In the discharge summary, the nurse should include the medical history of the patient, information about the client's critical pathway, and instructions for completing dressing changes.
In the discharge summary for a client postoperative following a radical mastectomy, the nurse should include the following information:
Medical history: This includes relevant medical conditions, previous surgeries, allergies, and any other pertinent information related to the client's health.
Information about the client's critical pathway: This refers to the specific care plan and timeline for the client's recovery and rehabilitation. It outlines the expected milestones and interventions to be followed.
Instructions for completing dressing changes: Since the client has undergone a radical mastectomy, wound care and dressing changes are crucial. The nurse should provide detailed instructions on how to clean the wound, apply dressings, and monitor for any signs of infection or complications.
Emergency code status may or may not be relevant to include in the discharge summary, as it typically pertains to the client's resuscitation preferences in case of a medical emergency. This information is more commonly documented in a separate document, such as an advance directive or code status form. However, if the client has specific code status preferences, it may be appropriate to include them in the discharge summary.
It's important to note that the specific requirements for a discharge summary may vary based on institutional policies and the healthcare provider's preferences.
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A 40-year-old married African American woman presents for an annual physical examination. When asked about the most recent mammogram, the patient reports that she gets anxious about the procedure and therefore did not follow through with last years’ mammogram.
She states she does breast self-exams occasionally. The patient has no history of breast lumps and no family history of breast cancer. She has two young children, whom she did not breastfeed. She remains sexually active, does not use tobacco, recreational drugs, or drink alcohol. The patient is not physically active. Her physical check-up is normal except for slightly elevated blood pressure.
Would you recommend a mammogram for this patient? Why or why not?
What is the recommendation for the patient’s slight elevation in blood pressure? Are any interventions necessary? If so, what are they?
What individual model to promote healthy behavior would you choose and what strategies would you suggest?
What community model to promote healthy behavior would you choose and what strategies would you suggest?
Yes, I would recommend a mammogram for this patient despite the fact that she gets anxious about the procedure and therefore did not follow through with last years’ mammogram.
Women aged 40-44 years with average risk of breast cancer should have the choice to begin annual breast cancer screening with mammography if they wish to do so. This is supported by the American Cancer Society in 2021 and many other organizations and associations in the United States.
Mammograms are crucial in detecting breast cancer early. Breast cancer screening has been shown to be a highly effective preventive tool in reducing breast cancer morbidity and mortality rates. Patients who have no history of breast cancer should still have regular mammograms after the age of 40. If the patient refuses, it is important to discuss the benefits of screening and the risks of breast cancer not being detected early.
Educational resources: Patients may benefit from educational resources on healthy behaviors, including nutrition, exercise, and disease prevention.Self-assessment: The patient should evaluate their lifestyle to identify areas for improvement and make necessary changes.
Reward system: Patients who make significant improvements in their lifestyle should be rewarded to increase their motivation to continue.Health fairs: Community models are ideal for promoting healthy behaviors. Health fairs are a good way to connect people with community resources and provide education on healthy behaviors.
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Which statements about adrenal suppression are correct? Select all that apply.
A. Can result in hypoadrenal crisis if long-term corticosteroid administration is slowly tapered B. Can result when the adrenal glands stop producing endogenous hormone because of long-term corticosteroid
supplementation
C Possible complication of long-term corticosteroid treatment
D. Can result when the adrenal glands produce too much endogenous steroid in addition to the steroid being administered
The correct statements about adrenal suppression are: can result when the adrenal glands stop producing endogenous hormone because of long-term corticosteroid supplementation and possible complication of long-term corticosteroid treatment. Here options B and C are the correct answer.
Adrenal suppression refers to the reduction or cessation of the production of endogenous (naturally occurring) corticosteroids by the adrenal glands.
Corticosteroids are hormones that regulate various physiological processes in the body, including inflammation and stress response.
Long-term administration of exogenous (external) corticosteroids, such as prednisone or dexamethasone, can suppress the adrenal glands' natural production of these hormones.
The continuous administration of corticosteroids can suppress the adrenal glands' function, leading to a decrease in the production of endogenous corticosteroids.
If this suppression is significant and the exogenous corticosteroids are abruptly discontinued or rapidly tapered off, it can result in a condition known as hypo-adrenal crisis or adrenal insufficiency.
This condition is characterized by a sudden drop in corticosteroid levels, leading to potentially life-threatening symptoms like low blood pressure, electrolyte imbalances, and shock. Therefore options B and C are the correct answer.
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medical surgical and nursing managemant of
Tonsilopharyngitis
Tonsilopharyngitis, often known as a sore throat, is a medical condition that can be treated with medical, surgical, and nursing management. In this question, we will discuss the medical, surgical, and nursing management of tonsilopharyngitis. Let us discuss medical and nursing management.
Medical management: Antibiotics like penicillin are the most commonly used drugs to treat tonsillopharyngitis. If the cause of the condition is a virus, then antibiotics may not be used. Analgesics and antipyretics may be used to relieve the fever and pain. Surgical management: If the tonsillopharyngitis is caused by an underlying condition like tonsil stones or sleep apnea, surgical intervention may be recommended. The most common surgical procedure for tonsil removal is tonsillectomy.
Nursing management: One of the primary goals of nursing management is to promote comfort, hydration, and nutrition. Therefore, the nursing management of tonsillopharyngitis includes the following activities: Encourage patients to consume fluids to prevent dehydration. Advise patients to avoid irritating or spicy meals until their symptoms have improved. Encourage patients to rest and avoid exposure to cold or moist air. Monitor the patient's vital signs and report any abnormalities or changes. The patient's throat and neck should be checked for redness, swelling, or tenderness regularly.
