Critical access hospitals (CAHs) are paid by Medicare through a cost-based reimbursement system. Medicaid and other insurers also pay CAHs through various reimbursement methods, such as fee-for-service or managed care contracts.
Critical Access Hospitals (CAHs) are reimbursed on a cost-based reimbursement method by Medicare. Medicare reimburses CAHs based on the reasonable costs incurred in furnishing covered hospital and skilled nursing facility services to Medicare beneficiaries. These costs include direct costs, such as salaries and wages, and indirect costs, such as overhead costs and capital-related costs.
Medicaid also pays CAHs through various reimbursement methods, such as fee-for-service or managed care contracts. Other insurers may also use these or similar reimbursement methods, depending on the specific contract terms. Additionally, some states have programs that provide supplemental payments to CAHs to help cover their costs of providing care to uninsured and underinsured patients.
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Assume you want to examine the reponse of a number strains to a 2,3,5 triphenyltetrazolium (TTC) agar overlay. Place the available options in the correct order (start to finish) that would allow you to perform the test most effectively.
1. Place YPD agar medium with strains at 30°C
2. Assess any color formation in the TC overlay after an appropriate period of time
3. Wait to for TTC to set
4. Inoculate strains on the surface of YPD agar medium in small patches
5. Overlay molten TC agarose
6. Incubate the strains for 48-72 hours.
Triphenyltetrazolium chloride (TTC) is a redox indicator and has been employed as an electron acceptor in a wide range of microbiological assays.
If you want to examine the reponse of a number strains to a 2,3,5 triphenyltetrazolium (TTC) agar overlay, then the most effective steps to perform the test are given below:
Step 1: Inoculate strains on the surface of YPD agar medium in small patches.
Step 2: Overlay molten TC agarose.
Step 3: Wait for TTC to set.
Step 4: Place YPD agar medium with strains at 30°C.
Step 5: Incubate the strains for 48-72 hours.
Step 6: Assess any color formation in the TC overlay after an appropriate period of time.
Thus, the correct order that would allow you to perform the test most effectively is:Inoculate strains on the surface of YPD agar medium in small patches Overlay molten TC agarose Wait for TTC to setPlace YPD agar medium with strains at 30°CIncubate the strains for 48-72 hours Assess any color formation in the TC overlay after an appropriate period of time.
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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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A client with multiple medical issues has the following ABG results: pH: 7.50 PCO2:41 HCO3: 32 PO2: 96 What is your interpretation of this result?
The interpretation of this result is that the patient is having respiratory alkalosis with metabolic alkalosis.
The medical client's ABG results are pH: 7.50 PCO2:41 HCO3: 32 PO2: 96. The interpretation of this result is that the patient is having respiratory alkalosis with metabolic alkalosis.
What is Respiratory alkalosis? Respiratory alkalosis is a medical disorder in which increased respiration (hyperventilation) results in decreased levels of carbon dioxide (CO2) in the blood and an increase in blood p H.
This results in the alkalinization of arterial blood. In this case, the respiratory system is trying to expel more carbon dioxide than the body is producing, resulting in a lower concentration of carbon dioxide in the blood.
What is Metabolic alkalosis?Metabolic alkalosis is a medical condition characterized by the rise of blood pH caused by the overproduction of bicarbonate. As a result of the overproduction of bicarbonate, the body develops a decrease in hydrogen ion concentration.
This can result in an increase in blood pH, which is termed alkalosis. In this case, the HCO3 level is higher than the normal range, which means that the patient is suffering from metabolic alkalosis.
The pH value is also higher than normal range, which confirms the presence of alkalosis. Hence, the interpretation of this result is that the patient is having respiratory alkalosis with metabolic alkalosis.
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To increase the absorptive surface of the small intestine its mucosa has these Multiple Choice a. Rugae b. Lacteals c. Tenia coli d. Villi
The absorptive surface of the small intestine mucosa can be increased by the presence of villi. Villi are finger-like projections that increase the surface area of the small intestine for efficient absorption of nutrients. Therefore, the correct answer is option D, Villi.
What is the small intestine?The small intestine is a long, thin tube that is located in the abdominal cavity. The small intestine is responsible for most of the chemical digestion and absorption of nutrients from the food we consume. The small intestine consists of three parts, the duodenum, the jejunum, and the ileum.
The innermost layer of the small intestine's wall is the mucosa. The mucosa lines the lumen, which is the hollow central cavity of the small intestine. The mucosa is made up of tiny finger-like projections called villi that help to increase the surface area of the small intestine, which aids in the absorption of nutrients.
So, the correct answer is D
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1.
explain when convenctional radiography is preferred over DXA scan.
Give examples.
