Twenty years ago, Johnny killed his wife in a fit of rage when he came home one night and saw her in bed with another man. Based on the mandatory sentencing guidelines at the time of his conviction, Johnny was sentenced to life in prison without any opportunity for parole.

For the past 20 years, Johnny has been a model prisoner. He finished his college degree and worked as a cook in the prison kitchen. One day, a fight in the mess hall between two other prisoners resulted in the death of one prisoner and several injuries to prison guards. At the time, Johnny was working in the kitchen and took no role in the fight.

After the fight, the warden of the prison imposed a series of punishments. First, the warden ordered a 24-hour lockdown of the prison. This lockdown lasted 10 days, during which prisoners were not allowed out of their cells.

Second, the warden ordered that prisoners be deprived of all “treats” including adult magazines, reading materials, caffeinated sodas, candy, and desserts; visiting privileges for all prisoners were halted for one year.

Finally, and perhaps worst, the warden decided to isolate the most violent prisoners for an extended period. Because of Johnny’s murder conviction, the warden ordered Johnny to serve six months in solitary confinement.

After doing his time in solitary, Johnny filed an internal complaint with the warden. In his complaint, Johnny argued that the warden’s punitive measures violated his Eighth Amendment rights. The warden denied Johnny’s complaint and Johnny then filed a complaint in the federal court.

 please represent the warden, who is most likely represented by the government.  Show, using case law and other legal arguments, how the warden’s measures did not constitute violations of the Eighth Amendment. 

Constructing the Identity of ‘Youth’

In this assignment you will consider how the categories of “youth” and “childhood” vary over time and across cultures. To do this, you will answer a series of questions regarding photos you select of the “jobs” of young people in three different contexts: (1) 19th and early 20th-century America; (2) Present day America; and (3) Present Day India, Nigeria, or Brazil (select one).

In present day United States culture, childhood is a nurturing time of carefree exploration and personal development, where a child’s main job is to go to school. However, this was not always the way we understood youth and childhood in the U.S., and it is not how it is understood across all countries. In fact, the concept of childhood is linked closely to social class identities. In other words, in societies (or families) that have more socioeconomic resources, childhood is a time period set aside for parental nurturing, carefree exploration, and personal development. On the other hand, in contexts of severe economic hardships, childhood is a luxury that many families cannot afford. Instead, children enter the labor force at a much younger age as a necessity of family survival (Barone 2015).

Explore the ways that the social identity of “youth” and the category of “childhood” vary across the three social contexts mentioned above by incorporating photos of the expected jobs of young people in each context.  Using your selected photos and assigned readings (e.g., course text, resources provided below, supplemental materials provided by your instructor, and two additional scholarly sources), create a 12-slide PowerPoint presentation (including one title slide and one references slide in APA style).

Your PowerPoint presentation should include two main parts:

1. Seven of your slides must contain photos with brief descriptions. Be sure to include a minimum of three photos for each of the three social contexts (you can include multiple photos per slide). You must obtain photos from public Internet searches and properly cite each photo.

   In your description of each photo, be sure to:

• Describe how the photo helps you understand the expectations and value of “youth” and “childhood” in that society. In other words, what clues does the photo give you to determine how the identity of youth is constructed in that society?

1. In the remaining three slides, address the following questions:

• Explain how the identity of “youth” and the time period of “childhood” is socially constructed and how it varies over time and across countries.
• Explain how social class impacts the social construction of “youth” and “childhood.”
• Discuss how comparing the different photos across your three social contexts help you understand the ways in which these categories are socially constructed.

To assist you with this assignment, watch this short video on child labor in developing countries (Links to an external site.), https://www.youtube.com/watch?v=PdmiUb9_E94 as well as this video on the history and struggle to end child labor in the United States (Links to an external site.) https://youtu.be/s9U4Vx6ImpE. Sociologists have a rich history of using images to call attention to social issues. For inspiration on this assignment, please also take a look at this short video (Links to an external site.) https://www.bbc.com/news/av/magazine-17673213 (or read the article posted below the video) highlighting the work of Lewis Hine, an American sociologist who used photography to advocate for changes to child labor laws in the early 20th century.

