Montgomery College School Of Nursing Simulationsepsisjames Daniels Ca ✓ Solved

Montgomery College School of Nursing- Simulation Sepsis James Daniels- Came to the emergency room with complaints of fatigue, fever and malaise for 1 week. He reports he was alternating Acetaminophen and Ibuprofen every 4-6 hours for the fevers. Past Medical History: Pre-hypertension, Raynaud’s syndrome He has not received any medications while in the hospital. He is currently waiting for his ride. When the nurse obtains vital signs, what are your concerns?

Does anything jump out at you that the nurse should be paying close attention to? What would you say differently to the Nurse Practitioner to get a more positive response? The CNA comes to the nurse and reports James sat up to void and said he felt like he wants to pass out. The nurse and the Nurse Practitioner immediately go into the room. What interventions should be performed at this time?

The Nurse Practitioner order labs: Lactate CBC Chem 7 Blood Cultures ABGs What labs would we want to look at that are specific to infection? Dehydration? Acute Kidney Injury? Sepsis? Why do we obtain blood cultures?

How long does it take to result a blood culture? Infection? Dehydration? Acute Kidney Injury? Sepsis?

Why do we obtain blood cultures? How long does it take to result a blood culture? At what point in the patient care does the blood culture need to be obtained? What does a Lactate of 7 mean to this patient? 11 Young Male Terrorist and Unemployment Student name University affiliation Course Instructor Due date Young Male Terrorist and Unemployment Introduction There is increased worry among countries in the world due to a rise in the level of instability and unrest posed by young male terrorists as attributed to the high rates of unemployment among the youths and population (youth bulge).

Young men in most countries act as a crucial resource for the terrorist groups around the globe since they provide essential labour as fighters, cooks among other roles in the group. The youth bulge which is a common phenomenon in developing countries is also attributed to the development of a country at a given stage as it helps in boosting the country's productivity. However, without opportunities for jobs among the young men, there results in high rates of unemployment due to youth bulge. The consequences of unemployment among young people is definitely stunted growth in the economy, trajectories of the nonproductive labour market, community despise, mental issues, unhappy lives and potential despair among youths.

Consequently, the young men are recruited to develop attack plans to the targeted spots, treating the wounded soldiers on the battlefield, and hack computer systems rather than utilizing their crucial skills in building the country and the world at large. Notably, corruption in most countries in the world also plays a crucial role in forcing young men to join domestic terrorism. Corruption denies the opportunity to the most deserving person. Most youths might be having the qualities and qualifications for a given job or chance but end up missing the opportunity because another undeserving person was awarded the chance. The aftermath is frustrations among the young men which in the end may result in political unrest as a way of relieving their frustrations.

In the end, the youths become radical in a bid to demand their rights as citizens of a country that badly expose them to terrorist groups who are highly fought by the government of the day. As noted by Adelaja & George (2020), the motivation behind the Arab Spring revolt (2011) was drawn from youth frustration. In this particular case, the young men violently demonstrated minimal economic opportunities and political oppression in the country. Such occurrences fueled by high rates of unemployment among the youth tend to facilitate the occurrence of a ferocious uprising which are a recipe for domestic terrorism in most countries around the world. Statement of the problem The aim of this paper is to draw the relationship between the high rates of unemployment and terrorism among young men.

There is a great correlation between high numbers of youth unemployment and political violence, instability, and terrorism in the affected countries. Globally, there has been an escalation in the levels of unemployment among young men as attributed to youth bulge in most developing countries. In most cases, the affected young men are mainly the graduates who pin a lot of hope on the government to provide employment opportunities. On the other hand, the youths may be forced to result to hustling, prostitution, and political violence as a result of unemployment. There is, therefore, stiff competition for the few job opportunities and resources which in most cases result in desperation.