Conventional radiography is preferred over DXA scan when assessing fractures, lung conditions, and dental structures due to its ability to provide detailed information in these areas.
1. Fracture assessment: Conventional radiography is the preferred method for evaluating fractures as it offers detailed imaging of bones, allowing for accurate assessment of fracture location, alignment, and severity.
Example: A patient presenting with a suspected wrist fracture would undergo conventional radiography to obtain X-ray images of the wrist and assess the presence and characteristics of the fracture.
2. Lung conditions: Conventional radiography is commonly used for diagnosing and monitoring lung conditions, providing information on lung structure, abnormalities, and pathologies such as infiltrates, masses, or fluid accumulation.
Example: A patient with symptoms of pneumonia would undergo a chest X-ray to evaluate the presence of lung infiltrates, consolidations, or other abnormalities indicative of an infection.
3. Dental structures: Conventional radiography plays a vital role in dental examinations, allowing for detailed imaging of teeth, roots, and surrounding structures, enabling the detection of dental caries, periodontal disease, and impacted teeth.
Example: A patient with tooth pain would undergo dental X-rays to evaluate the presence of cavities, root abnormalities, or other dental issues that could be causing the pain.
In summary, conventional radiography is preferred over DXA scan for assessing fractures, lung conditions, and dental structures due to its ability to provide detailed imaging and specific diagnostic information in these areas.
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Pitocin (oxycotin) at 40 ml/hr. Supplied: One liter bag of normal saline containing 30 units of Pitocin. Directions: Determine how many units of Pitocin the patient is receiving per hour.
Let's take a look at the question:Supplied: One-liter bag of normal saline containing 30 units of Pitocin. Pitocin (oxytocin) at 40 ml/hr.Directions: Determine how many units of Pitocin the patient is receiving per hour.
Pitocin is a medication used to induce labor or improve contractions during childbirth. Pitocin (oxytocin) is a natural hormone produced by the pituitary gland. It induces the uterus to contract, helping labor progress and delivery. It comes as a solution in a 100 mL glass bottle, which contains 10 units of oxytocin per mL.
First, convert the supplied Pitocin to ml; a liter is 1000 ml, and the bag contains 30 units of Pitocin.1000 ml / 30 units = 33.33 ml/u.
Now that we have the concentration of Pitocin per milliliter (33.33 ml/u), we can multiply it by the rate (40 ml/hr).33.33 ml/u x 40 ml/hr = 1333.33 u/hr.
Since there are only 10 units of Pitocin per ml, we must divide our answer by 10.1333.33 u/hr / 10 = 133.33 u/hr.
Therefore, the patient is receiving 1200 units of Pitocin per hour, as a one-liter bag of normal saline contains 30 units of Pitocin.
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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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Consider the various emotions and feelings the patient may be experiencing (ex. Fear, despair, anger, hopelessness, etc.). One of the greatest traits that a nurse has is the ability to provide empathetic care. As an aspiring registered nurse how do you prepare to engage in this plethora of emotions? Discuss a patient interaction in which you may have encountered such an occurrence. Support your findings with spiritual passages.
250 words
As an aspiring registered nurse, to engage in the plethora of emotions a patient might experience, one needs to prepare by having emotional intelligence, empathy, self-awareness, cultural competency, and excellent communication skills.
These traits would help to provide the best emotional care to the patient, to build trust and rapport with them, and to meet their needs. It's essential to understand the emotional state of a patient, which can help to build rapport and provide better care.
Empathetic care is a way of caring that puts the patient's emotions first and builds a connection of trust and respect between the healthcare professional and the patient.
Empathy is the ability to perceive and understand another person's feelings, needs, and emotions and is an essential aspect of patient-centered care. One way of developing empathy is through active listening and being present in the moment.
A patient interaction that required empathetic care may be a patient with a chronic illness or a terminal illness. This situation could lead to fear, despair, hopelessness, or anger. In such a scenario, as an aspiring registered nurse, I would first seek to connect with the patient emotionally, providing reassurance, and emphasizing the importance of hope and faith in the face of adversity.
I would also acknowledge the patient's feelings, listen actively to their story, and understand their perspective. This would help to build rapport with the patient and improve the patient-nurse relationship.
As a Christian nurse, I would draw inspiration from various spiritual passages, such as "Come to me, all you who are weary and burdened, and I will give you rest" (Matthew 11:28). This passage would help to remind me of the power of faith in times of struggle. Another passage that would help me is "Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God" (Philippians 4:6).This passage would help me to have a positive attitude and focus on the patient's needs.
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A nurse is caring for a client who is post operative following arthroscopy and reports a pain scale level of 6 on a scale of 0 to 10 after receiving ketorolac 1hr ago,which of the following actions should the nurse take.
