The post-work for the VCBC Experience should be submitted to Canvas within 48 hours of its completion. The Experiential Learning Orientation should be referred to for further clarification, and to ensure that the assignment is correctly saved.
As a part of the reflection journal, the student must complete a patient education concept relating to their client for the day, and answer the following four questions in the reflection journal:. The following guidelines will be useful when preparing the journal :Reflect on the care provided to the client, making a clear connection between the experience and the patient education concept.
Links between the concept and other nursing concepts should be identified and discussed, highlighting the importance of these concepts and their relevance to the scenario. The student should describe how abnormal signs and symptoms were recognized and the actions taken to prioritize care. This could include the implementation of different nursing interventions, the provision of treatment, or the administration of medication.
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"A nurse is collecting data from older adult client who has
cysistis,which of the following should the nurse anticipate
A reffered pain in right shoulder
B orange colored urine
C .Hypothermia
D Confusion
When a nurse is collecting data from an older adult client who has cystitis, the nurse should anticipate confusion. The answer is D.Confusion.
This is because a urinary tract infection (UTI) caused by cystitis in an older adult client can lead to delirium and confusion. Cystitis, or bladder inflammation, is caused by bacteria, such as E. coli, that enter the bladder through the urethra. Women are more likely to develop cystitis because their urethras are shorter than men’s urethras, and they are closer to the anus, where E. coli is found.
The signs and symptoms of cystitis include dysuria (painful urination), urinary frequency, urgency, and sometimes hematuria (blood in urine). In an older adult client, cystitis may present with additional symptoms, such as confusion, delirium, and incontinence.
These symptoms are known as acute confusional states (ACS), and they may be caused by UTIs. ACS is a temporary state of confusion that usually resolves after the UTI is treated. The referred pain in the right shoulder (option A) is common with liver disorders or gallbladder problems, but not with cystitis. Orange-colored urine (option B) is also not associated with cystitis. Hypothermia (option C) is not a typical symptom of cystitis, which is an infection of the bladder.
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A patient suffering from a intense thirst, abdominal pain, and vomiting and dry skin. A) Hypoglycemia B) Seizure C) Hyperglycemia
The patient's symptoms of intense thirst, abdominal pain, vomiting, and dry skin are consistent with Hyperglycemia (Option C), which is a condition characterized by high blood sugar levels.
What is Hyperglycemia?
Hyperglycemia is a condition where there are elevated levels of glucose (sugar) in the blood. It can result from decreased insulin production by the pancreas or the body’s inability to use insulin properly (insulin resistance).
Symptoms of Hyperglycemia:
Hyperglycemia is a medical emergency. The symptoms of hyperglycemia can include excessive thirst, abdominal pain, vomiting, dry skin, confusion, drowsiness, frequent urination, rapid heartbeat, shortness of breath, and fruity breath odor.
Treatment for Hyperglycemia:
The treatment of hyperglycemia depends on its severity. Mild hyperglycemia can be managed by drinking plenty of fluids and eating a healthy diet. In severe cases, hospitalization may be required to control the patient's blood sugar levels.
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You are having a discussion with a neighbor who has a 14-year-old son. The neighbor expresses concern about his son and substance abuse problems he has heard about. • The neighbor describes his son’s friend, who was a bright and motivated student but has become sullen and withdrawn and lacks the motivation he once had. In addition, he has a chronic cough but denies that he smokes cigarettes. • The neighbor mentions that his son has told him that his friends have been playing drinking games at parties. A few weeks later, the neighbor calls you because his son is extremely drowsy and unable to speak. The neighbor notes that their bottle of alprazolam is missing.
1. What will you do first? 2. What do you think could be the son’s issue? 3. What treatment would you expect his son to receive?
The substance abuse has led to an addiction which is a chronic disease that is characterized by compulsive drug seeking and use, despite the harmful consequences.
The answer to the following questions in case of drowsiness and unconsciousness are as follows:
1. The first thing I will do is to inform the neighbor to call 911 and ask for emergency medical help to be sent to their home as the child is extremely drowsy and unable to speak.
2. Based on the information given, the son's issue could be related to substance abuse. Substance abuse is the act of consuming substances, such as drugs or alcohol, in amounts that are harmful or hazardous.
It is likely that the son might have taken the alprazolam, which is a prescription medication used to treat anxiety disorders, panic disorders, and anxiety caused by depression.
