Case Study Atelectasis MM, age 55, is admitted with acute cholecystitis, elevated WBC, and a fever of 102 F. She had a cholecystectomy and transferred to the med surg unit from ICU on her second post op day. She has a NGT to low wall intermittent suction, IV D5 1/4NS with 40mEq KCL at 125 ml/hr, diet as tolerated; TCDB q2h; incentive spirometer (IS) q2h while awake; dangle in am; ambulate in morning; morphine 10mg IM q4h prn pain, ampicillin (Omnipen) 2g IVPB q6h; chest x-ray in am

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Answer 1

Atelectasis Case Study MM, age 55, was admitted with acute cholecystitis, a high WBC, and a fever of 102 F. On her second post-operative day, she was transferred to the med surg unit from the ICU after undergoing a cholecystectomy.

She had a NGT to low wall intermittent suction, IV D5 1/4NS with 40mEq KCL at 125 ml/hr, a diet as tolerated; TCDB q2h; incentive spirometer (IS) q2h while awake; dangle in am; ambulate in the morning; morphine 10mg IM q4h prn pain, ampicillin (Omnipen) 2g IVPB q6h; and a chest x-ray in the morning.

Atelectasis is a lung condition in which the lung tissue collapses due to a blockage in the air passages, preventing oxygen from reaching the lungs. Atelectasis is a common problem in patients recovering from surgery, especially abdominal surgeries like cholecystectomy.

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Related Questions

The primary aim of a therapist operating from the____ perspective is to help partners to identify and change the unspoken rules and beliefs that govern their recurring patterns of behavior. a. behavioral b. reframing c. systems d. cognitive
e. emotionally focused

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Answer: E. emotionally focused

Explanation:

answer d cognitive function

Could secondary trauma be a looming threat for the counselor
when issues with psychological testing arise? If so, is there any
pre or post-actions that a counselor can take to lessen this
threat?

Answers

Counselors facing issues with psychological testing may experience secondary trauma. They can mitigate this threat through self-care, supervision, debriefing, therapy, and maintaining boundaries.

Yes, secondary trauma can indeed be a looming threat for counselors when they encounter issues with psychological testing. Witnessing the emotional struggles of their clients and dealing with challenging test results can have a cumulative impact on counselors' well-being.

To lessen this threat, counselors can take certain pre and post-actions. Before engaging in psychological testing, counselors should prioritize self-care and establish a strong support system. They should engage in regular supervision or consultation with experienced colleagues to process their emotions and concerns. During the testing process, counselors can practice mindfulness techniques and boundary setting to maintain their emotional resilience.

After encountering challenging test results, counselors should debrief with a trusted colleague or supervisor to reflect on their emotions and any potential secondary trauma. Engaging in self-reflection and seeking therapy themselves can also be beneficial. Regular self-care activities such as exercise, relaxation techniques, and hobbies should be incorporated into their routine to promote emotional well-being and prevent burnout.

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Based on the position of the female bladder in relation to the vagina and uterus, what do you think happens to the bladder during the last month of pregnancy? Also be sure to describe where the female bladder is located!
he uterus lies over the bladder and presses upon it during early pregnancy. Later the uterus rises out of the pelvis. As the uterus grows larger and moves upward, the bladder is pushed forward and pulled upward.

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The female bladder is located in the lower part of the pelvis.During the last month of pregnancy, the bladder is pushed forward and pulled upward due to upward movement of the uterus.

As pregnancy progresses, the uterus expands to accommodate the growing fetus. In the early stages of pregnancy, the uterus lies over the bladder, exerting pressure on it. This pressure can sometimes lead to increased frequency of urination during the first trimester.

However, as the pregnancy advances, the uterus gradually rises out of the pelvis, and the bladder is affected by this upward movement. With the continuous growth of the uterus, it begins to push against the bladder, causing it to be displaced forward and upward in the abdominal cavity.

As a result, the bladder's capacity to hold urine may be reduced during the last month of pregnancy. This compression can cause increased pressure on the bladder and result in more frequent urination for the expectant mother. Additionally, the displaced bladder may also contribute to feelings of urinary urgency and discomfort.

In summary, During pregnancy, the position of the bladder is altered due to the expanding uterus. The displacement of the bladder can vary among individuals, and factors such as the size and position of the uterus can influence the extent of bladder displacement.

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For some, the etiology of substance abuse disorders is the result of a genetic predisposition (biological), whereas others might argue that addiction or abuse is the result of using substances as a coping mechanism that will act as a reinforcer (behavioral learning).
Why might an adolescent with a maternal and paternal family history of alcohol and drug abuse problems be concerned that they will develop a substance use disorder or addiction?
What recommendations do you have for the adolescent in helping to reduce the risk of developing a substance use disorder?
Be sure to also address stress, coping and peer relationships in your response.

Answers

Adolescents with a family history of substance abuse may worry about developing addiction due to genetic predisposition and learned coping behaviors.