A administer oxycodene 5mg orally
B .Give acetamninophen 650mg rectally
C. Tell the client they can have another dose of ketorolac in 3hrs
The nurse should consider taking the following action: administer oxycodone 5mg orally, The correct option is A.
The client's pain level is still at 6 out of 10 after receiving ketorolac, which indicates that the current medication may not be providing adequate pain relief. Administering a stronger analgesic like oxycodone can help better manage the client's pain.
However, it's important for the nurse to follow the facility's protocols and consult the healthcare provider for specific medication orders and dosage instructions. Oxycodone is a potent opioid analgesic that is commonly used for the management of moderate to severe pain. It belongs to the class of medications known as opioid agonists, which work by binding to opioid receptors in the central nervous system to reduce pain perception, The correct option is A.
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A patient with severe BPH (benign prostatic hyperplasia) is at risk for hydronephrosis. True False indicative of: Si"
A patient with severe BPH (benign prostatic hyperplasia) is at risk for hydronephrosis - True
Hydronephrosis refers to a possibility in a patient with severe benign prostatic hyperplasia (BPH). The non-cancerous enlargement of prostate gland, which can restrict overall flow of urine, is what distinguishes BPH from other conditions. The urethra may get compressed when the prostate grows, preventing the flow of urine from the bladder.
The condition which is known as hydronephrosis, which results from a buildup of urine in the kidneys, can be brought on by this typical obstruction. If untreated, hydronephrosis can be a dangerous condition that calls for medical attention to clear the obstruction and avoid future problems.
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The provider ordered heparin 1,200 units/hour. Heparin is available as 40,000 units in 1 L D5W. What is the correct IV flow rate in milliliters per hour? Enter your answer as a whole number. Use Desired-Over-Have method to show work.
The correct IV flow rate in milliliters per hour is 30 ml/hour.
To determine this, we can use the Desired-Over-Have method, which involves setting up a proportion:
Desired rate / Available rate = Desired amount / Available amount
In this case, the desired rate is 1,200 units/hour, and the available rate is 40,000 units/L of D5W.
Desired rate / 1 hour = 1,200 units
Available rate / 1 L = 40,000 units
To find the desired amount, we can set up the proportion:
1,200 units / 1 hour = x units / 1 L
Solving for x, we have:
x = (1,200 units / 1 hour) × (1 L / 40,000 units)
x = 0.03 L/hour
Since the question asks for the flow rate in milliliters per hour, we can convert liters to milliliters by multiplying by 1,000:
x = 0.03 L/hour × 1,000 ml/L
x = 30 ml/hour
Therefore, the correct IV flow rate is 30 ml/hour.
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Physical assessment.
1. Introduction procedures including AIDET
2. Head-to-toe physical assessment
3. Safety checks and procedures before leaving the patient
A physical assessment is a critical component of healthcare to evaluate and monitor the patient's health status. The assessment provides an opportunity for the healthcare provider to gather information about the patient's health, identify potential risks, and take appropriate measures to improve their overall health.
The assessment process involves several steps that must be followed to ensure comprehensive evaluation of the patient's health. The following discussion highlights the critical components of a physical assessment, including introduction procedures, head-to-toe assessment, and safety checks
The AIDET framework is an effective tool to use when introducing oneself to a patient. The framework includes the following:
A - Acknowledge the patientI - Introduce oneself
D - Duration
E - Explanation
T - Thank you
Head-to-toe physical assessment: The head-to-toe physical assessment is a comprehensive examination of the patient's body from head to toe. This assessment provides an opportunity for the healthcare provider to evaluate the patient's overall health status, identify potential risks, and make appropriate recommendations. The head-to-toe assessment should include vital signs, skin, head and neck, chest, cardiovascular system, abdominal, musculoskeletal, and neurological systems.
Safety checks and procedures before leaving the patient: Safety checks and procedures are essential before leaving the patient to ensure their safety and well-being. These checks include ensuring that the patient is safe, comfortable, and their immediate needs are met. It is also essential to document the patient's response to the assessment, including vital signs and other critical information. If there are any significant concerns identified, it is essential to escalate the matter to the appropriate authority for further investigation and management.
In conclusion, the physical assessment is an essential component of healthcare to evaluate and monitor the patient's health status. It is essential to follow the procedures, including introduction procedures, head-to-toe assessment, and safety checks, to ensure comprehensive evaluation and management of the patient.
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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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The parent states that the child will not chew the tablet but will take oral liquids. Erythromycin is also available as 400 mg/5 mL. After obtaining the physician's
permission for the change, how many milliliters should be dispensed?