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What is the ICD-10 code for Lysis of small intestinal adhesions,
open approach
The ICD-10 code for lysis of small intestinal adhesions, open approach is K56.69.
In the ICD-10 classification, K56 refers to "Paralytic ileus and intestinal obstruction without hernia." The code K56.69 signifies "other intestinal obstruction unspecified. "Open approach refers to a surgical technique that involves cutting through the skin and tissue to gain access to the surgical area.
In this case, lysis of small intestinal adhesions involves separating or cutting down adhesions that develop between different tissues inside the small intestine. Adhesions can form due to previous surgeries, infection, or inflammation and can cause blockages leading to pain, nausea, vomiting, and other symptoms.
When these adhesions cannot be resolved using non-surgical interventions, surgical lysis is done. The open approach is used when laparoscopic procedures are not possible due to technical difficulties, extensive scarring, or other medical reasons.
This surgical technique involves making a large incision in the abdomen, allowing the surgeon to have full access to the small intestine. After the procedure, patients are observed for any signs of complications such as bleeding, infection, or wound healing problems. Proper coding of the procedure is crucial for proper billing and documentation purposes.
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What are the safety guidelines for vincristine preparation and administration? A. Reconstitute in a minibag of 5% dextrose in water and administer IV push. B. Dilute in a 10mL syringe with normal saline and administer IV push. C. Use an infusion pump to administer intravenously over 30 minutes. D. Prepare in a minibag and infuse intravenously over 5-10 minutes
Vincristine is an antineoplastic medication used to treat a variety of cancers, including lymphomas and leukemias. It is important to understand the safety guidelines when preparing and administering vincristine.
The following are the safety guidelines for vincristine preparation and administration: Always dilute vincristine in normal saline (NS). Never use dextrose or any other type of solution. Vincristine should be prepared by trained personnel. It should not be reconstituted by the person who will administer it, but rather by another trained person.
Vincristine should be administered intravenously (IV) over 30 minutes using an infusion pump. Never give an IV push, because doing so can lead to severe neurotoxicity and other adverse effects. Prior to administration, check for blood return from the catheter.
Vincristine must be administered through a catheter placed in a central vein. Other types of veins, including peripheral veins, should not be used. After administration, flush the catheter with normal saline to ensure that all the medication is delivered to the patient. These guidelines will help to ensure the safe administration of vincristine and prevent potential complications.
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A 55-year old male has been is admitted to the hospital and the following AGB was obtained pH of 7.25 (oormal 7.35-7.45) CO2 of 30 mmHg (normal 35-45 mmHg) HCO3 of 18 mEq/L normal 22-26 mEq/L W 1) What is the acid/base disorder, explain your answer. Include whether compensation has occurred and if compensation has occurred it is partial or full, explain your answer i 2) Which systems can potentially compensate for this patients acid/base disorder. How would each of the systems you identified compensate for this patients acid base disorder
1. The acid/base disorder in this case is metabolic acidosis with partial respiratory compensation.
2. The respiratory system and the renal system can potentially compensate for this patient's acid/base disorder. The respiratory system compensates by increasing ventilation to decrease CO2 levels, while the renal system compensates by adjusting the excretion and reabsorption of bicarbonate ions.
Regarding compensation, partial respiratory compensation has occurred. This is evident by the decrease in the partial pressure of carbon dioxide (CO2) to 30 mmHg, which is below the normal range (35-45 mmHg). The respiratory system compensates for metabolic acidosis by increasing ventilation to eliminate more CO2 and decrease its concentration in the blood. However, the decrease in CO2 is not fully within the normal range, indicating partial compensation.
The renal system compensates by regulating the excretion and reabsorption of bicarbonate ions (HCO3-). In metabolic acidosis, the kidneys increase the reabsorption of bicarbonate and excrete more hydrogen ions (H+). This helps to restore the bicarbonate levels and regulate the pH balance in the body.
It's important to note that in this case, the compensation is partial because the CO2 level is still below the normal range. Full compensation would occur if both the pH and CO2 levels were within the normal range.
In conclusion, the patient, in this case, has metabolic acidosis, indicated by a low pH and bicarbonate level. The partial compensation observed suggests that the respiratory system has responded by decreasing the partial pressure of carbon dioxide to partially correct the acidosis.
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OB type questions:
1. What maternal complications can arise in clients in HELLP?
2. What labs are abnormal in HELLP?
3. Management for client with risk factor for diabetes?
4. What is polyhydramnios?
5. What is the priority nursing assessment before giving Magnesium Sulfate?
1. What maternal complications can arise in clients with HELLP Maternal complications that can arise in clients with HELLP include: 1. Hemorrhage, 2. Placental abruption, 3. Disseminated intravascular coagulation (DIC), 4. Acute renal failure, 5. Pulmonary edema, 6. Rupture of the liver, 7. Stroke.
HELLP syndrome is a severe and potentially life-threatening pregnancy complication that affects the blood and liver. Women with HELLP syndrome often have high blood pressure and problems with the way their blood clots.2. What labs are abnormal in HELLP Laboratory abnormalities in HELLP syndrome include: 1. Elevated liver enzymes (AST and ALT),
2. Thrombocytopenia (platelet count <100,000/microliter), 3. Hemolysis (elevated bilirubin and LDH levels). These laboratory findings are often accompanied by symptoms such as upper right quadrant pain, headache, visual disturbances, and hypertension.
3. Management for clients with risk factor for diabetes Management for clients with a risk factor for diabetes involves: 1. Education and counseling regarding lifestyle modifications such as exercise and diet, 2. Monitoring of blood glucose levels, 3. Screening for diabetes during pregnancy,
4. Medications such as insulin or oral hypoglycemics as indicated. It is important for healthcare providers to identify and manage diabetes risk factors early in pregnancy to prevent adverse maternal and fetal outcomes.4.