It is also possible that the son might be using alcohol and smoking cigarettes, which are both substances that can lead to addiction. Chronic cough may indicate respiratory tract issues related to smoking.
3. Substance abuse treatment is designed to help individuals overcome addiction. It may include several stages and interventions to help the person overcome addiction, maintain sobriety, and build a life in recovery.
The treatment that I would expect the son to receive would include a comprehensive assessment to determine the extent of his addiction and any underlying mental health issues.
The son will undergo a detoxification process to manage withdrawal symptoms. The treatment plan may also include behavioral therapies, group therapy, and family therapy.
In addition, the son will be taught skills to avoid relapse, and he may also be prescribed medications to help with withdrawal symptoms and to prevent relapse.
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A physician orders ampicillin 0.2 g/kg/d IV to be delivered in divided doses q6h. The patient weighs 110 lb. How many mg are needed per dose? How many grams of ampicillin would the patient receive"
A physician orders ampicillin 0.2 g/kg/d IV to be delivered in divided doses q6h. The patient weighs 110 lb. 10000 mg are needed per dose. 40 grams of ampicillin would the patient receive.
To calculate the amount of ampicillin needed per dose, we first convert the patient's weight from pounds to kilograms. Since 1 lb is approximately 0.45 kg (1 lb / 2.2), we divide the weight of 110 lb by 2.2 to get 50 kg.
Next, we multiply the weight (50 kg) by the prescribed dosage of 0.2 g/kg to find the amount of ampicillin needed per dose. This calculation is 50 kg x 0.2 g/kg = 10 g. To convert grams to milligrams, we multiply by 1000, resulting in 10,000 mg per dose.
For the total amount of ampicillin the patient would receive in a day, we consider the dosing frequency of every 6 hours (q6h), which means the patient will receive the medication 4 times in a day.
Therefore, we multiply the dose per administration (10 g) by the number of doses in a day (4 doses), giving us a total of 40 g of ampicillin the patient would receive in a day.
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albutamol can be used in obstetrics because it: A. inhibits spasmogen release from neutrophils B. helps the mother breathe better C. relaxes uterine smooth muscle D. relaxes the cervix
Albutamol can be used in obstetrics because it relaxes uterine smooth muscle.
This is option C
What is Albutamol?Albutamol is a medication that can be used in the treatment of bronchospasm. The medication is classified as a short-acting β2-adrenergic receptor agonist. Albutamol is used in obstetrics to relax uterine smooth muscle.
Obstetrics is a medical specialty that deals with pregnancy, childbirth, and the postpartum period. Obstetricians provide care for women and their babies throughout pregnancy, childbirth, and the postpartum period.
The uterine smooth muscle is made up of myometrial cells. The smooth muscle cells in the uterus have unique properties that enable them to generate contractions. These contractions help in the movement of the fetus through the birth canal, and they also help in the expulsion of the placenta after delivery.
So, the correct answer is C
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-Identify 1 health behavior modification you pursued.
-Using the Health Behavior Change Model, specify the steps you have
taken on how the behavior was modified. In a concept map form.
Health Behavior Change Model includes Precontemplation, Contemplation, Preparation, Action, Maintenance, Termination.
A general example of how the Health Behavior Change Model can be applied to modify a health behavior.
Health Behavior: Regular Exercise
Steps in Behavior Modification:
Precontemplation: Recognizing the need for regular exercise due to sedentary lifestyle and health concerns.
Contemplation: Evaluating the benefits and barriers of regular exercise, considering options for incorporating exercise into daily routine.
Preparation: Setting specific goals for exercise frequency, duration, and type. Gathering information on exercise programs and facilities.
Action: Initiating regular exercise by following a structured exercise plan, attending fitness classes, or engaging in physical activities.
Maintenance: Sustaining the exercise routine over time by establishing a schedule, overcoming challenges, and seeking support from friends or a fitness community.
Termination: Achieving a long-term behavior change where regular exercise becomes a habit and an integral part of a healthy lifestyle.
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At
the proximal tubules, _______ is actively transported out of the
filtrate, and _________ follows by _________. Fill in the blanks
please
In the proximal tubules, substances such as glucose and amino acids are actively transported out of the filtrate, and water follows by osmosis.