How many milliliters would be needed per dose?
The amount of oral liquid erythromycin to be dispensed depends on the prescribed dosage. Without the dosage information, the specific milliliter amount cannot be determined.
When converting from a tablet formulation (e.g., 400 mg) to an oral liquid formulation (e.g., 400 mg/5 mL), the prescribed dosage must be provided by the physician. The dosage will determine the amount of liquid to be dispensed. For example, if the prescribed dosage is 200 mg, then half of the tablet's strength should be dispensed, resulting in a specific amount in milliliters.
Furthermore, the milliliters needed per dose will depend on the prescribed dosage. The physician will specify the desired dosage, usually in milligrams (mg), and the pharmacist will calculate the corresponding volume of oral liquid needed for each dose. This calculation is based on the concentration of the oral liquid formulation, such as 400 mg/5 mL.
To determine the exact amount in milliliters for dispensing and per dose, the physician's prescribed dosage is essential. Only with the specific dosage information can the pharmacist accurately calculate the appropriate volume of oral liquid to dispense and the milliliters required per dose.
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after prolonged fasting (more than a week), blood glucose is higher than before the fast, and erratic, what is the basis of this?
During prolonged fasting, after a week or more, the blood glucose level increases compared to the level before the fast. The reason behind this erratic rise is gluconeogenesis that is the process by which glucose is generated from non-carbohydrate sources.
The process of gluconeogenesis is the process by which glucose is synthesized from non-carbohydrate precursors in the liver cells. It provides glucose to various tissues when glucose supply is low and energy is required. A few amino acids and fatty acids serve as precursors for the synthesis of glucose in the liver cells. These are either obtained from the muscle or the adipose tissues that have been degraded to produce energy.
Blood glucose level and gluconeogenesis The level of glucose in the blood is essential to maintain a healthy life and to supply energy to the various cells of the body. Gluconeogenesis plays a crucial role in regulating the level of glucose in the blood. During the fast, the body is in need of energy, and the glucose level in the blood decreases. To supply energy to the body, gluconeogenesis becomes active, and glucose is synthesized from non-carbohydrate precursors such as amino acids and fatty acids.
The process of gluconeogenesis continues to keep the glucose level in the blood at an appropriate level. When fasting continues for an extended period, the glycogen stores in the liver also decrease, and the body needs more glucose to provide energy. In such a case, gluconeogenesis may become hyperactive, leading to the production of excess glucose that leads to an erratic increase in the glucose level in the blood.
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L.S. is a 7-year-old who has been brought to the emergency department (ED) by his mother. She immediately tells you he has a history of ED visits for his asthma. He uses an inhaler when he wheezes, but it ran out a month ago. She is a single parent and has two other children at home with a babysitter. Your assessment finds L.S. alert, oriented, and extremely anxious. His color is pale, and his nail beds are dusky and cool to the touch; other findings are heart rate 136 beats/min, respiratory rate 36 breaths/min regular and even, oral temperature 37.3" C (99.1* F), Sa02 89%, breath sounds decreased in lower lobes bilaterally and congested with inspiratory and expiratory wheezes, prolonged expirations, and a productive cough. QUESTIONS: 1. As you ask Ms. S. questions, you note that L.S.'s respiratory rate is increasing; he is sitting on the side of the bed, leaning slightly forward, and is having difficulty breathing. Give interventions are appropriate at this time and rationalize it. 2. Identify the nursing responsibilities associated with giving bronchodilators. 3. He improves and 24 hours later is transferred to the floor. Asthma teaching is ordered. You assess Ms. S.'s understanding of asthma and her understanding of the disorder L.S. tells you that he loves to play basketball and football and asks you whether he can still do these activities. How will you respond? 4. What additional information should be included in your discharge teaching regarding how to prevent acute asthmatic episodes and how to manage symptoms of exacerbation of asthma? 1. As you ask Ms. S. questions, you note that L.S.'s respiratory rate is increasing; he is sitting on the side of the bed, leaning slightly forward, and is having difficulty breathing. Give interventions are appropriate at this time and rationalize it. 2. Identify the nursing responsibilities associated with giving bronchodilators. 3. He improves and 24 hours later is transferred to the floor. Asthma teaching is ordered. You assess Ms. S.'s understanding of asthma and her understanding of the disorder L.S. tells you that he loves to play basketball and football and asks you whether he can still do these activities. How will you respond? 4. What additional information should be included in your discharge teaching regarding how to prevent acute asthmatic episodes and how to manage symptoms of exacerbation of asthma? 1. As you ask Ms. S. questions, you note that L.S.'s respiratory rate is increasing; he is sitting on the side of the bed, leaning slightly forward, and is having difficulty breathing. Give interventions are appropriate at this time and rationalize it. 2. Identify the nursing responsibilities associated with giving bronchodilators. 3. He improves and 24 hours later is transferred to the floor. Asthma teaching is ordered. You assess Ms. S.'s understanding of asthma and her understanding of the disorder L.S. tells you that he loves to play basketball and football and asks you whether he can still do these activities. How will you respond? 4. What additional information should be included in your discharge teaching regarding how to prevent acute asthmatic episodes and how to manage symptoms of exacerbation of asthma?