What is polyhydramnios Polyhydramnios is a condition in which there is an excessive amount of amniotic fluid in the uterus. This can occur due to a variety of reasons, including fetal anomalies, maternal diabetes, or twin-to-twin transfusion syndrome. Signs and symptoms of polyhydramnios may include a larger-than-normal uterus, shortness of breath, and swelling in the legs. Treatment for polyhydramnios may include amnioreduction (removal of excess fluid), close fetal monitoring, and delivery of the baby if complications arise.
5. What is the priority nursing assessment before giving Magnesium Sulfate The priority nursing assessment before giving Magnesium Sulfate is to check the patient's deep tendon reflexes (DTRs) to assess for hyperreflexia. Magnesium Sulfate is a medication that is often used to prevent seizures in women with preeclampsia or eclampsia. However, it can also cause respiratory depression and cardiac arrest in high doses. Checking the patient's DTRs can help the nurse assess the patient's neuromuscular status and determine if it is safe to administer the medication. If the patient has hyperreflexia (exaggerated reflexes), this may be an indication that the medication should be held or the dose adjusted.
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Does a person in need of an organ transplant have a moral right
to obtain that transplant, supposing the availability of the needed
organ and how should we choose who gets a transplant?
The ethical debate on whether a person in need of an organ transplant has a moral right to obtain it is ongoing, and determining who gets a transplant involves complex considerations.
Yes, there is an ongoing ethical debate regarding whether a person in need of an organ transplant has a moral right to obtain that transplant, assuming the availability of the required organ. The issue revolves around the allocation and distribution of a limited resource, where demand often exceeds supply. Determining who gets a transplant involves complex considerations, such as medical urgency, potential for success, and fairness in the allocation process.
In organ transplantation, the scarcity of organs necessitates the establishment of fair and transparent criteria for prioritization. Factors commonly considered include the severity of the recipient's condition, the potential for successful transplantation, the expected post-transplant prognosis, and the time spent on the waiting list. Medical urgency is typically a significant factor, as those with life-threatening conditions or rapidly deteriorating health may be given higher priority. Additionally, some allocation systems aim to balance considerations of need, potential benefit, and equitable distribution, ensuring that individuals with the greatest need and best chances of a successful transplant are prioritized while minimizing bias or discrimination in the process.
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A 4-year old boy is brought in with pain and swelling of the right thigh after a fall in the home. An x-ray film reveals an acute fracture of the right femur. Questioning of the mother reveals that the boy has had two other known fractures-left humerus and left tibia- both with minimal trauma. The family history is notable for a bone problem during childhood in the boy’s father that got better as he grew into adulthood. A diagnosis of osteogenesis imperfecta is entertained.
1. What are the four types of osteogenesis imperfecta? How are they genetically transmitted?
2. Which two types are most likely in this patient? How might they be distinguished clinically?
3. Further workup result in a diagnosis of type I osteogenesis imperfecta. What clinical features may the boy expect in adult life?
4. What is the pathogenesis of this patient’s disease?
Osteogenesis imperfecta (OI) is a disorder of connective tissue that affects bones. The pathogenesis of OI is related to defects in the genes that produce type I collagen. As a result, there are four types of osteogenesis imperfecta.
The genetics transmission is as follows: Autosomal dominant inheritance type: Types I, II, III, and IV Autosomal recessive inheritance type: Types V, VI, VII, and VIII Dominant negative mutations type: Types IX and X Autosomal dominant inheritance type: The following are the four types of OI with their mode of genetic transmission:i. Type I: Autosomal dominant inheritance. Type II: Autosomal dominant inheritance. Type III: Autosomal dominant inheritance Iv. Type IV: Autosomal dominant inheritance Autosomal recessive inheritance type: i. Type V: Autosomal recessive inheritanceii. Type VI: Autosomal recessive inheritance. Type VII: Autosomal recessive inheritance.
Type VIII: Autosomal recessive inheritance Dominant negative mutations type :i. Type IX: Dominant negative mutations. Type X: Dominant negative mutations The two types most likely in this patient are type I and type IV. This can be distinguished clinically as the type I variant shows blue sclera, recurrent fractures, and mild limb deformities, while the type IV variant shows mild fractures, mild-to-moderate bone deformities, and normal sclera.
In adult life, the boy may expect to show clinical features such as a propensity for bone fractures that may be less frequent and will experience improvement of fractures over time. He may also expect blue sclera, hearing loss, and mild bone deformities.The pathogenesis of this patient’s disease relates to defects in the genes that produce type I collagen. These collagen fibers are a major component of the extracellular matrix of bones, tendons, skin, and various organs. When these fibers are defective, they cause structural and functional defects in tissues, resulting in skeletal deformities and fractures.
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develop a teaching plan of incentive spirometry to health care
students.
Developing a teaching plan for incentive spirometry to healthcare students involves explaining the purpose and technique of using incentive spirometry, demonstrating proper usage, and providing opportunities for hands-on practice and feedback.
Incentive spirometry is a technique used to improve lung function and prevent respiratory complications. The teaching plan should start with an overview of the importance of incentive spirometry in promoting lung health and preventing atelectasis. It should include a detailed explanation of the technique, including how to position the device, take deep breaths, and maintain proper breathing patterns. Demonstrations should be provided, highlighting correct technique and addressing common mistakes. Students should have the opportunity to practice using the device themselves, with feedback and guidance from the instructor. Additionally, the teaching plan should cover indications, contraindications, and potential complications associated with incentive spirometry. It should emphasize the importance of patient education and monitoring to ensure effective use. Overall, the teaching plan should provide a comprehensive understanding of incentive spirometry and equip healthcare students with the knowledge and skills necessary to educate and support patients in its proper use.