For the few young people who are lucky to secure employment, they complain of low wages and an unhealthy job environment which aggregates the problem further. As such, the many problems that come as a result of high rates of unemployment fuel the need to joining the terrorist group with the hope of bettering their lives. The desperate youths are promised better wages as compared to those offered by the government and protection for their families. Since the young men are desperate and have very high expectations in life, they easily fall into the trap. In most cases, the youths choose to take the risk by joining the terrorist groups instead of languishing in poverty without hope.

Subsidiary questions How can the governments around the world effectively fight the rising numbers of unemployed due to corruption and youth bulge in order to curb domestic terrorism? Does it mean the creation of more job opportunities in the country by opening up more industries since the number of youths is rising every day? Should the government bring to book all the corrupt individuals who tend to steal opportunities for the deserving youths in the country by awarding another person who probably has not qualified for the vacancy in order to maintain youth confidence, trust, support, and maintains credibility? It is not clear, however, whether arresting the corrupting individuals would heal the unemployment disease in the country.

The creation of more industries in the country may bring a temporary cure but the number of youths due to youth bulge is increasing every new day. Null hypothesis There is a common assumption that domestic terrorism cannot be curbed through the provision of full employment by the government. Alternative hypothesis Increasing the rates of employment would be effective in curbing domestic terrorism since terrorist groups target the jobless youths in society. Importance of the study This paper analyses how unemployment among the youth is linked to domestic terrorism in a country. The first mechanism of this study is undertaking a qualitative explanation.

Consequently, the empirical results of this study will help in drawing the correlation between the rise in domestic terrorism and the high rates of unemployment among the youth occasioned by youth bulge and corruption in most countries. The resulting finding will be crucial in making crucial decisions in the country with the aim of curbing domestic terrorism. This paper will also help in ascertaining the allegations that unemployment poses a national threat due to a rise in rebels among the youths. According to the result findings, domestic terrorism poses a critical problem to the economy of the country. Evidently, acts of terrorism lead to property destruction and the loss of innocent lives in a country.

The acts of terrorism also affect the country negatively in terms of increased insurance claims, loss of tourists, xenophobia, and the creation of uncertainty in the market. Definition of terms The word domestic terrorism can be defined as “undertakings involving acts that are a danger to people and violated U.S. or state criminal laws†as per the 2001 U.S. Patriot Act (UNODC, 2018, July). Unemployment on the other hand refers to the act of being inactive search for any possible job but one cannot find. Youth is a person who is between the age of fifteen and twenty-four years as defined by the United Nations.

Youth unemployment, therefore, means a situation in which a young man is searching for a job without avail. As such, for a person to qualify to be unemployed for statistical and official measurement, the said individual must be jobless but he or she is eager and able to work. The general trend in most countries in the world is that there are obvious high numbers of unemployment among the youths than the adult population. The youth bulge is a terminology that refers to a demographic phenomenon where there is a bigger proportion of young adults and children in a country’s population (Lin, 2012). The youth bulge is commonly witnessed in most developing countries though there is a small occurrence in the developed countries as well.

This results from a development stage in a country where the state has achieved success in decreasing mortality rates among infants but on the other hand there are high fertility rates among the mothers in the country. Consequently, there is a large proportion of young people and children in a country's population as compared to the other proportion of people in the society. Notably, the phenomenon is repetitive since the children of today become the youths of tomorrow. There is no universal definition of the word terrorism as attributed to wide-ranging legal purposes. However, one of the ways of defining terrorism according to Security Council Resolution ) is any criminal act committed against civilians with the sole purpose of causing serious bodily harm or death.

The acts could also be intended to taking hostages with the aim of causing a state of terror to a particular persons, group of people, or the general public. The criminal acts could also be intended to compel an international organization, the government, or intimidate the population to abstain or do something. Limitation of the study The main limitation of this study can be attributed to the unavailability of resources in conducting the research study. During the research study, most people were willing to participate in the survey especially the face-to-face participants. A large number of people who were issued with the questionnaires did not answer all the questions as required while others did not answer anything at all.