Administer supplemental oxygen, position L.S. upright, provide reassurance, and administer a short-acting bronchodilator to alleviate respiratory distress. Assess respiratory status, educate on medication use, monitor for adverse effects, and document bronchodilator administration.
With proper asthma management, L.S. can still participate in physical activities, emphasizing the need for control, medication use, and symptom monitoring. Discharge teaching should include trigger avoidance, inhaler use, asthma action plan, recognizing worsening symptoms, managing asthma in different environments, and educating family members.
As L.S.'s respiratory rate is increasing and he is experiencing difficulty breathing, immediate interventions are required. Administering supplemental oxygen helps improve oxygenation, while positioning L.S. upright helps optimize lung expansion. Providing reassurance helps alleviate anxiety, and administering a short-acting bronchodilator, such as albuterol, helps relax the airway smooth muscles and relieve bronchoconstriction, improving L.S.'s breathing.
Nursing responsibilities associated with giving bronchodilators include assessing respiratory status before and after administration, monitoring vital signs and oxygen saturation, documenting the medication administration, educating the patient and family on proper inhaler technique, and monitoring for any adverse effects or allergic reactions.
When L.S. asks about participating in basketball and football, it is important to respond positively and encourage his involvement in physical activities. Emphasize that with proper asthma management, including regular use of prescribed medications, monitoring symptoms, and having an asthma action plan, he can still engage in sports while minimizing the risk of exacerbations.
In discharge teaching, additional information should be provided on avoiding triggers that may precipitate acute asthmatic episodes, such as allergens or irritants. Educate L.S. and his family on proper inhaler use, including correct technique and timing of medication administration. Provide an asthma action plan outlining steps to manage worsening symptoms or exacerbations. Emphasize the importance of regular follow-up with healthcare providers and the need for ongoing monitoring and adjustments to the treatment plan as necessary.
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Emerald Green 30-year-old female was admitted for TBI you're falling off of her four wheeler. She has a history of borderline hypertension, polynephritis, bipolar type 1, diabetes type 2. She is alert to person only. She cannot Express words but understands when you talk to her. Just weakness on the left side upper and lower extremities. He says her pain is three out of 10 and it's in her head as a headache. She's taking oxycodone 20 mg 4 hours PRN. She has a 5-year-old child and a 7 year old child. My husband works over the road and does not miss it often. Her and her mother had a good relationship with her mother visits every day brings the children to see her. She is a two assist with a walker and only can ambulate 5 ft. The last lab values were white blood count elevated red blood count normal lipid panel normal analysis showed two plus white blood cell count specific gravity 0.145. cheese assistance with dressing bathing and grooming. Vital signs temperature 101.1 blood pressure 128/ 80 post 88 respirations 20 O2 saturation 98% on RA. Patient currently on thinking liquids and has healing trach incision on neck. Trach remove 3 days ago. Patience is a Seventh-Day Adventist. Your mother practices as a Jehovah witness and it's very upset with the staff when they gave what to her when she was admitted her trauma. About them going against her religious practices.
Read scenario above and answer the following questions:
What is your initial plan for this patient when you're planning the plan of care?
What assessments should you do on this patient and what kind of assessment would you be expected to find?
What medications would you expect this patient to be on?
The initial plan for the patient when planning the plan of care should include interventions to prevent infection, monitor vital signs, assist with ADLs as needed, etc. The assessments that should be done on this patient include neurological assessment, cardiovascular assessment, etc. The medications that this patient is expected to be on are oxycodone and antibiotics.