In the proximal tubules of the nephrons in the kidneys, reabsorption of filtered substances takes place. Active transport mechanisms are responsible for moving certain substances out of the filtrate and back into the bloodstream. One example is glucose. Glucose is actively transported out of the filtrate by specific carrier proteins embedded in the luminal membrane of the proximal tubule cells. This transport process allows glucose to be reabsorbed and returned to the bloodstream. Similarly, amino acids are also actively transported out of the filtrate using carrier proteins.
The movement of water follows the reabsorption of solutes. Once glucose and amino acids are actively transported out of the filtrate, the solute concentration in the surrounding interstitial fluid increases. This creates an osmotic gradient that drives water movement. Water molecules move passively by osmosis from the filtrate into the interstitial fluid and eventually back into the bloodstream. This reabsorption of water helps maintain the body's fluid balance and prevents excessive loss of water through urine production.
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Functions in lipid and carbohydrate metabolism and detoxification of harmful substances
A. Rough endoplasmic reticulum
B. Mitochondria
C. Smooth endoplasmic reticulum
D. Golgi apparatus
E. Lysosome
The Smooth endoplasmic reticulum has functions in lipid and carbohydrate metabolism and detoxification of harmful substances.
Smooth endoplasmic reticulum (SER) is a cytoplasmic organelle that is part of the endoplasmic reticulum. It differs from the rough endoplasmic reticulum in that it lacks ribosomes on its cytoplasmic surface. SER plays a significant role in carbohydrate and lipid metabolism and detoxification of toxic substances.
However, let's go through all the given options to be sure of the answer:
The Rough endoplasmic reticulum has ribosomes attached to its outer surface and is involved in the synthesis of proteins.
Mitochondria are involved in the production of ATP (Adenosine triphosphate), the cellular respiration process, and producing energy for cells.
Golgi apparatus is responsible for protein modification and packaging and preparing them for delivery to different cell locations.
Lysosomes are responsible for the digestion of intracellular debris and waste products, including complex molecules such as proteins and cellular organelles.
Hence, the Smooth endoplasmic reticulum has functions in lipid and carbohydrate metabolism and detoxification of harmful substances.
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What is the name of the gene that is expressed in cartilage cells? What is the name of one of the genes expressed in cells committed to being an osteoblast?
Name two genes that are expressed in migrating cranial neural crest cells that are then shut off when they enter the pharyngeal arches. What are two genes expressed in these neural crest cells once they enter the pharyngeal arches?
Collagen (COL2A1) and Osterix (OSX) are the genes expressed in cartilage cells and osteoblasts, respectively. Sox10, FoxD3, Hoxa2, and Hoxb2 are the genes expressed in neural crest cells.
Cartilage cells and osteoblasts play a vital role in the skeletal system. The expression of Collagen (COL2A1) is significant in cartilage cells. It is the primary structural protein in the extracellular matrix of cartilage. The extracellular matrix of cartilage is responsible for providing support to the body's weight. Osterix (OSX) is one of the genes expressed in cells committed to being an osteoblast. Osterix plays an essential role in the differentiation of mesenchymal cells into osteoblasts, which are responsible for bone formation.
Neural crest cells contribute to the formation of various structures in the body, including bones, cartilage, and muscles. The genes Sox10 and FoxD3 are expressed in migrating neural crest cells that play a vital role in their migration from the neural tube to the pharyngeal arches. Once neural crest cells enter the pharyngeal arches, Hoxa2 and Hoxb2 are expressed, playing a vital role in the proper development of the pharyngeal arches. Therefore, these genes are significant in the development of various structures in the body.
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Should enoxaparin be administered to patients post
parathyroidoctomy with tracheostomy?
Enoxaparin should not be administered to patients post-parathyroidectomy with a tracheostomy.
Enoxaparin is an anti-coagulant heparin with a low molecular weight, it is used to prevent blood clots from developing or getting bigger. It is usually administered subcutaneously and is often prescribed for people who have undergone major surgery like hip replacement to prevent DVT, as well as those who have a high risk of blood clots.
Enoxaparin must not be given to patients undergoing parathyroidectomy and tracheostomy as it significantly increases the risk of postoperative hematoma formation.
Hematoma is the collection of solid blood under the tissues and it causes the blood pressure to drop. if left untreated it can lead to coma or even death. therefore enoxaparin should not be administered to patients after parathyroidectomy surgery.
