the trailer for La Otra Conquista, the conversion of the Native folks was brutal and violent. Making this situation more difficult for the Catholic clerics was the fact that there were so many Natives!

Well, sure, disease and violence killed many natives, but among those who remained, they were all part of different cultures, they had different languages, and they had different religious beliefs. From the perspective of a Catholic Priest, this was an extremely difficult situation– because each group that they encountered, they had to start almost from scratch. They had to 

1) learn the language again, or at least learn how to communicate,

2) find ways to understand the new native religion they encountered and tell them why Christianity was better, and 

3) they had to travel a lot!

One way that they tried to ease this process was by bringing all of the Indians into one place, and settling them there. 

THIS IS REALLY IMPORTANT SO I AM MAKING IT BOLD:

The act of bringing all of the Indians from different places, who had different cultures, and different religions shows us something very important: the Spanish clergy, even if they knew that the native populations in the Americas were really diverse, they treated them all the same. To the Spanish, they were all indios, or Indians. This is the beginning of a kind of racism that basically disrespects the people they are trying to control.

You might think that this was understandable. I mean, what did the Spanish know about racism way back in the late 1500s? Well, they knew a little (the Muslims in the Reconquista were often African), but what makes it worse is that even though their experience taught them that the indigenous peoples of the Americas were very different from one another (kind of like the difference between a Canadian and a Mexican), they still put them into a single category: Indian. And that category survived for hundreds of years, to the point where people who were indigenous in Spanish America thought of themselves as simply Indians (the way the Spanish categorized them) as opposed to being who they actually were. In a sense, then, they stopped being different peoples, and started to become a single race that was invented by someone else.

Once they were able to organize native folks into villages (no matter what their background was), conversion became much easier. It also became easier to punish native folks– for not doing enough work, for not coming to church, for not donating time, money, or goods to the church, or even not paying their rent on time. Yes, when native folks moved into villages, they had land on which they often had to pay rent! They were also supposed to donate to the church, and pay for services, such as baptism, marriages, etc. 

The Church (and by extension, the Spanish crown), in addition to working towards the “Christianizing” of the native population, they were also making a lot of money! (check out the bling in the picture below!)

People who did not abide by the Church were punished, and harshly, as seen in your readings about the Inquisition. (In your reading, you should pay special attention to the auto de f [act of faith]). Look it up! 

What you will see in the coming weeks is that there is a lot more attention paid to the issue of race. Not by us, but by the Spanish government. In New Spain in particular, but also throughout Spanish America, there had always been much racial mixing (unlike in the British Colonies), and that racial mixing led to a lot of confusion about who was Indian (and thus deserved an “Indian life”, so to speak), about who was a mestizo, or who was white. And there were a lot of battles around those categories, because the stakes were pretty high! 

If you looked like an Indian and could still legally “prove” that you were white, your life prospects were much better, and you had many more opportunities open to you. Is that possible? Check out the document for this week, “Scandal at the Church,” which occurred in 1782, but I think it will prepare us nicely about some of the rather confusing discussions that we will be having about race in colonial Latin America in the coming weeks!

Pathophysiology Discussion Reply Maydeli Capo

Bellow is the post od another student. and i need a reply for that

A patient who is 4 days postcoronary artery bypass surgery reports she is having new chest pain that is different from my angina pain. The pains onset was 5 or 6 hours ago upon first waking up in the morning. The patient has a new pericardial friction rub and a low-grade fever of 100.5F. The patient is diagnosed with acute pericarditis.

  1. Why was this patient at risk for developing pericarditis?
  • Post cardiac surgery is a risk factor to developing acute pericarditis. Some of the symptoms of acute pericarditis include pericardial friction rub, chest pain and changes in electrocardiogram. The patients findings are indicative of this. 
  1. Why is this patient now at risk for cardiac tamponade?
  • The fact that this patient has an infection and inflammation predisposes to the accumulation of fluid in the pericardial cavity thus compressing the heart and making it difficult for blood to circulate properly. Pericarditis is a risk factor for cardiac tamponade.
  1. What are the signs or symptoms that would be indicative of cardiac tamponade in this patient? What is the underlying pathophysiology of these signs and symptoms?
  • Signs and symptoms of cardiac tamponade include chest pain, dizziness, anxiety, confusion, low blood pressure, distended neck veins, and muffled heart sounds. The underlying cause of cardiac tamponade in this patient is the pericarditis, once this is resolved then the cardiac tamponade can be also addressed.