1. The initial plan for the patient when planning the plan of care should include the following:
Implement interventions to prevent infection.Monitor vital signs and report signs of fever.Assist with activities of daily living (ADLs) as needed.Monitor the incision site and report any signs of infection or delayed healing.Ensure that the patient has appropriate pain relief and observe for signs of opioid toxicity.Provide emotional support and counseling as needed.2. The following assessments should be done on this patient:
Neurological assessment: Assess the patient's level of consciousness, orientation, cognition, speech, and motor function.Cardiovascular assessment: Assess the patient's heart rate, rhythm, blood pressure, and peripheral pulses.Respiratory assessment: Assess the patient's respiratory rate, rhythm, depth, and oxygen saturation.Gastrointestinal assessment: Assess the patient's bowel sounds, appetite, and hydration status.Genitourinary assessment: Assess the patient's urinary output, color, and clarity of urine, and any signs of infection.Skin assessment: Assess the patient's skin integrity, wound healing, and any signs of infection or pressure ulcers.3. The medications that this patient is expected to be on are:
Oxycodone 20 mg every 4 hours PRN: This is for pain relief.Antibiotics: This is to prevent or treat any infection that may be present.To know more about activities of daily living (ADLs), refer to the link below:
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The prescriber orders a 27 kis child to have 100% of maintenance flulds, Using the formula: First 10 kg at 100ml per kg Second 10 kg at 50ml perkg All remaining ks at 20mi per kig. Calculate the amount of fluid the child should receive in mL. per hour: 136.7 mL/hr 70 mL/hr 68.3 mL/hr 102 mL/hr
The child should receive 68.3 mL of fluid per hour. Hence, option C is correct.
The prescriber orders a 27 kg child to have 100% of maintenance fluids. Using the formula: First 10 kg at 100 ml per kg. Second 10 kg at 50 ml per kg. All remaining kgs at 20 ml per kg.
The formula for calculating maintenance fluids is: First 10 kg: 100 ml per kg. Next 10 kg: 50 ml per kg. All remaining kg: 20 ml per kg.
Now, the amount of fluid the child should receive in mL per hour will be calculated as follows: First 10 kg: 10 kg x 100 ml/kg = 1000 ml. Next 10 kg: 10 kg x 50 ml/kg = 500 ml.
All remaining kg: 7 kg x 20 ml/kg = 140 ml. Total fluids required in 24 hours = 1000 ml + 500 ml + 140 ml = 1640 ml
Therefore, the amount of fluid the child should receive in mL per hour = 1640 ml/24 hours = 68.3 ml/hr. Therefore, the child should receive 68.3 mL of fluid per hour. Hence, option C is correct.
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The blood pressure in someone's heart is 1.70 104 Pa at a
certain instant. An artery in the brain is 0.42 m above the heart.
What is the pressure in the artery? The density of blood is 1060
kg/m^.
The pressure in the artery is 4380.588 Pa.
Blood pressure in the heart and an artery in the brain A blood pressure of [tex]1.70 \times10^4[/tex]Pa at a particular instant is present in someone's heart. The artery in the brain is 0.42 m above the heart. We need to calculate the pressure in the artery using the given information.
The hydrostatic equation relates the pressure difference to the height difference of a fluid column. As we have a fluid column, that is, blood in this case, we can use the hydrostatic equation to relate the pressure difference to the height difference of the column. Pressure is directly proportional to the density of the fluid column and the height of the column. P = ρgh
Where: P = Pressure ρ = Density g = Acceleration due to gravity h = Height of the fluid column As the density of the fluid column remains constant, we can directly relate the pressure difference to the height difference between two points. Using this information, we can relate the pressure at the heart and the artery.
Pressure at the heart = Pa Height difference between the heart and the artery = 0.42 mWe can now calculate the pressure at the artery using the above equation.Pressure at the artery = ρgh= 1060 kg/m³ * 9.81 m/s² * 0.42 m= 4380.588 Pa
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Diazepam/Alprazolam/Lorazepam/ Clonazepam/Temazepam
Drug name Classification
Pregnancy Category
Side effects
Averse reaction
route of administration
Nursing considerations( including labs, VS etc...)
Nursing considerations: Monitor vital signs (especially respiratory rate), assess for sedation and cognitive impairment, caution with concurrent use of other CNS depressants,
Here is the information you requested for the listed medications:
1. Diazepam:
- Classification: Benzodiazepine
- Pregnancy Category: D
- Side effects: Drowsiness, dizziness, confusion, blurred vision, muscle weakness
- Adverse reactions: Paradoxical reactions (agitation, aggression), respiratory depression, dependence
- Route of administration: Oral, intravenous, intramuscular
- Nursing considerations: Monitor vital signs (especially respiratory rate), assess for sedation and cognitive impairment, caution with concurrent use of other CNS depressants, assess for signs of dependence and withdrawal symptoms, monitor liver function tests.
2. Alprazolam:
- Classification: Benzodiazepine
- Pregnancy Category: D
- Side effects: Drowsiness, dizziness, headache, confusion, impaired coordination
- Adverse reactions: Paradoxical reactions (agitation, aggression), respiratory depression, dependence
- Route of administration: Oral
- Nursing considerations: Monitor vital signs (especially respiratory rate), assess for sedation and cognitive impairment, caution with concurrent use of other CNS depressants, assess for signs of dependence and withdrawal symptoms, monitor liver function tests.