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Describe the ways the CST principles of human dignity and the
common good, comparatively, support and inform each other.
The principles of human dignity and the common good mutually reinforce and support each other. Human dignity recognizes the inherent worth and value of every individual, while the common good emphasizes the well-being and flourishing of the community as a whole.
The principle of human dignity acknowledges that every person possesses inherent worth and should be treated with respect and dignity. It recognizes the fundamental rights and freedoms of individuals, such as the right to life, liberty, and security. This principle is closely tied to the concept of the common good, which emphasizes the well-being and flourishing of the entire community. The common good recognizes that individuals are interconnected and interdependent, and their well-being is linked to the well-being of the community as a whole. In promoting the common good, societies and institutions strive to create conditions that enable all individuals to reach their full potential and enjoy a dignified life.
Human dignity and the common good are mutually supportive because the recognition of human dignity is essential for the pursuit of the common good, and the realization of the common good contributes to upholding and promoting human dignity. Respecting and protecting human dignity is a foundational principle for promoting the common good.
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New to writing prescriptions. Can someone help me confirm my results of how the script should look?
Robert Judson (DOB 11/23/1968) is in your officeon September 19, 2020,for a routine 6 month follow up. He has a history of seizure disorder,which has been seizure free with levetiracetam under the care of a neurologist for over two years. Neurology is now discharging him back to your care and you have agreed to take over the prescription. He takes 1500mg two times per day. He wants to continue to use his mail order pharmacy,so he will need a 90-daysupply. You will see him on follow up in the office again in 12months,so he will need enough to last until then. He has NKDA. His address is: 5284 Riverdale Dr. Grand Rapids, MI 30302. You will need to look up the available dosages of this medication and complete a full prescription with all the required elements.
Prescription writing is an essential skill for healthcare professionals, and it's important to ensure accuracy and completeness when creating a prescription.
When writing a prescription, it is crucial to include all the required elements to ensure clarity and proper dispensing of the medication. Here's a step-by-step guide for writing a prescription for Robert Judson:
Patient Information:
Begin by providing the patient's information:
Full name: Robert Judson
Date of birth: 11/23/1968
Address: 5284 Riverdale Dr., Grand Rapids, MI 30302
Date:
Include the date of the prescription. In this case, it is September 19, 2020.
Medication Details:
Include the name of the medication, its strength, and the prescribed dosage:
Medication: Levetiracetam
Strength: Look up the available strengths of levetiracetam. For the purpose of this example, let's assume 500mg tablets.
Prescribed dosage: 1500mg
Frequency: Two times per day
Quantity:
As the patient wants a 90-day supply, calculate the total quantity needed:
Daily dosage: 1500mg × 2 = 3000mg
90-day supply: 3000mg × 90 = 270,000mg
Note: In practice, it is recommended to prescribe the specific number of tablets rather than the total amount in milligrams.
Directions for Use:
Provide clear instructions on how to take the medication:
"Take 1 tablet by mouth two times daily."
Refills:
Indicate the number of refills allowed or if it is a one-time prescription:
"No refills" (assuming the patient will require a follow-up appointment for prescription renewal).
Prescriber's Information:
Include your information as the prescriber:
Name: Your Full Name
Professional designation: MD (or relevant designation)
Address: Your clinic or office address
Contact details: Your phone number and/or email address
Example Prescription:
Using the information provided, here's an example prescription for Robert Judson:
Date: September 19, 2020
Patient Information:
Robert Judson
DOB: 11/23/1968
Address: 5284 Riverdale Dr., Grand Rapids, MI 30302
Medication:
Levetiracetam 500mg tablets
Dosage:
Take 1 tablet by mouth two times daily.
Quantity:
Dispense: 270 tablets
Refills:
No refills
Prescriber's Information:
Your Full Name, MD (or relevant designation)
Your Clinic/Office Address
Phone: [Your Phone Number]
Email: [Your Email Address]
Please note that the example prescription assumes 500mg tablets and a 90-day supply. Adjustments may be required based on the available strengths and the specific needs of the patient.
Remember to comply with local regulations and guidelines when writing prescriptions, and always consult your supervising physician or preceptor for any specific requirements or recommendations.
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Still on 5/23/2022 - the physician decides that 2 more RBCs should be transfused for Ms. Johnson today. Can the sample collected on 5/19/2022 be used for today's pretransfusion compatibility
testing?