Adolescents with a familial history of alcohol and drug abuse problems face an increased risk of developing a substance use disorder or addiction. Firstly, genetic factors can contribute to a higher susceptibility to substance abuse. Research suggests that certain genetic variations may make individuals more vulnerable to the effects of drugs and alcohol, increasing the likelihood of developing a substance use disorder.

Secondly, growing up in an environment where substance abuse is prevalent can also influence an adolescent's risk. The learned behaviors and coping mechanisms associated with substance abuse within the family can be passed down through generations. Adolescents may observe family members using substances as a means of coping with stress or emotional difficulties, leading them to perceive substance use as a potential solution or reinforcement.

To help reduce the risk of developing a substance use disorder, it is important for the adolescent to take proactive steps. Firstly, fostering healthy coping mechanisms for managing stress is crucial. Encouraging the adolescent to engage in activities such as exercise, hobbies, and social support networks can provide alternative ways to cope with stressors without resorting to substance use.

Additionally, building strong peer relationships can be beneficial. Positive peer influences and supportive friendships can serve as protective factors against substance abuse. Encouraging the adolescent to seek out healthy friendships and engage in activities that do not involve substance use can help reduce their risk.

Lastly, open communication within the family is essential. Creating a safe and non-judgmental environment where the adolescent feels comfortable discussing their concerns and experiences can facilitate early intervention and support. Providing education about the risks of substance abuse and maintaining ongoing dialogue can help the adolescent make informed choices and seek help if needed.

In summary, an adolescent with a family history of alcohol and drug abuse problems may be concerned about developing a substance use disorder due to genetic predisposition and learned behaviors associated with substance abuse. To reduce the risk, it is important to focus on healthy coping mechanisms, positive peer relationships, and open communication within the family.

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leadership and management
question 3:What are the experience and educational background
of nurse managers at all levels of your organization? Do they have
formal education in business or management?

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The experience and educational background of nurse managers at all levels of an organization vary significantly. It is essential to note that not all nurse managers have formal education in business or management. Some may have extensive experience in healthcare settings and hold advanced degrees in nursing or other related fields.

The educational and experiential requirements for a nurse manager position may vary depending on the organization. Generally, nurse managers hold a degree in nursing, and some may have a master's degree in nursing. An advanced degree in healthcare management or business administration can also be an added advantage when it comes to pursuing a nurse manager's position. Besides, nurse managers can take additional courses or training programs in management and leadership to gain more experience in this area.

In conclusion, while a formal education in business or management is not necessarily required, it can be advantageous for nurse managers to hold advanced degrees in nursing, healthcare management, or business administration. Additionally, it is essential for nurse managers to have experience in healthcare settings and to take training programs to gain more experience in management and leadership.

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Joshi Kamakani – 70 year old male with metastatic prostate cancer. Joshi is a retired engineer that the Palliative Care home care team and the NP has been looking after him at home for the last two months. Joshi was diagnosed with inoperable prostate cancer three years ago and has been treated with ablative hormone therapy.
His wife called you yesterday stating that he is in a lot of pain and therefore spends most of his time on the couch. He cannot get around on his own and is very fatigued.
Past medical History:
HTN
GERD
Medications:
Prednisone 5mg PO BID
Leuprorelin 22.5 mg IM every 3 month
Hydrocholorthiazide 25mg daily
Pantoprazole 40mg PO daily
Morphine slow release 100 mg q12h
You are a home health nurse taking care of Joshi. Use the resources available in your community to create the following care plan.
1. What are the 3 priority questions you will ask Joshi and his wife during the patient interview? (You may only ask 3 questions, so make sure you are focusing on the priority of care)
2. What are your 3 priority safety concerns for Joshi?
3. Create a plan of care to address the needs of Joshi and his wife.

Answers

Priority questions for Joshi and his wife:

Are you experiencing any pain or discomfort that is not being adequately managed with the medication currently prescribed?

Are you experiencing any changes in your appetite or weight?

Are you experiencing any confusion or difficulty with daily activities such as bathing, dressing, and grooming?

Priority safety concerns for Joshi:

The risk of falls due to his fatigue and inability to ambulate

The risk of medication errors due to confusion or difficulty swallowing

The risk of depression or anxiety due to his prognosis and decreased mobility

Plan of care to address the needs of Joshi and his wife:

Conduct regular pain assessments and adjust medication as needed to ensure adequate pain management.

Assess for any changes in appetite or weight and provide appropriate interventions such as tube feeding or oral care.

Assess for any cognitive or functional changes and provide appropriate interventions such as home health aides or adult day care.

Provide education on pain management, medication safety, and wound care.

Provide emotional support and resources for Joshi and his wife, such as counseling or support groups.

Assist with activities of daily living such as bathing, dressing, and grooming to prevent further decline in functional abilities.

Provide support for the family to ensure they are able to provide adequate care and manage their own emotional needs.

Coordinate with the oncology team and community resources for any additional interventions such as hospice care if needed.

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