3. Lorazepam:
- Classification: Benzodiazepine
- Pregnancy Category: D
- Side effects: Sedation, dizziness, weakness, unsteadiness
- Adverse reactions: Paradoxical reactions (agitation, aggression), respiratory depression, dependence
- Route of administration: Oral, intravenous, intramuscular
- Nursing considerations: Monitor vital signs (especially respiratory rate), assess for sedation and cognitive impairment, caution with concurrent use of other CNS depressants, assess for signs of dependence and withdrawal symptoms, monitor liver function tests.
4. Clonazepam:
- Classification: Benzodiazepine
- Pregnancy Category: D
- Side effects: Drowsiness, dizziness, coordination problems, memory issues
- Adverse reactions: Paradoxical reactions (agitation, aggression), respiratory depression, dependence
- Route of administration: Oral
- Nursing considerations: Monitor vital signs (especially respiratory rate), assess for sedation and cognitive impairment, caution with concurrent use of other CNS depressants, assess for signs of dependence and withdrawal symptoms, monitor liver function tests.
5. Temazepam:
- Classification: Benzodiazepine
- Pregnancy Category: X
- Side effects: Drowsiness, headache, blurred vision, dizziness
- Adverse reactions: Paradoxical reactions (agitation, aggression), respiratory depression, dependence
- Route of administration: Oral
- Nursing considerations: Monitor vital signs (especially respiratory rate), assess for sedation and cognitive impairment, caution with concurrent use of other CNS depressants, assess for signs of patient dependence and withdrawal symptoms, monitor liver function tests. Note: Temazepam is contraindicated in pregnancy due to potential harm to the fetus.
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What is the main use of the EMB agar plate?
The EMB agar plate stands for Eosin Methylene Blue agar plate. It is a selective and differential media commonly used to detect and isolate fecal coliforms. It is utilized to determine the presence of bacteria such as Escherichia coli in a sample.
This media can differentiate between lactose fermenters and lactose non-fermenters because of the presence of dyes in the agar.The dyes are selective because only the gram-negative bacteria can withstand the lethal effects of the eosin Y and methylene blue. The acidic products from lactose fermentation produce a metallic green sheen around the colonies of lactose fermenters, which helps in their differentiation from non-fermenters that have a pale coloration.
The EMB agar plate is particularly useful in the differentiation of lactose-fermenting and non-lactose fermenting bacteria.The EMB agar plate's primary use is to distinguish between fecal and non-fecal coliform bacteria. EMB agar is an important medium used in the examination of water, food, and dairy products to detect the presence of coliform bacteria. This test is essential in identifying harmful pathogens and establishing water and food safety.
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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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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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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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When comparing testicular and prostate cancers, which of the following is related only to prostate cancer:
A• Commonly metastasizes before being identified
B• High cure rate following an orchiectory of affected testicle and chemotherapy.
C© A risk factor is - having a history off an undescended testicle.
D. A risk factor is - having more than 10 sexual partners.
None of the given options is related only to prostate cancer. It is important to note that both testicular and prostate cancers have unique characteristics, risk factors, and treatment approaches.
Let's analyze each option:
A. Commonly metastasizes before being identified: This statement does not apply only to prostate cancer. Both testicular and prostate cancers have the potential to metastasize before being identified, depending on the stage and aggressiveness of the cancer.
B. High cure rate following an orchiectomy of affected testicle and chemotherapy: This option is specific to testicular cancer. Orchiectomy (surgical removal of the affected testicle) is a common treatment for testicular cancer, and chemotherapy is often used as an adjuvant therapy. Prostate cancer does not typically involve orchiectomy as a primary treatment.
C. A risk factor is having a history of an undescended testicle: This statement is not specific to prostate cancer. A history of an undescended testicle is a known risk factor for testicular cancer, but it is not directly related to prostate cancer.
D. A risk factor is having more than 10 sexual partners: This statement is also not specific to prostate cancer. Having multiple sexual partners is considered a risk factor for various sexually transmitted infections, including some types of human papillomavirus (HPV) that can increase the risk of developing certain cancers, including prostate cancer. However, it is not a risk factor exclusively associated with prostate cancer.
None of the given options is related only to prostate cancer. It is important to note that both testicular and prostate cancers have unique characteristics, risk factors, and treatment approaches.
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List 3 activity statements in Management of Care that you should consider as the nurse when providing care to your assigned client. Provide a rationale for each statement. You may copy and paste the statement from the NCLEX test plan, but your rationale should be unique.
