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Respond to what the person wrote to this discussion in one paragraph 2 references APA 7TH edition

 

Janice is a 45yo Caucasian female with symptoms of Non-Alcoholic Fatty Liver Disease. Her BMI is 40 and she was diagnosed with DM2 3 years ago. Her last HgbA1c was 7.4. She lives a sedentary lifestyle. She states she has significant fatigue but is otherwise asymptomatic.

What diagnostics would you order for Janice? Why?

Most patients with NAFLD are asymptomatic and difficult to diagnose. Their symptoms may be vague such as abdominal discomfort, fatigue and nausea, and therefore need further testing to get an accurate diagnosis which include imaging test such as an abdominal ultrasound, a magnetic resonance (MRI) or a CT scan. An ultrasound cannot identify inflammation or fibrosis but is the first imaging study done to evaluate for hepatic steatosis. A CT scan can be done to assess the structure of the liver. It is an option for determining hepatic steatosis; however, there is significant radiation associated with this imaging study. Through blood test, the liver enzymes Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) are used to determine if there are liver problems. Transient elastography is a newer imaging study on the horizon. Described as a pulse-echo ultrasound, it has shown usefulness in determining the presence of fibrosis. This may be helpful in determining if a liver biopsy is necessary. A liver biopsy is the gold standard for determining if NAFLD is present and for staging the severity of NAFLD.

What treatment plan would you recommend for her?

The first treatment plan I would recommend for Janice is a lifestyle change of getting up and moving. Initially, increased physical activity, a low cholesterol/low-fat diet, decreased caloric consumption, avoidance of trans fats, and weight loss can make significant improvements in the disease. Lifestyle modifications not only have the potential to improve liver disease but can also improve common comorbidities (for example, hypertension, diabetes, and hyperlipidemia) The Mediterranean diet has shown improvement in hepatic steatosis and insulin sensitivity in NAFLD patients. Encouraging a reduction in calories along with good food choices is recommended. Dietary changes should include complete avoidance of high-fructose corn syrup and trans fats, as these dietary choices are associated with hepatic steatosis development and insulin resistance. Patients with NAFLD should not consume alcohol. Interestingly, some studies have been performed supporting that coffee consumption is associated with reducing hepatic fibrosis. One or two cups of unsweetened coffee can be seen as a benefit in patients with NAFLD. A weight loss of 3% to 10% can improve disease progression and normalization of AST levels, but weight gain can lead to NASH recurrence. Hepatic steatosis can be reduced with even a 3% weight loss. Exercise, both with and without weight loss, has shown benefits for the patient with NAFLD.

What is her prognosis?

Janice has a chance of living a long life if she sticks to a diet change, exercises, and monitors her blood sugars and A1C. If there is little damage to her liver, she can reverse the symptoms of the disease before it progresses.

 

 

Sample Answer

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This course starts with an outline of the correspondence cycle, the method of reasoning and hypothesis. In resulting modules of the course, we will look at explicit use of relational connections in close to home and expert life. These incorporate relational correspondence, bunch correspondence and dynamic, authoritative correspondence in the work environment or relational correspondence. Rule of Business Communication In request to make correspondence viable, it is important to follow a few rules and standards. Seven of them are fundamental and applicable, and these are clear, finished, brief, obliging, right, thought to be, concrete. These standards are frequently called 7C for business correspondence. The subtleties of these correspondence standards are examined underneath: Politeness Principle: When conveying, we should build up a cordial relationship with every individual who sends data to us.

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It is a unique cycle that oversees force, closeness and limits, cohesiveness and flexibility of route frameworks, and makes pictures, topics, stories, ceremonies, rules, jobs, making implications, making a feeling of family life An intelligent cycle that makes a model. This model has passed ages. Notwithstanding the view as a family and family automatic framework, one of the greatest exploration establishments in between family correspondence centers around a family correspondence model. Family correspondence model (FCP) hypothesis clarifies why families impart in their own specific manner dependent on one another ‘s psychological direction. Early FCP research established in media research is keen on how families handle broad communications data. Family correspondence was perceived as an exceptional scholastic exploration field by the National Communications Association in 1989. Family correspondence researchers were at first impacted by family research, social brain science, and relational hypothesis, before long built up the hypothesis and began research in a family framework zeroed in on a significant job. Until 2001, the primary issue of the Family Communication Research Journal, Family Communication Magazine, was given. Family correspondence is more than the field of correspondence analysts in the family. Examination on family correspondence is normally done by individuals in brain science, humanism, and family research, to give some examples models. However, as the popular family correspondence researcher Leslie Baxter stated, it is the focal point of this intelligent semantic creation measure making the grant of family correspondence special. In the field of in-home correspondence, correspondence is normally not founded on autonomous messages from one sender to one beneficiary, yet dependent on the dynamic interdependency of data shared among families It is conceptualized. The focal point of this methodology is on the shared trait of semantic development inside family frameworks. As such, producing doesn’t happen in vacuum, however it happens in a wide scope of ages and social exchange.

Standards are rules end up being followed when performing work to agree to a given objective. Hierarchical achievement relies significantly upon compelling correspondence. So as to successfully impart, it is important to follow a few standards and rules. Coming up next are rules to guarantee powerful correspondence: clearness: lucidity of data is a significant guideline of correspondence. For beneficiaries to know the message plainly, the messages ought to be sorted out in a basic language. To guarantee that beneficiaries can without much of a stretch comprehend the importance of the message, the sender needs to impart unmistakably and unhesitatingly so the beneficiary can plainly and unquestionably comprehend the data.>

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