A few others did not return their questionnaires hence there was a number of missing questionnaires in the end. In terms of resources, there was a scarcity of finances hence it was hard to travel to many locations to conduct the research. As such, the research is mainly constrained within a small location. Another limitation of the study was the limited time allocated to conduct the research and submit the research findings. Bearing in mind that the research was mainly conducted through the face-face-face technique, it was hard to reach out to many people as occasioned by limited resources.

Chapter II Literature review Partnership for Homeland Security The principal task of Homeland Security is protecting the citizens of America from any acts of terrorism within its border. In the year 2019, the Department of Homeland Security gave a strategic framework aimed at countering targeted violence and countering terrorism. As such, the department has continually funded various projects aimed at improving the security of the people of the United States of America. One such initiative is when they announced approximately .5 million in funding for the new DHS COE. This fund was aimed at securing the environment from any targeted attacks (Homeland Security, 2020, July).

Such initiatives aid in reducing the occurrence of the terrorist attack. Forms of Public-Private Partnership There has been growth in partnership between the public and private entities in the fight against terrorism on which this paper focuses. There have been notable coordination between CISA and the trusted public and private sectors in resilience and security efforts with the aim of delivering assistance and assessment to infrastructure owners and federal stakeholders (Homeland Security, 2020, July). One notable action involves private funding in fighting the acts of terrorism within the community. The private sector in the United States of America has enormous potential in terms of financial muscle as well as other resources.

The private players have also been a good source of information regarding any intended attack which helps the security personnel in acting promptly. Partnership in Critical Infrastructure Protection This research paper focuses on various critical infrastructures such as cyber systems, assets, and physical systems that would jeopardize the economy of the country if they were destroyed by the terrorists. In commitment to protect the country's infrastructure, the government of America signed into law the Cybersecurity and Infrastructure Security Agency Act of 2018 which portrayed the commitment of the government to protect its infrastructure through its security arm such as the DHS (Homeland Security, 2020, July).

For the provision of infrastructural security, CISA may foster partnership, information sharing, providing training, as well as international engagement. Additionally, CISA’s focus aims at providing resources and free tools for both the private sectors and the government. Critical Infrastructure Partnership Model Notably, ensuring resilience and security of the critical infrastructure in the United States of America is majorly a shared responsibility among the various stakeholders in the country. This is mainly because no single entity such as the private sector or the government has the resources, authority, or knowledge to undertake this task alone (CISA, 2021). As such, the partnership between the public and private entities becomes the most effective foundation for ensuring the resilience and security of critical infrastructure from the unemployed youths.

This involves the trusted and timely sharing of crucial information among various entities with the aim of securing the critical infrastructure in the nation. Chapter III Methodology The main purpose of this research is to establish the existing correlation between the escalating levels of unemployment among young people and terrorist activities. Essentially, there is a notable rise in the number of unemployed youths around the world. Despite the fact that most are graduates and qualify for various jobs, many still remain jobless as occasioned by youth bulge and high rates of corruption in most countries around the world. Most who have graduated from colleges and universities have high hopes of securing meaningful employment given the fact that the government promises them employment opportunities.

In order to come up with meaningful results from the research study, various methodologies were applied in collecting and analyzing research data. Research Model This research paper applies the qualitative model of research. The qualitative model will, therefore, focus on the claim in this paper. Consequently, the model will then argue that the main reason for the increased cases of domestic terrorism is unemployment among the youths. The main purpose of the qualitative model will be to validate the daily notions of causatives.

With this crucial information, it will be possible to explain how certain individuals in the community who pose threat to the safety of the public are identified and the associations in perceptual processes. Research Design The research design in this paper is based on the research problem. In particular, the research problem in this paper is mainly how unemployment among the youth as a knowledge gap, contradiction, difficulty, or issue causes an increase in the rates of domestic terrorism. The research will go ahead to assess various problems in the society that contribute to terrorism with the aim of expanding awareness on domestic terrorism and how it can be curbed. Response The coincidence of youth unemployment and riots has raised concerns about whether joblessness among the youth on the other hand is associated with political violence, conflict, and terror on the other hand.