Assessing the client's healthcare needs and developing an individualized care plan allows for tailored interventions and prevents adverse events. Prioritizing and coordinating nursing interventions based on the client's changing condition ensures timely and efficient care.
Assess the client's healthcare needs and develop an individualized care plan based on the assessment findings.
Rationale: This statement emphasizes the importance of conducting a comprehensive assessment of the client's healthcare needs.
By assessing the client's physical, emotional, and psychosocial well-being, the nurse can gather relevant information to develop an individualized care plan.
This allows for tailored interventions that address the client's specific needs and promote optimal health outcomes. A thorough assessment also enables the nurse to identify any potential risks or complications, facilitating early intervention and prevention of adverse events.
By adhering to this activity statement, the nurse ensures that the care provided is patient-centered, evidence-based, and focused on meeting the unique needs of the individual.
Prioritize and coordinate nursing interventions based on the client's changing condition and healthcare priorities.
Rationale: Prioritization and coordination of nursing interventions are crucial aspects of effective care management. The nurse must continually assess the client's changing condition, reassess priorities, and adapt the care plan accordingly.
By prioritizing interventions, the nurse can address immediate and high-risk needs promptly, minimizing potential harm to the client. Coordinating interventions involves collaborating with the healthcare team, delegating tasks appropriately, and ensuring seamless communication to provide safe and coordinated care.
This activity statement highlights the nurse's role in effectively managing care and ensuring that interventions are timely, efficient, and aligned with the client's healthcare priorities.
Evaluate the effectiveness of nursing interventions and modify the care plan as needed.
Rationale: Evaluation of nursing interventions is essential to determine their effectiveness in achieving desired outcomes. By monitoring and assessing the client's response to interventions, the nurse can identify whether the care plan is achieving the intended goals or if modifications are necessary.
Evaluation allows for ongoing optimization of care and ensures that interventions are evidence-based and individualized to meet the client's changing needs. By adhering to this activity statement, the nurse promotes a continuous improvement process, enhancing the quality of care and facilitating positive patient outcomes.
The regular evaluation also contributes to evidence generation, as the nurse can identify successful interventions that can be shared with the healthcare team and integrated into future care practices.
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Indications of increased intra-abdominal pressure = how many
mmHg indicate increased intra-abdominal pressure
Indications of increased intra-abdominal pressure are typically seen when the pressure exceeds 12 mmHg. Increased intra-abdominal pressure, also known as intra-abdominal hypertension (IAH), can have various causes and can lead to a condition called abdominal compartment syndrome (ACS) if left untreated.
Intra-abdominal pressure refers to the pressure within the abdominal cavity, which houses organs such as the stomach, liver, intestines, and others. Under normal circumstances, the intra-abdominal pressure ranges between 0 and 5 mmHg. However, when the pressure exceeds 12 mmHg, it is considered increased or elevated, indicating intra-abdominal hypertension.
Increased intra-abdominal pressure can occur due to several reasons, such as trauma, surgical procedures, obesity, fluid overload, gastrointestinal disorders, or conditions like ascites (abnormal fluid accumulation in the abdominal cavity). It can also be a consequence of mechanical ventilation in critically ill patients.
When intra-abdominal pressure rises above the normal range, it can lead to abdominal compartment syndrome (ACS). ACS is a potentially life-threatening condition characterized by the sustained elevation of intra-abdominal pressure, resulting in impaired organ perfusion and function. It can adversely affect various systems, including the cardiovascular, respiratory, and renal systems. Timely recognition and management of increased intra-abdominal pressure are crucial to prevent the development of ACS and its associated complications.
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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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1.5 L within 10 hours.
drop factor is 15 gtt/min
Find the
___mL/hour
___mL/minute
____gtt/min
To calculate the mL/hour, mL/minute, and gtt/min, we can use the given information. The infusion rate for this scenario would be 150 mL/hour, 2.5 mL/minute, and 37.5 gtt/min.
To find the mL/hour, we need to convert the volume from liters to milliliters and divide it by the time in hours. In this case, 1.5 L is equal to 1500 mL (1 L = 1000 mL). So, the mL/hour rate would be 1500 mL divided by 10 hours, which equals 150 mL/hour.
To calculate the mL/minute, we divide the mL/hour rate by 60 (since there are 60 minutes in an hour). Therefore, 150 mL/hour divided by 60 minutes equals 2.5 mL/minute.
To determine the gtt/min, we multiply the mL/minute rate by the drop factor. In this case, 2.5 mL/minute multiplied by 15 gtt/min equals 37.5 gtt/min.
Therefore, the infusion rate for this scenario would be 150 mL/hour, 2.5 mL/minute, and 37.5 gtt/min.
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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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