The Constructing of the Identity of ‘Youth’ assignment:

• Must include 12 PowerPoint slides (including one title slide and one references slide), formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.).
• The Title slide must include the following:
  • Title of presentation
  • Student’s name
  • Course name and number
  • Instructor’s name
  • Date submitted
• Must use your textbook and at least two scholarly sources.
  • The Scholarly, Peer Reviewed, and Other Credible Sources table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
• For help searching the library’s scholarly resources, check out Database Search Tips tutorial video (Links to an external site.).
• Must include a separate references slide that is formatted according to APA style as outlined in Ashford Writing Center (Links to an external site.). For more information regarding APA, including samples and tutorials, visit the Ashford Writing Center, located within the Learning Resources tab on the left navigation toolbar, in your online course.

Reference

Barone, F.  (2015, February 12).  A Cross-Cultural Perspective on Childhood (Links to an external site.). Yale University.  Retrieved from: http://hraf.yale.edu/a-cross-cultural-perspective-on-childhood/

Instructions: Respond by extending, refuting/correcting, or adding additional nuance. Response must be in current APA format, must be grammatically correct and must be at least 200 words.

Clinical Manifestations of Acute Kidney Injury

The possible types of Acute Kidney Injury as per M.r J.R clinical manifestation are perenal injury and intrinsic injury. In perenal injury, the kidney may normally be functioning, but renal perfusion linked to vomiting or diarrhea results in a decreased arterial filtration rate. Some symptoms of perenal injury include nausea, fatigue, and vomiting. And as from the presented case, M.r J.R has shown these symptoms. Besides, there are clinical manifestations of gastroenteritis and possible renal injury. These are possible signs of perenal injury type of Acute Kidney Injury. 

The intrinsic injury happens when there is injury to the kidney, resulting to loss in kidney function. A common type of intrinsic injury is acute tubular necrosis, with the usual cause such as nephrotoxic (toxic agents to the tubular cells) (Rahman, Shad & Smith, 2012). Some of these toxic agents may include medicine. They are more severe when the patient has an existing condition that increases risk of having acute kidney disease. As from the presented case, M.r J.R has been using pain-relieving medicines such Pepto-Bismol, which can be harmful if overused with existing kidney disease. Toxic medicines may limit the normal homeostatic responses to volume depletion, thus resulting in the decline of renal functions. This type of acute kidney has symptoms such as nausea and fatigue, which were presented by M.r J.R. A clinical manifestation of possible renal injury is linked to this type of acute kidney injury.

Risk Factors 

There are various risk factors for acute kidney injury. From the given case, Mr. J.R might have the following risk factors.

• Age: Mr. J.R is 73 years old, and people older than 65 years are susceptible to developing acute kidney injury; this is due to the functional deterioration of the kidney due to the aging process and a reduced renal reverse (American nurse, 2015).
• Sepsis: Sepsis can be a risk factor in Mr. J.R’s case, mainly because he has infections such as diarrhea and inflammatory response during this process can lead to the adaptive response of the tubular epithelial cells, which reduces functions of the cells to minimize energy demand, and can result in reduced kidney function.
• Toxic medications can also be a risk factor for kidney disease since they limit the normal homeostatic responses to volume depletion, resulting in the decline of renal functions.

Complications On Hematologic System (Coagulopathy and Anemia) and the Pathophysiologic Mechanisms Involved

In this case, hematologic system functions will reduce significantly. This is because damaged kidneys generate fewer erythropoietin (EPO), a hormone responsible for indicating bone marrow to create red blood cells. With reduced EPO, the body will make fewer red blood cells signifying less oxygen is supplied to other body tissues. Besides, chronic kidney disease can lead to low levels of nutrients such as vitamin B12 and folate to make red blood cells (Nih.gov, 2014). The case of fewer red blood cells leads to anemia. Besides, chronic kidney disease can lead to venous thromboembolism, making it easier for the body to form blood clots; this is mainly seen with kidney problems causing welling or higher levels of proteins in the urine.

Ms. P.C. Case Study Questions

Clinical Manifestations and Microscopic Examination of the Vaginal Discharge

The most possible diagnosis for Ms. P.C is a pelvic inflammatory disease. This disease mainly happens when sexually transmitted bacteria extends from the vagina and affects the uterus, fallopian tube, or ovaries. Ms. P.C has presented clinical manifestations such as abdominal pain, nausea, emesis, and vaginal discharge, which is thick, greenish-yellow in color, and very smelly; these are all symptoms of pelvic inflammatory disease (Higuera, 2019). Besides, the positive high white blood cells count in her microscopic examination of the vaginal discharge is a positive sign for pelvic inflammatory disease.