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Pulmonary function studies have been ordered for a client with emphysema. The nurse would anticipate that the test would demonstrate which of the following results? Select one alternative:
A. Increased residual volume, decreased forced expiratory volume, increased total lung capacity, decreased vital capacity
B. Decreased residual volume, decreased forced expiratory volume, decreased total lung capacity, increased vital capacity
C. Decreased residual volume, increased forced expiratory volume, increased total lung capacity, increased vital capacity
D. Increased residual volume, increased forced expiratory volume, decreased total lung capacity, decreased vital capacity
Increased residual volume, decreased forced expiratory volume, increased total lung capacity, decreased vital capacity. Here option A is the correct answer.
Emphysema is a type of chronic obstructive pulmonary disease (COPD) characterized by damage to the air sacs (alveoli) in the lungs. This damage leads to loss of elasticity and destruction of the lung tissue, resulting in decreased airflow and difficulty in exhaling.
Pulmonary function studies, such as spirometry, are commonly ordered for clients with emphysema to assess their lung function. These tests provide valuable information about various lung volumes and capacities.
In emphysema, the following results would be anticipated in the pulmonary function studies:
Increased residual volume (RV): Emphysema causes air trapping in the lungs, leading to an inability to fully exhale. This results in an increased residual volume, which is the volume of air remaining in the lungs after maximum exhalation.
Decreased forced expiratory volume (FEV): Emphysema affects the ability to forcefully exhale air, leading to a decreased FEV. FEV measures the volume of air forcefully exhaled in one second during a forced vital capacity (FVC) maneuver.
Increased total lung capacity (TLC): Emphysema can cause hyperinflation of the lungs due to air trapping. This results in an increased TLC, which is the total volume of air in the lungs at maximal inspiration.
Decreased vital capacity (VC): Vital capacity is the maximum volume of air that can be exhaled after a maximum inhalation. In emphysema, the damaged lung tissue and decreased elasticity reduce the ability to fully inhale and exhale, leading to a decreased vital capacity.
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Order: theophylline 300 mg PO q6h. The strength available is 150 mg/
15 mL. How many milliliters of this bronchodilator will you administer
to the child? please use full dimensional analysis with units thank you
Answer:
30 ml q6h
Explanation:
The amount of theophylline needed: 300 / (150/15) = 30 ml
Which of the following substances are components of the blood plasma? O Platelets O All of these substances are components of blood plasma None of these substances are components of blood plasma O Leukocytes O Erythrocytes
Platelets, leukocytes, erythrocytes all of these substances are components of blood plasma.
Blood plasma is the yellowish fluid component of blood that makes up about 55% of its total volume. It is composed of various substances, including platelets, leukocytes (white blood cells), and erythrocytes (red blood cells).
Platelets are small, disk-shaped cell fragments that play a crucial role in blood clotting. They are responsible for forming a clot to prevent excessive bleeding when a blood vessel is damaged. Platelets are abundant in blood plasma and are essential for the body's hemostatic mechanisms.
Leukocytes, or white blood cells, are an integral part of the immune system. They help defend the body against infectious agents, such as bacteria, viruses, and fungi. Leukocytes are present in blood plasma, and their main function is to recognize and destroy foreign substances or pathogens, contributing to the body's defense against infection.
Erythrocytes, or red blood cells, are the most abundant cells in blood plasma. Their primary function is to transport oxygen from the lungs to the body's tissues and carry carbon dioxide, a waste product, from the tissues back to the lungs for elimination. Erythrocytes contain hemoglobin, a protein that binds to oxygen and gives blood its red color.
In summary, all three substances platelets, leukocytes, and erythrocytes are components of blood plasma. They each have unique roles in maintaining the body's overall health and functioning.
Blood plasma is a complex mixture of water, proteins, electrolytes, hormones, waste products, and various other components. It serves as a vital medium for transporting nutrients, hormones, and waste materials throughout the body. Understanding the composition and functions of blood plasma is essential for comprehending the physiological processes occurring in the circulatory system.
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How should the nurse plan to move a client who is obese and immobile? ► A. Trapeze board B. Mechanical lift C. Transfer board D. Gait Belt Drug Calculation
Answer: The answer is option B. Mechanical lift.
A mechanical lift is a specialized medical equipment that is utilized to transfer or move immobile or incapacitated clients, generally those with restricted mobility due to obesity, injuries, or neurological illnesses.
The equipment assists nurses and caregivers in transferring clients in a safer, easier, and more dignified manner. A mechanical lift is often used when the client cannot be lifted or moved safely with the help of a gait belt, transfer board, or other manual lifting devices that are too dangerous and stressful for both the client and the healthcare provider.
The answer is option B. Mechanical lift.
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Another type of adaptive immune cell can recognize viral infected cells and
attack them directly with perforins and granzymes. It recognized the infected cell
due to the presence of viral proteins on the cell surface of the infected mucosa
cells bound to a ___.
Another type of adaptive immune cell can recognize viral infected cells and attack them directly with perforins and granzymes. It recognized the infected cell due to the presence of viral proteins on the cell surface of the infected mucosa cells bound to a MHC class I molecule.
Adaptive immune cells are the components of the immune system that learn to respond to specific antigens over time. Unlike the innate immune response, which is instant and generic, the adaptive immune system takes time to adapt to a new challenge. When the immune system recognizes a foreign substance, specialized cells are activated that target that specific substance. These cells include B cells and T cells, as well as macrophages, dendritic cells, and other cells that help to identify and target pathogens.