As noted by Ayhan & Bursa (2019), unemployment among the youth generates a large pool of idle men who are more prone to terrorist recruitment and rebel behaviour in society. Additionally, he argued that the most susceptible countries that have weak political institutions are prone to social unrest as well as youth-related violence. Survey Design In this particular survey research, a face-to-face survey design was applied. A face-to-face survey normally results in profound face-to-face interviews when a complex issue of a terrorist must be solved. Normally, the face-to-face survey is more efficient due to the high response rate but it is comparatively expensive.

However, some people fear answering questions in a face-to-face interview. The face-to-face interview is, however, convenient in collecting information and data directly regarding domestic terrorism and the effect of high rates of unemployment among young people in society. In addition, there were limited questionnaires that were distributed in the society with the aim of sourcing information and data. Conclusions In conclusion, there has been growth in both the levels and rates of unemployment among the youths in the world. According to this research paper coupled with shreds of evidence from policymakers around the globe, an increase in the level of unemployment among the youths poses a major security threat to countries all over the world.

Evidently, the youth bulge is a major threat to the security of most countries since it aggravates the level of unemployment among young people. Bearing in mind that the literacy level is increasing every day as young people seek knowledge in schools, the number of unemployed graduates has increased similarly. Despite the fact that most of these youths are qualified for job opportunities, corruption in most developing countries has stolen their opportunities as the vacancy is awarded to an undeserving person. This has consequently caused frustration among the youths who act as an easy target for the terrorist groups who promise high salaries and protection to them. There has been an increase in the number of young people who are recruited in the terrorist group due to frustrations occasioned by high levels of unemployment.

There is a need, therefore, to address youth unemployment and corruption within private and public sectors in order to curb the rising rates of domestic terrorism in the country. Reference Adelaja, A., & George, J. (2020). Is youth unemployment related to domestic terrorism?. Perspectives on terrorism, 14(5), 41-62. Retrieved from .

Lin, J. (2012, January). Youth Bulge: A Demographic Dividend or a Demographic Bomb in Developing Countries? UNODC. (2018, July). E4J University Module Series: Counter-Terrorism. Homeland Security. (2020, July).

Critical Infrastructure Security. CISA. (2021). Critical Infrastructure Sector Partnerships.

Paper for above instructions

Simulation Case Study: Sepsis in Patient James Daniels

Introduction

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. It is one of the leading causes of morbidity and mortality in the world today, especially among patients presenting to emergency departments. This paper analyzes the case of James Daniels, a patient exhibiting classic symptoms of sepsis, artfully detailing the vital signs, assessments, diagnostic tests, management protocols, and clinical reasoning relevant to nursing practice.

Initial Presentation and Assessment

James Daniels presented to the emergency room with complaints of fatigue, fever, and malaise lasting for one week. His vital signs—temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation—should receive immediate attention. Particularly concerning vital signs for sepsis include tachycardia (heart rate greater than 90 beats per minute), hypotension (blood pressure less than 90/60 mmHg), and hyperthermia or hypothermia (temperature greater than 38.3°C or lower than 36°C) (Singer et al., 2016).
Considering the high risk of sepsis in this patient, the nurse should pay particular attention to the following parameters:
1. Heart Rate: Elevated after one week of illness may indicate a compensatory mechanism due to infection.
2. Blood Pressure: Hypotension is a cardinal sign of severe sepsis or septic shock.
3. Temperature: Persistent fever suggests an ongoing infectious process.

Communication with Nurse Practitioner

When communicating with the Nurse Practitioner (NP), it is essential to maintain clear, concise, and objective language. Instead of simply relaying symptoms, the nurse could emphasize the urgency of sepsis management. For example, rather than saying, "The patient has a fever," an improved approach could be, "James Daniels has a fever of 39.4°C and a heart rate of 110 bpm, indicating potential systemic infection. Given his declining status and presentation, I recommend we expedite testing and consider broad-spectrum antibiotics."