Microorganism Involved

The microorganism involved is bacteria. Greenish-yellow in color, smelly vaginal discharge, and abnormal white blood cells, as seen in the case of Ms. P.C, are signs of bacterial infection (Higuera, 2019). This bacteria travels from vagina to womb or fallopian tubes, causing an infection. Several types of bacteria can cause pelvic inflammatory disease; however, the common types are gonorrhea or chlamydia infections. They are mainly acquired during unprotected sex (Higuera, 2019). Besides, someone can get bacteria when they gets into the reproductive region when the usual barrier, which is formed by the cervix, is disrupted; this happens mostly during menstruation (Mayo clinic, 2019). As from the Ms. P.C case, she admits to having unprotected sex once in a while, and her LMP also ended three days ago. These can be one of the causes of the bacteria. 

Criteria to Recommend Hospitalization

Treatment of pelvic inflammatory disease is essential since it helps relieve acute symptoms, exterminate the current infection, or minimize the disease’s long-term effect. This as well helps in the reduction of the transmission of the infection to a sexual partner. A patient can be urgently admitted to the hospital if they have severe symptoms such as the ones shown by Ms. P.C., such as nausea and vomiting. Another factor is when the patient has signs of pelvic peritonitis.

The criteria I will use to recommend hospitalization to Ms. P.C include administering antibiotics. The first treatment line is to prescribe antibiotics immediately to Ms. P.C after receiving the lab test. The recommended antibiotics are penicillin, cefoxitin, metronidazole, ceftriaxone, and doxycycline (Das, Ronda & Trent, 2016). They help in stopping the growth of the bacteria or kills it. The patient should then be checked after three days of taking the antibiotics to monitor and ensure the treatment is working. It is also imperative to advise the patient to continue taking the antibiotics to finish the dose even if the condition improves. If the oral antibiotics do not work or in the cases of severe symptoms, the patient will continue in the hospital, where the intravenous medication will be recommended (Das, Ronda & Trent, 2016). Surgery can also be considered when the patient shows signs of scarring on the fallopian tubes. One or both of the fallopian tubes can be removed. Treating Ms. P.C’s sexual partner will also be recommended to avoid the bacteria’s reinfection. While out of the hospital, Ms. P.C will be advised to refrain from any sexual activities until the treatment is completed. 

References

Rahman, M., Shad, F., & Smith, M. (2012). Acute kidney injury: A guide to diagnosis and management. American Family Physician, 86(7), 631-639.

American nurse. (2015, July 13). American nurse: The official Journal of the American Nurses Association (ANA). American Nurse. https://www.myamericannurse.com/acute-kidney-injury/

Das, B. B., Ronda, J., & Trent, M. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment. Infection and Drug Resistance, 9, 191–197. https://doi.org/10.2147/IDR.S91260

Higuera, V. (2019). Pelvic inflammatory disease (PID). Healthline. https://www.healthline.com/health/pelvic-inflammatory-disease-pid#risks

Mayo clinic. (2019, October 18). Iron deficiency anemia – Diagnosis and treatment – Mayo Clinic. Mayo Clinic – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/diagnosis-treatment/drc-20355040

Nih.gov. (2014, July 16). Anemia in chronic kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/anemia (Links to an external site.)

Respond to the following post in two different replies. Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource that is different than the one you used for the initial post.

Respectfully agree and disagree with your peers’ responses and explain your reasoning by including your rationales in your explanation.

APA format,  Cites three or more references, using at least one new scholarly resource . 

1st POST ( PLEASE RESPOND)

The purpose of this discussion post is to review ML’s new diagnosis and potential treatment options. For ML, her new diagnosis of stage A heart failure does not mean she has any structural abnormality with her heart. The pathophysiology of this condition includes the fact that ML has preexisting conditions that increase her risk of developing heart failure in the future, if left untreated. The conditions that would cause ML to be diagnosed with stage A heart failure and potentially lead to further heart failure staging if left untreated include hypertension, coronary artery disease, or diabetes mellitus (Woo & Robinson, 2020). The main goal with stage A heart failure includes managing comorbidities to prevent heart failure development (Tanaka, 2018). The main goal of this belongs with consistent blood pressure management. 

