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Describe in detail the pathophysiological process of sickle cell anemia and of congestive heart failure.

Need 2 nursing posts done. 300 words min EACH, min 1 scholarly source (NO OLDER than 5 years*****), APA format. Please answer every question with each post.

POST 1

A 17-year-old African American female from the inner city complains of severe chest and abdominal pain. Upon examination, the attending physician performs an EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming she is drug seeking, he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, Temperature = 99.9 F, Respirations = 28. The pain seems out of proportion to the physical findings. During a review of her medical history, she tells the provider that she has history of sickle cell anemia. At this time, it is determined that she is in a sickle cell crisis.

1. What is the etiology of sickle cell anemia?

2. Describe in detail the pathophysiological process of sickle cell anemia.

3. Identify hallmark signs identified from the physical exam and symptoms.

4. Describe the pathophysiology of complications of sickle cell anemia.

5. What teaching related to her diagnosis would you provide?

POST 2

Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back. This is relieved by him sitting up. His vitals are 180/110, Pulse = 88, Temperature = 98.0 F, Respirations = 20. After a thorough work-up, he is diagnosed with congestive heart failure.

1. What is the etiology of congestive heart failure?

2. Describe in detail the pathophysiological process of congestive heart failure.

3. Identify hallmark signs identified from the physical exam, diagnostic lab work and symptoms.

4. Describe the pathophysiology of complications of congestive heart failure

5. What teaching would you provide this patient to avoid heart failure symptoms?

Discuss the alternate FTC analysis that is applied if they are suspect but not found to be per se illegal.

3 pages

A physician-hospital organization (PHO) consists of 15 hospitals – with 2,247 staffed beds – and approximately 500 physicians. The PHO operates in a very large section of south Georgia, including the cities of Valdosta, Tifton, Thomasville, Moultrie, and Waycross. The PHOs’ physician members represent approximately 90 percent of all physicians practicing in the region.

The PHO served as a vehicle through which competing hospitals and physicians could bargain collectively with health plans to obtain higher fees for themselves. The owner PHOs, member hospitals, and member physicians canceled contracts with payors and informed them that the PHO would be the sole entity through which they would enter into payor contracts. To contract with the PHO, payors allegedly have had to accept the fixed physician fee schedule and fixed discount of no more than 10 percent off hospital list prices.

  1. Explain why this arrangement would be found “per se” illegal under the FTCs’ analysis.
  2. What kind of actions could be taken to restructure this arrangement to avoid a determination that it is per se illegal?
  3. Discuss the alternate FTC analysis that is applied to such cases if they are suspect but not found to be per se illegal.

Discuss the physician’s dual function under an MCO model of care.

2 pages)

you are asked to review the paper by A. Mains, A. Coustasse, K. Lykens: Physician Incentives: Managed Care and Ethics and answer the questions below.

  1. Consider this idea from the paper: “Medicine is a moral enterprise. Because MCOs are involved in the delivery of medical care, they too, are moral entities. However, MCOs are also businesses.”
  2. Explain the idea that the authors sought to convey.
  3. Discuss the physician’s dual function under an MCO model of care.
  4. What concerns do you have about the physician- patient relationship under MCOs?

What are the methods a nurse can use to gather cultural information from patients?

What are the methods a nurse can use to gather cultural information from patients? How does cultural competence relate to better patient care? Discuss the ways in which a nurse demonstrates cultural competency in nursing practice.

2 Reference in APA format, 250 words, NO PLAGIARISM.