A key feature of the adaptive immune system is the ability to form memory cells that can recognize a particular antigen years after it was last encountered. This allows for rapid and efficient responses to repeat infections by the same pathogen. There are two primary types of adaptive immune cells: B cells and T cells. Each type of cell plays a specific role in recognizing and targeting specific pathogens and foreign substances.
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Your protocols states you must administer 0.2mg/kg of atropine. The vial comes
supplied as 8mg in 5 milliliters. Your patient weighs approximately 55 pounds.
How much will you withdraw into your syringe?
3.11842 ml of atropine needs to be withdrawn into the syringe.
We need to calculate the amount of atropine that needs to be withdrawn into the syringe. Here are the steps to calculate the answer.
Step 1: Convert the weight of the patient from pounds to kilograms.
1 pound = 0.453592 kilograms
Therefore, the weight of the patient is 55 × 0.453592 = 24.94736 kg (approx)
Step 2: Calculate the amount of atropine that needs to be administered.
Atropine dose = 0.2mg/kg × 24.94736 kg
Atropine dose = 4.989472 mg (approx)
Step 3: Calculate the volume of the vial that corresponds to the calculated dose.
The vial comes with 8mg in 5 milliliters.
Therefore,1 mg of atropine = 5 / 8 milliliters
4.989472 mg of atropine = (5 / 8) × 4.989472 = 3.11842 ml (approx)
Therefore, 3.11842 ml of atropine needs to be withdrawn into the syringe.
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Cite reference page(s) from the Timby textbook.
Susan Watts, a 30-year-old female client, was diagnosed with schizophrenia and was treated with paliperidone (Invega) 9 mg PO every day and benztropine (Cogentin) 1 mg PO2× a day. The client arrives at the clinic and is exhibiting the following symptoms. She is repeating what is said to her (echolalia) and is telling you that the sirens are loud and the paramedics are working hard to save the man. She yells over at the paramedics, she sees and tells them they are doing a great job. She has a flat affect and is bouncing her knees up and down as she sits staring at the wall where she is seeing and hearing the hallucination. Her husband is with her and stated he is worried about his wife because she has not bathed, washed, or combed her hair for 2 days now. She has not gone to work for the past week. He stated that she keeps failing to take her medications even with reminding. The client’s husband asks the LPN/LVN if there is any way the drug therapy could be managed differently so his wife will be more compliant.
(Learning Objective14)
a. What can be done to help improve the client’s compliance with the medications?
b. Explain the administration considerations for the prescribed medications. (Use a drug handbook or use
a. The medication regimen can be changed to include long-acting injectable medication instead of oral medication to improve the client’s compliance with the medications. It can be given every two weeks rather than every day, ensuring the client takes the medication, and there is no need for daily medication administration.
b. Explain the administration considerations for the prescribed medications. (Use a drug handbook or use a reference page(s) from the Timby textbook.)Invega (paliperidone) is used to treat schizophrenia and schizoaffective disorder. It is an antipsychotic medication that functions by balancing the levels of dopamine and serotonin in the brain. Paliperidone is available in extended-release tablets in dosages ranging from 1.5 mg to 12 mg. The suggested starting dose is 6 mg per day. It should be taken once a day, with or without food. It must be swallowed whole and should not be chewed, divided, or crushed.
Cogentin (benztropine) is an anticholinergic medication that is used to alleviate Parkinsonism and extrapyramidal disorders caused by antipsychotic medications such as Invega. It helps to minimize involuntary movements, tremors, and rigidity. Benztropine is available in 0.5-mg and 1-mg tablets and is taken orally. The usual dosage range is 2 mg to 6 mg per day, divided into two or three doses. It should be taken at the same time every day, with or without meals.
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Source: Lilley, L. L., Collins, S. R., & Snyder, J. S. (2019). Pharmacology and the nursing process (9th ed.). Mosby.
Subject: NR 293 Pharmacology for Nursing Practice
Welcome to Week 3 of the Community Cafe!
This week's content covers the concept of gas exchange. You will learn about respiratory drugs, their mechanism of action and side effects, and nursing considerations. Make sure to review the Learning Outcomes and Objectives in this week's Canvas module. In addition, just a reminder that you can begin posting to each week’s Community Café on Sunday before the week begins.
Chapter 36 in your textbook covers the following drugs: antihistamines, decongestants, antitussives, and expectorants. These medications are taken mainly for prevention or to alleviate symptoms of respiratory illness, particularly allergies and the common cold. Other types of respiratory drugs are covered in Chapter 37 and include a variety of drugs to treat asthma and chronic obstructive pulmonary disease (COPD).
Bronchodilators are an important class of drugs used in the treatment of respiratory illnesses. The beta-agonists relax and dilate airways by stimulating the beta2 adrenergic receptors of the autonomic nervous system located in the lungs (Lilley et al., 2019). To help you better understand the mechanism of action and side effects of bronchodilators, take a moment to review Part 3: Chapters 18 - 21 in your textbook.
Question:
Write short summary and reflection on what you have learned about the gas exchange, and bronchodilators, including information on nursing interventions and patient education and 1 or 2 questions related to concepts that are still unclear.
In Week 3, the attention was on gas exchange and respiratory medications. Medical attendants find out about drug activities, intercessions, and patient schooling for ideal respiratory consideration.
Summary of the gas exchange, and bronchodilators, including information on nursing interventions and patient educationGas exchange, and bronchodilators, including information on nursing interventions and patient education, is a pivotal cycle in the respiratory framework, and understanding it is fundamental for medical caretakers. This week's focus on respiratory medications, specifically bronchodilators, sheds light on the mechanisms of action and potential side effects of these drugs.
Attendants ought to think about quiet instruction on appropriate inhaler strategies, expected unfriendly responses, and the significance of adherence to recommended medication. Assessing drug interactions, encouraging patient compliance, and monitoring respiratory status are examples of nursing interventions.