The blood sample collected on 5/19/2022 cannot be used for 5/23/2022 pretransfusion compatibility testing. The reason is that the sample collected four days ago might not show an accurate result as a person's blood is subjected to change.
What is Pretransfusion compatibility testing?
Pretransfusion compatibility testing is the process of determining whether the blood of a donor is compatible with the blood of a recipient before a blood transfusion.
Compatibility testing, often known as crossmatching, can help to prevent transfusion reactions that are harmful or fatal to the patient who receives blood. It's crucial to complete the compatibility testing process before giving any blood product to the patient. The aim of compatibility testing is to reduce the risk of transfusion reactions.
Compatibility testing is divided into two phases: type and screen and crossmatching.
The following is the procedure
First, ABO and Rh blood types are determined through a type and screen procedure. Next, the sample is tested for the presence of certain irregular antibodies through a screen. Then, the patient's serum and donor RBCs are mixed in a crossmatch. Finally, the compatibility of the blood is assessed.To learn more about Blood sample visit:
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Myosin binding sites are specifically found on
A. F-actin
B. tropomyosin
C. troponin
D. G-actin
E. myosin
Myosin binding sites are specifically found on F-actin (Option A).
What are myosin-binding sites?Myosin is a motor protein that is found in muscle tissues. It is responsible for muscle contraction and is present in the thick filaments of muscles. Myosin binds to actin filaments, and this is essential for muscle contraction.
Muscle contraction occurs as a result of the sliding of actin filaments over myosin filaments, and this occurs in the presence of calcium ions. The myosin head binds to the actin filament, and ATP energy is used to break the bond between myosin and actin. This allows the myosin head to move, and it binds to another site further down the actin filament. As a result of this, the actin filaments slide over the myosin filaments, leading to muscle contraction.
Thus, the correct option is A.
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Which use of restraints in a school-age child should the nurse question?
The use of restraints in a school-age child should be carefully considered and only used when absolutely necessary for the safety of the child or others. The nurse should question any use of restraints that appears to be excessive, unnecessary, or in violation of established policies or guidelines.
Some specific situations where the use of restraints in a school-age child may be questioned by the nurse include:
1. Using restraints as punishment: Restraints should never be used as a form of punishment or discipline.
2. Using restraints to control behavior: Restraints should not be used solely to control a child's behavior or for the convenience of staff.
3. Using restraints without adequate justification: There should be clear documentation of the reasons why the restraints are being used, and they should only be used if there is a clear threat to the safety of the child or others.
4. Using restraints that are inappropriate or unsafe: The type of restraint used should be appropriate for the child's age, size, and level of development, and should not put the child at risk of injury.
In general, the nurse should advocate for the least restrictive means of managing challenging behaviors in school-age children, and work collaboratively with other members of the healthcare team to ensure that the child's rights and safety are protected.
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The
physician ordered amikacin 15mg/kg/day IV Divided in 4 equal doses
for a client who is 60kg. how many milligrams should the nurse
administer for each dose? round to the nearest tenth as
needed
The nurse should administer approximately 225 milligrams of amikacin for each dose to a client who weighs 60 kilograms, following the physician's order of 15 mg/kg/day divided into 4 equal doses.
To calculate the dose of amikacin for each administration, we multiply the client's weight (60 kg) by the prescribed dosage of 15 mg/kg/day.
Dose per day = 15 mg/kg/day × 60 kg = 900 mg/day
Since the dose needs to be divided into 4 equal parts, we divide the total daily dose by 4 to determine the dose for each administration.
Dose per administration = 900 mg/day ÷ 4 = 225 mg
Therefore, the nurse should administer approximately 225 milligrams of amikacin for each dose.
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A 32 year old male arrives in the emergency room with a temperature of 39.1°C. He is suffering from chest pain and breathing difficulties.
Physical examination reveals a palpable spleen tip, splinter haemorrhages, needle tracks in his left arm (antecubital fossa), and a heart murmur.
A blood culture grew an organism (clusters of large cocci, no haemolysis). A Gram stain was positive.
Is this patient at an increased risk of septicaemia due to his drug use?
The patient is at an increased risk of septicaemia due to his drug use.A 32 year old male arrives in the emergency room with a temperature of 39.1°C, suffering from chest pain and breathing difficulties.