For ML, the main goal in her treatment therapy will include good blood pressure control. According to Woo and Robinson (2020), ACE inhibitors are typically the first line of treatment, as research has displayed these medications to improve patient symptoms, decrease mortality, and increase life expectancy. As these medications are typically shown to reduce the mechanisms that lead to heart failure, this would be the recommended drug of choice for ML to prevent her progression of stage A heart failure. Due to the fact that digoxin has not been shown to present a mortality benefit, although it may improve quality of life in patients with congestive heart failure, this would not be the first choice of treatment for ML. If, however, this was chosen for ML to treat her stage A heart failure and she was experiencing halos, this would be a sign of digoxin toxicity (Cummings & Swoboda, 2020). If ML has any renal impairment, she would be at increased risk for developing digoxin toxicity. To evaluate for toxicity, a random digoxin level should be checked as well as confirming when the last dose was taken by ML. Once an EKG and basic lab values are obtained, Digibind is an antidote that will assist with eliminating the toxicity, especially in life-threatening instances (Cummings & Swoboda, 2020). 

If digoxin is chosen to be the treatment for ML, special consideration should be taken if ML is an older adult or has renal impairment (Woo & Robinson, 2020). Along with this, digoxin was associated with increased risk of death and worsening heart failure in women compared to men (Jackson, 2015). Due to these risks and potential complications, ACE inhibitors will remain to be the drug class of choice for ML. Due to the risk of hypotension, a low-dose ACE inhibitor should be initiated, with a gradual increase in dose occurring to improve exercise tolerance and to relieve any potential symptoms. While doing this, BP and renal function should be closely monitored. Along with this, due to the risk of increased potassium levels, serum electrolyte levels should be regularly monitored. Lastly, one potential side effect that is typically the primary cause for discontinuation amongst patients is the risk of a persistent dry cough (Woo & Robinson, 2020). Ideally, with proper treatment and close monitoring, ML’s stage A heart failure will not progress to additional stages. 

2ND POST (PLEASE RESPOND)

 The purpose of this post is to discuss heart failure and the implications of using digoxin as a treatment option
Pathophysiology of Stage A heart failure. According to Cleveland Clinic (2021), Stage A heart failure is where though one is not having heart failure, the risks are high due to family history or other health medical conditions such as diabetes, hypertension, alcohol use, cardiomyopathy, drug use, coronary artery diseases, metabolic syndrome, rheumatic fever, and others. This means that the patient has a high risk for heart failure, but they do not have symptoms or structural heart diseases
Digoxin is the rational drug choice for treatment of this individual because it does not affect contractility. In addition to that is for maintenance as it does not cure heart failure. As stage A is just a risk and not fully heart failure, there is no need to alter the function of the heart. According to American Heart Association (2021) women need to get low dose digoxin, the advantage to this is, the low doses are beneficial hemodynamic, neurohormonal, and in clinical effect (Gheorghiade, 2017).
The patient’s concern about halos should digoxin be prescribed is a legit concern. When a patient has digoxin toxicity, there are a myriad of side effects and some are visual which include the haloes. If that happens, the patient should notify the provider immediately and get blood work to assess the serum level, tapering may be the first option that complete discontinuance of the medication (Pincus, 2016).
There are gender considerations related to medication treatment as women have increased mortality rates than men. One of the reasons is due to the hormone interaction and digoxin. Progestin increases the serum digoxin levels as it causes the reduction of digoxin excretion through the kidneys (Rathore, 2018).
Digoxin monitoring is very important as it has a very narrow safety range and to ensure therapeutic levels are met. Blood work is done as recommended especially after a few hours from last dose taken. The results will aid in adjusting medications or maintaining the regimen. In addition to that blood work is essential as it will monitor magnesium and potassium levels that can alter digoxin levels. Lastly if there is digoxin toxicity, there is an antidote that can be given to prevent adverse issues (Lab tests, 2020) 

RESPOND TO EACH POST WITH 300-350 WORDS.