One hazy idea is the separation between different bronchodilators and their particular signs. How can nurses evaluate bronchodilator therapy's efficacy effectively? The significance of non-pharmacological interventions in the management of respiratory conditions is yet another concern.
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what is the highest cumulative dose of doxorubicin
The highest cumulative dose of doxorubicin is 550-700 mg/m² for adults.
What is Doxorubicin?
Doxorubicin is a chemotherapy medication that is used to treat a variety of cancers, including bladder cancer, breast cancer, lung cancer, and others. Doxorubicin is an anthracycline antibiotic, which means it interferes with the development of cancer cells by damaging their DNA and preventing their replication. It also blocks an enzyme called topoisomerase II, which is involved in DNA replication and repair.
What is the cumulative dose of doxorubicin?
The cumulative dose of doxorubicin refers to the total amount of the drug that a patient has received over the course of their treatment. This is important because doxorubicin can cause serious side effects, particularly to the heart, and these risks increase with higher cumulative doses. In general, the highest cumulative dose of doxorubicin for adults is 550-700 mg/m². However, this can vary depending on the type of cancer being treated, the patient's age and overall health, and other factors. Patients receiving doxorubicin should be carefully monitored for signs of heart damage, such as shortness of breath, chest pain, or an irregular heartbeat.
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Given the biomedical model of healthcare and considering the rapidly-paced healthcare environment that limit providers by time constraints, providers may be provider- or disease-centric in an effort to quickly diagnose at the expense of recognizing the patient may have needs or goals that are not disease/provider focused. As such:
Providers may prioritize efficiency and diagnosis over recognizing the patient's needs and goals in the biomedical model of healthcare.
Given the biomedical model of medical care and the time limitations in the quickly paced medical services climate, suppliers might focus on effectiveness and determination over perceiving the patient's more extensive necessities and objectives. This methodology, known as supplier or infection driven care, centers basically around recognizing and treating the illness, frequently disregarding the patient's singular requirements, inclinations, and objectives. It might prompt an absence of patient-centeredness and an inability to address the comprehensive prosperity of the patient. Perceiving and tending to the patient's requirements past the illness driven point of view is significant for giving far reaching and patient-focused care that thinks about the patient overall individual with special qualities and conditions.
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This disorder is caused by hyper secretion of growth hormone
after epiphyseal plate closure
A. Achondroplastic dwarfism
B. Gigantism
C. Pituitary dwarfism
D. Osteomalacia
E. Acromegaly
The disorder caused by hypersecretion of growth hormone after epiphyseal plate closure is Acromegaly.
What is Acromegaly?
Acromegaly is a hormonal disorder characterized by the body's production of too much growth hormone, even after the growth plates have closed. When the growth plates in your bones have closed, the bones stop growing, and no further increase in height is possible. The disorder causes excess growth in the hands, feet, and face, leading to a variety of physical and medical issues.
Acromegaly can be caused by benign tumors in the pituitary gland, which produces growth hormone, as well as other tumors or growths in the body that secrete growth hormone. Symptoms of acromegaly include enlarged hands and feet, thickening of the skin and tissues, joint pain, sleep apnea, and other issues.
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Which of the following statements is TRUE regarding sensory receptor potentials? a. They follow all-or-none law b. They are graded in size, depending on stimulus intensity c. They always bring the membrane potential of a receptor cell away from threshold d. They are action potentials e. They always bring the membrane potential of a receptor cell toward threshold
The following statement is true regarding sensory receptor potentials they are graded in size, depending on stimulus intensity (Option B).
A sensory receptor potential is a type of graded potential that is generated by a sensory receptor cell in reaction to an environmental stimulus. The degree of membrane depolarization, or the degree to which the membrane potential of the receptor cell is raised, is proportional to the strength of the stimulus. The sensory receptor potential is created by the influx of ions into the receptor cell in response to a stimulus.
There are three main types of potentials: resting potentials, graded potentials, and action potentials. Resting potentials are created by ion pumps that transport ions across the cell membrane. Graded potentials are short-lived changes in the membrane potential of a cell. They are created by the interaction of stimuli that trigger the opening or closing of ion channels in the cell membrane. Because they are graded, their amplitude is directly proportional to the magnitude of the stimulus that elicited them. In contrast, action potentials are the long-lasting changes in membrane potential that occur when a neuron is depolarized to the threshold and triggers an all-or-nothing response.
Thus, the correct option is B.
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The physician has prescribed beclomethasone (Beclovent) and albuterol (Proventil) for 24 Minutes, 34 Seconds a 35 -year-old female client with asthma. In reviewing the use of metered-dose inhalers (MDis) with the client, the nurse should provide which of the following instructions? "To administer an MDI, you must use a spacer that holds the medicine so that you can inhale it. Put the end of the spacer in your mouth and inhale after you depress the inhaler. Your can use either medication fert: "Use the albuterol frst, waiting at least 1 to 2 minites between puffs, and follow with the beclomethasone. Rinse your mouth with water after using the bedomethasone" "Use the beclomethasone first, holdine the movehple is i fo 2 inches fram your mouth, and inhte deeply after you release the medicine. Wait for 10 seconds between puffs. Repeat tiger procedare with the albuterol inhaler." "The inhaters should not be used within 1 hour of each ofher, sD whed ule the tianes of use carcfully. Hold the inthaler in your mouth and breathe in #owly hoddne the medicine-as fore as: passible.
The nurse should instruct the 35-year-old female client with asthma to "Use the albuterol first, waiting at least 1 to 2 minutes between puffs, and follow with the beclomethasone.