Physical examination reveals a palpable spleen tip, splinter haemorrhages, needle tracks in his left arm (antecubital fossa), and a heart murmur.A blood culture grew an organism (clusters of large cocci, no haemolysis). A Gram stain was positive. The patient is at an increased risk of septicaemia due to his drug use.
Intravenous drug abuse is a significant risk factor for bloodborne infections, such as HIV, hepatitis, and bacterial endocarditis, which can all cause sepsis. When you inject drugs, bacteria can enter your bloodstream through shared needles or syringes. Bacteria can also enter your bloodstream if you inject drugs and your skin is not clean.In this case, needle tracks are found in the patient's left arm (antecubital fossa), which is an indicator of intravenous drug abuse.
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Question 49 The field of environmental health originated in an attempt to reduce exposure to infectious diseases. It has since broadened to include all external factors (chemical, biological, and physica that can potentially affect health. True False Question 50 Changes in the habits of individuals realistically has very minor effects on the environment. True False Cell division is a loosely regulated process. A number of mechanisms help uncontrolled cell division, repair mutations to the DNA sequence, and eliminate abnormal cells. True False Question 48 3 pts Inherited genetic abnormalities account for only a small proportion of cancer. Most experts believe that lifestyle habits and environmental exposures cause the majority of cancers. True False
48. The statement is true
49. . The statement is true
50. The statement is false
How do we explain?The field of environmental health originated in an attempt to reduce exposure to infectious diseases. It has since broadened to include all external factors (chemical, biological, and physical) that can potentially affect health.
50: Changes in the habits of individuals realistically have very minor effects on the environment.
Cell division is a highly regulated process with multiple mechanisms in place to ensure controlled cell division, repair DNA mutations, and eliminate abnormal cells.
48:
Inherited genetic abnormalities or mutations play a relatively small role in the development of most cancers. The majority of cancers are believed to be caused by a combination of lifestyle habits (such as tobacco use, poor diet, lack of physical activity) and environmental exposures.
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1. A 4-year-old child weighing 17.5 kg is to receive Fluconazole for systemic candida infection. The available adult dose is 150 mg. The safe dose range is 6 - 12 mg/kg/day not to exceed 600 mg/day. The Fluconazole is to be given IV bolus for day 1 and orally qday for 3 days. It is available in the following dosage form strength: injection solution 2 mg/mL and oral suspension 40 mg/mL. a) Compare how much the child is going to receive per dose using the Young's and Clark's rules and the dose range for the child? (2 marks) b) Based on your calculations in a) above, which of the rules give a safe dose for the child and why? (2 marks) c) What volume of the medication will be administered on day one if the doctor orders a dose of 120 mg? d) What volume of the medication will be administered on day 2 for the doctor's order?
Using Clark's rule, the total volume is 48 mL. Using Young's rule, the total volume is 2,875 mL. The volume of medication required on day one is 0.8 mL. The volume of medication required on day two is 3 mL.
a) To compare the amount of medication the child will receive using Young's rule and Clark's rule, we need to first calculate the total volume of the medication required based on the child's weight and the appropriate dose. Using Young's rule, we can calculate the total volume as 17.5 kg x 150 mg/kg = 2,875 mL. Using Clark's rule, we can calculate the total volume as 4 kg x 12 mg/kg = 48 mL.
To compare the amount of medication the child will receive using the safe dose range and the appropriate dose for the child, we can calculate the total volume as 17.5 kg x 6 - 12 mg/kg/day x 600 mg/day = 12,600 mL.
b) Based on the calculations in part a, Clark's rule provides a safe dose for the child because it falls within the recommended safe dose range of 6 - 12 mg/kg/day. Young's rule does not provide a safe dose as the calculated volume exceeds the recommended dose range.
c) To calculate the volume of medication to be administered on day one, we need to first calculate the appropriate dose based on the child's weight and the available dose strength. The appropriate dose for the child is 120 mg, which falls within the safe dose range of 6 - 12 mg/kg/day. The volume of medication required is 120 mg / 150 mg/kg = 0.8 mL.
d) To calculate the volume of medication to be administered on day two, we need to first calculate the appropriate dose based on the child's weight and the available dose strength. The appropriate dose for the child is 120 mg, which falls within the safe dose range of 6 - 12 mg/kg/day. The volume of medication required is 120 mg / 40 mg/mL = 3 mL.
