What are the effects of controlling BP in people with diabetes?

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What are the effects of controlling BP in people with diabetes?
Nursing DB questions
Just answer questions as thoroughly as possible, and concentrate on the questions and don’t focus on the scenario
L.N. is a 49-year-old white woman with a history of type 2 diabetes, obesity, hypertension, and migraine headaches. The patient was diagnosed with type 2 diabetes 9 years ago when she presented with mild polyuria and polydipsia. L.N. is 5’4″ and has always been on the large side, with her weight fluctuating between 165 and 185 lb. Initial treatment for her diabetes consisted of an oral sulfonylurea with the rapid addition of metformin. Her diabetes has been under fair control with a most recent hemoglobin A1c of 7.4%.
Hypertension was diagnosed 5 years ago when blood pressure (BP) measured in the office was noted to be consistently elevated in the range of 160/90 mmHg on three occasions. L.N. was initially treated with Lisinopril, starting at 10 mg daily and increasing to 20 mg daily, yet her BP control has fluctuated. One year ago, microalbuminuria was detected on an annual urine screen, with 1,943 mg/dl of micro-albumin identified on a spot urine sample. L.N. comes into the office today for her usual follow-up visit for diabetes and HTN.
Subjective data reveals that she is experiencing increased exertional SOB. She expresses concern because when this happens it takes her awhile to get her breath back to normal. Denies any pain or dizziness with these episodes.
Physical examination reveals an obese woman with a BP of 154/86 mmHg and a pulse of 78 bpm. Otherwise exam is unremarkable.
CC: “I am more short of breath when walking up stairs than I used to be”.
Questions
1. What are the effects of controlling BP in people with diabetes?
2. What is the target BP for patients with diabetes and hypertension?
3. Which antihypertensive agents are recommended for patients with diabetes?
4 What testing does this woman need ordered due to her change in status both SHORTNESS OF BREATH and BLOOD PRESSURE?
5. What is the significance of microalbuminuria in this woman? How does this affect her cardiovascular risk?
Write this case study up as a clinical note including all elements of plan of care regarding issues presented in the case.

What behaviors would someone with strong self-awareness demonstrate within the context of leading and managing groups?

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What behaviors would someone with strong self-awareness demonstrate within the context of leading and managing groups? Provide an example.
One of the five elements of emotional intelligence is self-awareness. What behaviors would someone with strong self-awareness demonstrate within the context of leading and managing groups? Provide an example.

Explain actions that could have been taken to manage risk by applying each of the five general principles used in the Culture of Safety model to this scenario.

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Explain actions that could have been taken to manage risk by applying each of the five general principles used in the Culture of Safety model to this scenario.
n Dec. 7, 2000, the Cincinnati OSHA office heard through media and police reports that there were two deaths at a nursing home in Ohio. OSHA determined that the FDA should take a lead role in performing an investigation.
Since the nursing home had many residents who had unhealthy respiratory systems, the nursing home routinely ordered and received tanks that contained pure oxygen. During one delivery, the supplier mistakenly delivered one tank of pure nitrogen in addition to the three tanks of pure oxygen that had been ordered. The nitrogen tank had both an oxygen and nitrogen label. An employee at the nursing home connected the nitrogen tank to the nursing home’s oxygen delivery system. This event caused two nursing home residents to die, and three additional nursing home residents were admitted to hospitals in critical condition. Within the following month, two of these three additional residents also died, bringing the total death toll to four.
write a 300 word paper discussing the following point
Explain actions that could have been taken to manage risk by applying each of the five general principles used in the Culture of Safety model to this scenario.
Cite at least 3 peer-reviewed, scholarly, or similar references and your textbook to support your information.

Discuss how you might diagnose, manage, and support the following two patients presenting with breast conditions: Discussion: Breast Conditions

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Discuss how you might diagnose, manage, and support the following two patients presenting with breast conditions:
Discussion: Breast Conditions
Throughout a woman’s life, her breasts go through many normal, healthy changes. However, patients do not always understand these changes and often visit health care providers for treatment. When examining these patients, you must be able to identify when a breast condition is the result of a safe and normal physiological change and when it is the result of an abnormal change requiring treatment and management. A diagnosis of a breast condition resulting from an abnormal change can be devastating for women, making emotional support as vital to women’s well-being as proper assessment, diagnosis, and management. For this Discussion, consider how you might diagnose, manage, and support the following two patients presenting with breast conditions:
Case Study 1:
You are seeing a 60-year-old Latina female, Gravida 4 Para 3104, who is concerned about a thick greenish discharge from her left breast for the past month. The discharge is spontaneous and associated with dull pain and burning. Upon questioning, she also tells you that she breastfed all her children and is currently not on any medications except for occasional Tylenol for arthritis. Her last mammogram, 14 months ago, was within normal limits. On exam, her left breast around the areola is slightly reddened and edematous. Upon palpation of the right quadrant, a greenish-black discharge exudes from the nipple. You note an ovoid, smooth, very mobile, non-tender 1 cm nodule in the RUIQ at 11:00 5 cm from the nipple. No adenopathy, dimpling, nipple discharge, or other associated findings. Her right breast is unremarkable. The patient expresses her desire to proactively decrease her risk for developing breast cancer.
Case Study 2:
You are seeing a 53-year-old African American female for a lump she found in her right breast two weeks ago in the shower. Her last mammogram was three years ago and she was told it was “benign.” She had two breast biopsies at ages 32 and 34 in her right and left breasts, respectively. At both times she had surgery for removal of fibroadenomas. She does not routinely do breast self-exams. Her mother had a mastectomy for breast cancer at age 63, and she heard that a paternal aunt had a breast removed for cancer when she was in her forties. Both mother and aunt are alive and well today. It was discovered on postmortem exam that her grandfather had prostate cancer. Menarche was at age 15 and she is still having monthly menses. She is Gravida 4 Para 3104 with her first childbirth at age 31. She was on oral contraception for 10 years, has no history of fertility treatments, and had a bilateral tubal ligation after the birth of her last child at age 35. Past medical history is noncontributory. She wants to know how likely it is that she will get breast cancer. Physical exam reveals breasts are symmetrical with no dimpling, retractions, or rash. Her right breast has a 2 cm non-tender, hard, fixed mass at 3:00 6 cm from her nipple. Left breast is non-tender without masses. No nipple discharge bilaterally. No anterior cervical, infra- or supraclavicular, or axillary adenopathy.
To prepare:
Review Chapter 15 of the Schuiling and Likis text.
Review and select one of the two provided case studies. Analyze the patient information.
Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.