Rinse your mouth with water after using the beclomethasone."When reviewing the use of metered-dose inhalers (MDis) with the client, the nurse should provide the instruction to "Use the albuterol first, waiting at least 1 to 2 minutes between puffs, and follow with the beclomethasone.
Rinse your mouth with water after using the beclomethasone."It is essential to use a spacer that holds the medicine to inhale it correctly. The end of the spacer should be placed in the client's mouth and inhaled after depressing the inhaler.The nurse should also advise the client to rinse her mouth with water after using the beclomethasone. This is because the medication can cause fungal infections in the mouth.
The inhalers should not be used within 1 hour of each other, so the nurse should advise the client to schedule the times of use carefully.
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Identify the subjective statement:
The patient's vehicle was noted to have 2' of frontal intrusion damage
The patient's vehicle was noted to be in contact with the other vehicle's rear end.
The patient's vehicle rear-ended the other vehicle with approximately 2' of frontal intrusion damage created
The patient's vehicle has 2' of crumpling on the front end and is resting against the rear end of the other vehicle
Question 3 of 10
Identify the subjective statement:
The patient displayed a circular burn on the inside of his thigh, approximately 1/2 the diameter of a dime
Upon examination the patient has a round wound that appears to be a burn approximately the width of a pen
The patient displayed a small circular burn of about 1/3" on the inside of his thigh
The patient has a cigarette burn to the inside of the thigh
The subjective statement in the given options is: "The patient has a cigarette burn to the inside of the thigh."
A subjective statement is one that includes personal opinions, interpretations, or value judgments rather than objective facts. In this case, all the other statements provide objective descriptions of the patient's condition or the vehicles involved in an incident.
However, the statement "The patient has a cigarette burn to the inside of the thigh" is subjective because it involves an interpretation of the nature of the injury. Whether the burn is actually caused by a cigarette or not is a subjective conclusion that requires further investigation or confirmation.
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Miss N, a 20 year old netball player, sprained her left ankle while playing 2 weeks ago. Her ankle is no longer swollen and she has regained full range of motion. However, she is complaining of weakness of her left ankle.
1. What would be the most appropriate ankle exercise for this patient?
2. Discuss whether contra-indications apply.
3. Describe 5 goals of the chosen exercise in
1. The most appropriate ankle exercise for a patient who has sprained her left ankle is heel drops, also known as calf raises. This exercise focuses on strengthening the muscles in the lower leg, which can help improve ankle stability.
2. The patient should avoid exercises that cause pain or discomfort, as well as any high-impact activities that could cause the ankle to twist or turn.
3. The five goals of the heel drop exercise are: to strengthen the calf muscles, to improve ankle stability, to improve balance and coordination, to prevent future ankle sprains, and to reduce the risk of developing chronic ankle instability.
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1. You are working when an amber alert is issued within the facility. You have read the procedures for your facility and know to:
Notify your clinical site supervisor and go to the nearest exit or assigned location.
Detain anyone who looks suspicious.
Report the location of suspicious persons to security.
Get a good description of suspicious person and note the direction of travel.
2. Hospitals and healthcare organizations use a mixture of color codes, code numbers and language in their programs. However, this word is commonly used to designate that an emergency is over. _________
3. Which responses would you use for a computer or electronic medical record outage? (select all that apply)
Verify computers, printers, and WOWs are plugged into red outlets.
Use red emergency phones.
Verify critical patient care equipment is functioning properly.
Reset equipment, if needed, by turning on and off.
Refer to downtime computer and printer on unit.
Locate downtime forms and use if directed.
4. You are working on an orthopedic floor and, when making rounds, you are confronted by a patient threatening others with a knife. He is attempting to cut through this traction device. Select the best response below:
Call the appropriate code and keep patients and visitors away from the area.
Sit down and calmly discuss the situation with the patient.
Get the help from another nurse and attempt to take away the knife.
Leave the room and pull the nearest fire alarm.
Call the hospital operator and ask to speak with security.
5. In the event of a fire, once your safety is assured, the first priority is:
Activate the alarm
Call the fire department
Locate the ABC fire extinguisher on the unit
Rescue any individual threatened by fire
Remain calm
6. When there is an influx of patients from a mass casualty event, a code triage _________ is called
7. There are two major categories of emergencies in healthcare facilities. An internal emergency could include which of the following: (select all that apply)
Fire
Hazardous spill
Flood
Security threat
Tornado
Phone outage
8.Select each of the steps used to demonstrate the PASS technique when discharging a fire extinguisher. (select all that apply)
Sweep spray from side to side
Pull the fire extinguisher off the wall.
Assume a position 5 to 10 feet from the fire.
Pull the pin.
Squeeze the handle.
Aim at the base of the fire.
Stand 5 to 10 feet from the fire.
Activate the ABC extinguisher.
9. A rapid response or emergency medical team is called when a patient's condition is rapidly declining.
True
False
10. Match the code name (left column) to the emergency situation (right column).
Code: Orange < ~~~~~~~> Threatening Individual
Code: Blue < ~~~~~~~~ > Missing Infant or Child
Code: Silver / Code 5 < ~~~~~~~~ > Weapon or Hostage Situation
Code: Gray <~~~~~~~~ > Respiration or Heart Stopped
Code: Amber Alert < ~~~~~~~~~~> Hazardous Spill
1. Where there is a Amber Alert, notify your clinical site supervisor and go to the nearest exit or assigned location.
2. Code - "All Clear"
3. - Verify critical patient care equipment is functioning properly.
- Reset equipment, if needed, by turning on and off.
- Refer to downtime computer and printer on unit.
- Locate downtime forms and use if directed.
4. Call the appropriate code and keep patients and visitors away from the area.
5. Rescue any individual threatened by fire.
6. Code triage "Mass Casualty" is called.
7. - Fire
- Hazardous spill
- Security threat
8. - Pull the pin.