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International pacemaker code – chamber sensed, chamber paced,
etc. – what does each letter represent?
The International Pacemaker Code (IPC) is a standardized set of letters used to describe the various functions of pacemakers. The IPC consists of five letters that describe various functions of the pacemaker, such as chamber sensed, chamber paced, etc.
These letters are used by medical professionals to help identify the pacemaker functions of a particular patient and to communicate that information to other medical professionals.
Here's what each letter in the IPC represents: Letter "O": Refers to a pacemaker that does not have sensing capability and therefore will pace regardless of whether or not the heart has initiated a beat.
Letter "I": Refers to a pacemaker that can sense activity in the right atrium of the heart and therefore initiate pacing if necessary.
Letter "II": Refers to a pacemaker that can sense activity in the right atrium and ventricle of the heart and can initiate pacing in either chamber.
Letter "III": Refers to a pacemaker that can sense activity in the right atrium and ventricle of the heart, but can only initiate pacing in the ventricle.
Letter "IV": Refers to a pacemaker that can sense activity in both the atria and ventricles, but can only initiate pacing in the ventricles.
In short, the five letters in the International Pacemaker Code represent the sensing and pacing capabilities of a pacemaker.
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According to the course textbook patients in early anemia are often asymptomatic. At what hemoglobin level are symptoms likely to appear?
According to the course textbook, patients with early anemia are often asymptomatic. Symptoms of anemia may not show in the early stage of anemia. Symptoms are likely to appear on the hemoglobin level below 10g/dL.
Symptoms of anemia appear when hemoglobin levels drop significantly and oxygen transport to the tissues and organs is reduced. The symptoms of anemia usually appear when the hemoglobin levels fall below 10g/dL. Symptoms of anemia often include dizziness, weakness, headaches, fatigue, shortness of breath, pallor, cold hands and feet, and rapid heartbeat.
Hemoglobin is the protein that is present in the red blood cells. It helps in the transportation of oxygen from the lungs to other parts of the body. Hemoglobin carries oxygen in the form of oxyhemoglobin. Oxyhemoglobin is the bright red-colored form of hemoglobin.
To ensure adequate tissue oxygenation, a sufficient hemoglobin level must be maintained. The amount of hemoglobin in whole blood is expressed in grams per deciliter (g/dl). The normal Hb level for males is 14 to 18 g/dl; that for females is 12 to 16 g/dl. When the hemoglobin level is low, the patient has anemia.
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What advantages can your identify for transmitting electronic claims? Are there any potential disadvantages as well?
Electronic claims transmission is an electronic system of sending medical claims to the insurance companies. The transmission of electronic claims is faster and efficient than the traditional method of filing insurance claims through paper claims.
Electronic claims have a faster processing time, which ensures faster payments to the providers. Electronic claims reduce the claim denial rate compared to paper claims. Electronic claims eliminate the cost of printing, mailing, and processing paper claims, thereby, reducing the overall administrative costs of healthcare providers. Electronic claims improve the accuracy of medical claims and reduce errors associated with handwritten paper claims. Additionally, electronic claims reduce the need for repetitive data entry into the system. Electronic claims also streamline the processing of medical claims by reducing the need for manual intervention.
Electronic claims require a high level of technical proficiency to complete the process, which might be challenging for some providers. The initial cost of implementing the electronic claims system might be high for smaller providers or practices. The possibility of a data breach or privacy violation is higher with electronic claims, and the safety of patients' electronic health records needs to be guaranteed. The electronic system is prone to downtime or system malfunction, which can result in delayed or lost claims. In such situations, the claim has to be re-submitted, which can lead to additional costs to the provider.
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John is an 83 year old client. He is simply frail, slightly
confused and has chronic cardiac fatigue. He uses a 4WF to ambulate
and has a normal diet. He needs support with his ADL’s.
John is an elderly client who is 83 years old. He uses a 4WF to ambulate and is described as frail and slightly confused with chronic cardiac fatigue. Furthermore, he needs support with his ADLs, but he maintains a typical diet.
In the healthcare setting, ADL (Activities of Daily Living) refer to basic daily self-care tasks, such as bathing, dressing, toileting, grooming, eating, and ambulating. Because John has difficulty with these activities, he requires assistance to accomplish them.