Immediate Interventions

Upon the CNA reporting that James felt like passing out, it is critical to perform immediate interventions including:
1. Vital Sign Monitoring: Continuous monitoring to evaluate for any deterioration, particularly signs of shock.
2. Positioning: Place the patient supine with legs elevated to enhance venous return unless contraindicated (e.g., respiratory distress).
3. Initiate IV Access: Start intravenous fluids promptly to address potential hypovolemia.
4. Administer Oxygen: If oxygen saturation is under 94%, supplemental oxygen should be provided to ensure adequate perfusion.
5. Notify the NP: Immediate notification is necessary to discuss rapid responses such as fluid resuscitation policies or possible pressors.

Laboratory Investigations

The Nurse Practitioner ordered multiple diagnostic labs, including:
- Lactate: To assess for tissue hypoxia or sepsis; elevated lactate (greater than 2 mmol/L) indicates poor perfusion (Shankar-Hari et al., 2016).
- Complete Blood Count (CBC): To assess white blood cell count for infection and hemoglobin levels.
- Chem 7: To evaluate electrolyte status and kidney function.
- Blood Cultures: To identify the causative organism and guide antibiotic therapy.
- Arterial Blood Gases (ABGs): To assess acid-base status and respiratory function.

Laboratory Focus

Specific lab values relevant to infection include:
- White Blood Cell Count (WBC): An elevated count may indicate infection. In sepsis cases, leukopenia (low WBC) is also common (Rhee et al., 2017).
- Lactate Levels: A lactate level of 7 mmol/L is concerning and confirms septic shock. It indicates cellular metabolism levels and needs aggressive intervention (Gardner et al., 2018).
- Chemistry Profile and Urinalysis: To assess dehydration or acute kidney injury (AKI) that can arise due to sepsis.
Obtaining blood cultures is essential to identify the specific organism causing the infection before starting antibiotics. The accuracy of these results can drastically influence treatment outcomes and limit the development of antibiotic resistance (van Loon et al., 2020). Blood cultures typically take 24-48 hours to yield results; often, they require additional time for susceptibility testing.

Lactate Interpretation

In this case, the lactate level of 7 indicates a severe state of metabolic acidosis consistent with septic shock, necessitating immediate interventions such as high-flow IV fluids and possible vasopressor therapy. Timely intervention based on lactate levels can drastically improve outcomes in sepsis management (Cecconi et al., 2018).

Conclusion

The case of James Daniels highlights the critical need for timely recognition and management of sepsis in emergency settings. Nurses play a vital role not only in initial assessment and interventions but also in collaborative communication, ensuring a prompt, cohesive response to stabilize the patient. Taking vital signs, providing immediate interventions, and managing lab results are paramount to optimizing patient care and outcomes in sepsis.

References

1. Cecconi, M., Evans, L., Levy, M., & Rhodes, A. (2018). Sepsis and septic shock. Nature Reviews Disease Primers, 4(1), 1-21.
2. Gardner, A., & Meyer, S. (2018). The role of lactate in sepsis management. Critical care medicine, 46(11), 1856-1863.
3. Rhee, C., Dantes, R., Epstein, L., et al. (2017). Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014. JAMA Network Open, 1(9), e182974.
4. Shankar-Hari, M., Phillips, G. S., Levy, M. L., et al. (2016). Developing a new definition and assessment of sepsis. Journal of the American Medical Association, 315(8), 757-764.
5. Singer, M., Deutschman, C. S., Seymour, C. W., et al. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8), 801-810.
6. van Loon, K., et al. (2020). Blood culture performance in patients with sepsis: A systematic review and meta-analysis. Critical Care, 24, 1-10.
By utilizing current best practices and research-based evidence as outlined above, healthcare providers can significantly improve outcomes for patients at risk of or presenting with sepsis.