- Aim at the base of the fire.
- Squeeze the handle.
- Sweep spray from side to side.
9. True
10. - Code - Orange - Threatening Individual
- Code - Blue - Missing Infant or Child
- Code - Silver / Code 5 - Weapon or Hostage Situation
- Code - Gray - Respiration or Heart Stopped
- Code - Amber Alert - Hazardous Spill
What is the explanation for the above?1. Amber Alert Response - Notify supervisor, exit facility, report suspicious persons, and gather descriptions. Detain anyone suspicious.
2. "All Clear" designates the end of an emergency in hospitals and healthcare organizations using color codes, code numbers, and language.
3. Computer outage response - Verify equipment, reset if needed, refer to downtime resources/forms, and ensure critical patient care equipment functions.
4. Threatening patient response - Call code, keep others safe, avoid confrontation, and seek help from security or operator.
5. Fire response priority - Ensure personal safety, rescue threatened individuals, activate alarm, call fire department, remain calm.
6. Mass casualty event - Code triage "Mass Casualty" is called to manage the influx of patients.
7. Internal emergency categories - Fire, hazardous spill, security threat. Tornado, flood, phone outage are external emergencies.
8. PASS technique steps - Pull pin, aim at fire base, squeeze handle, sweep spray side to side.
9. True. Rapid response or emergency medical team is called for a rapidly declining patient condition.
10. Code - Orange - Threatening Individual, Blue - Missing Infant/Child, Silver/Code 5 - Weapon/Hostage, Gray - Respiration/Heart Stopped, Amber Alert - Hazardous Spill.
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In general, screening should be undertaken for diseases with the following feature(s): a) Disease where screening incurs increased health risks. b) Disease for which the impact on health is low. c) Disease for which early treatment can have beneficial effects. d) Diseases with low prevalence in identifiable subgroups of the population
In general, screening should be undertaken for diseases with the following features: d) Disease for which early treatment can have beneficial effects.
Why is disease screening important?Disease for which early treatment can have beneficial effects. This is the most important factor to consider when deciding whether or not to screen for a disease. Early treatment can often lead to better outcomes for patients. For example, early detection and treatment of cancer can improve survival rates.
Diseases where screening incurs increased health risks, diseases for which the impact on health is low, and diseases with low prevalence in identifiable subgroups of the population should not be screened unless the benefits of screening outweigh the risks.
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Requirement needs for installing the CAC system.
CAC system storage capacity.
How the system helps ensure data integrity.
How the use, storage, and revision of data is managed within the system.
Managing coding alerts and reminders in the system.
How CAC Systems Incorporated will ensure interoperability between the CAC system and the existing EHR system.
The systems development life cycle and the tasks that would be included in each phase of the life cycle for the implementation of the CAC system.
The computer-assisted coding system (CAC) is installed using a pre-defined set of requirements. Let's take a look at some of the key components:Requirements for installing the CAC system include:CPU Processor: 3 GHz Dual Core Processor or greater Memory: DVD-ROM drives capable of reading dual layer DVDs are recommended for installation.
A modern version of an operating system, such as Windows 7, Windows 8, or Windows 10, should be installed on the computer. The CAC system should be able to connect to the internet for downloading updates.The CAC system storage capacity:Computer-Assisted Coding (CAC) systems are used to recognize and automatically capture information from electronic medical records (EMRs). The CAC software uses algorithms to automatically scan the EMRs and recognize information, such as diagnoses, treatments, procedures, and other relevant information.
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What steps a medical team can take to help a patient who have a
signs of trauma?
When a patient shows signs of trauma, the medical team must take immediate action to stabilize the patient and treat any injuries.
Here are some steps the medical team can take to help a patient who has signs of trauma: Assess the situation: The medical team must first assess the situation and determine the extent of the trauma. They must evaluate the patient's physical, mental, and emotional condition and gather as much information about the incident as possible. This will help them make informed decisions on how to proceed with the patient's treatment and care.
Communicate with the patient and their family: Finally, the medical team must communicate clearly and effectively with the patient and their family members throughout the treatment and recovery process. They must explain the patient's condition, the treatment plan, and any potential complications or side effects of the treatment. They must also listen to the patient and their family's concerns and answer any questions they may have.
Overall, when a patient shows signs of trauma, the medical team must act quickly and efficiently to stabilize the patient, treat any injuries, and provide emotional and psychological support to aid in their recovery.
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Why do you believe that quality can be viewed as a strength and
a weakness of the U.S. health care system? Post atleast 300
words
Put 2 examples and explanation and reference
The quality of the U.S. health care system can be viewed as both a strength and a weakness.
The United States has one of the most advanced health care systems globally, but this quality comes with significant drawbacks. Despite offering a higher standard of care, the quality of the U.S. healthcare system can also create barriers to receiving care. For example, the high cost of health care makes it unaffordable for some individuals, leading to an inability to access care. Additionally, patients in rural areas may not have access to specialist care because specialists tend to be concentrated in urban areas. These factors limit the ability of people to access and receive high-quality care.
On the other hand, the quality of U.S. healthcare attracts many patients from other countries who require treatment for complex conditions. For example, people travel from all over the world to receive cancer treatment at world-renowned institutions such as Memorial Sloan Kettering Cancer Center in New York City. U.S. hospitals and clinics are also known for their medical research and innovative treatment options.
References:
1. Aaron, H. J., & Schwartz, W. B. (2011). The painful prescription for health care in the United States: “Sicko” by Michael Moore. Annals of Internal Medicine, 144(2), 91-92.
2. Mayes, R. (2011). Quality in health care: The US leads all countries, but performance varies widely. BMJ, 342, d1.
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