Therefore, the caregiver must offer the necessary support to ensure that John is comfortable and has everything he needs. John's environment should be safe, easily accessible, and well-lit to avoid falls or other accidents. Additionally, regular exercise and physical therapy can help him improve his mobility and overall well-being. If necessary, the caregiver may need to monitor John's blood pressure and administer his medication. Finally, John's physician should be informed of his progress and any concerns.
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1. Stereotactic radiosurgery performed after the resection of a malignant meningioma is an example of which type of therapy? a. myeloblation b. immunosuppression c. neoadjuvant d. adjuvant
2. A patient with a BSA 1.8 m2 received six cycles of doxorubicin 30mg/m2. This patient's cumulative dose of doxorubicin is: a. 180mg b. 324mg c. 30mg d. 54mg
14. The nurse is exposed to a hazardous medication through ingestion by: a) drinking in an area where chemotherapy is administered b)pushing chemotherapy through an implanted port c)splashing chemotherapy into the eyes d)breathing in aerosolized particles from a chemotherapy spill
17. a patient is receiving bleomycin and reports dyspnea on exertion. the nurse anticipates an order for a: a)ventilation scan b)pulmonary function test c) computed tomography scan d)peak flow meter
26. which of the following methods should the nurse use to overcome barriers to patient education? a)allow misconceptions related to diagnosis b) limit time of questions c) provide effective symptoms management d)utilize significant others as translators
35. a patient with acute myeloid leukemia has had prior treatment with doxorubicin, bleomycin, vincristine, and dacarbazine. the physician withholds treatment with idarubicin because of: a) cumulative dose toxicity b) cytokine-release syndrome c) acute hypersensitivity reaction d) dose-limiting toxicity
49. the nurse questions administration of chlorambucil when: a)the platelet count is 385,000/mm3 b)radiation was completed 3 months ago c)a patient has fanconi syndrome d)daily doses of phenytoin are ordered
53. what type of precautions should be used when changing the dressing after an intradermal injection of talimogene laherparepvec? a)airborne b)contact c)standard d)droplet
55. symptoms of acute hypersensitivity reactions include: a)increased blood pressure and hypothermia b)shortness of breath and confusion c) neutropenia and thrombocytopenia d)headache and pustular rash
58. which of the following chemotherapy agents has the highest emetogenic potential? a)docetaxel b)carmustine c)irinotecan d)vincristine
60. which of the following is an example of proper glove use when administering hazardous drugs? a)changing chemotherapy gloves every house b)wearing two pairs of gloves over the cuff of the gown c)using powder-free chemotherapy gloves d)removing double gloves at the same time
Stereotactic radiosurgery performed after the resection of a d. adjuvant
a. 180mga) drinking in an area where chemotherapy is administeredb) pulmonary function testc) provide effective symptoms managementa) cumulative dose toxicityc) a patient has Fanconi syndromeb) contactb) shortness of breath and confusionb) carmustinec) using powder-free chemotherapy glovesWhat is the Stereotactic radiosurgery?Stereotactic radiosurgery acted after the medical procedure of a diseased meningioma is an example of secondary medicine.
Adjuvant therapy refers to supplementary situation given afterwards the basic treatment, to a degree enucleation, to reduce the risk of tumor repetition or to eliminate some surplus cancer containers.
The nurse is unprotected to a hazardous drug through swallow by drinking in an region place chemotherapy is executed. It is main to avoid consuming, draining, etc.
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the client living at the long-term care home is to be bathed
this evening. as per the care plan, the client is not allowed to
shower and is totally dependent. how will you provide a complete
bed bath?
When a client living in a long-term care home is not allowed to shower and is completely dependent, a complete bed bath should be given as per the care plan. The bed bath should be provided following the necessary hygiene protocol in order to avoid infection.
The complete bed bath should start with washing the face and progress from head to toe. Firstly, gather all the necessary equipment that is needed. The equipment will include basin, warm water, soap, towel, clean linens, and a change of clothes.Once the equipment is collected, make sure to ensure the client's privacy is maintained at all times. Use the water and soap to wet the washcloth. Then start cleaning the client's eyes, ears, nose, and face gently, taking care not to use too much water.
Once the face is washed, clean the neck and chest. Then move down the arms, starting with the upper arms and shoulders, before washing the lower arms and hands. Next, the back and buttocks should be washed, moving down to the legs, with attention to all the folds and crevices, including the genitals. Finally, the feet are washed. To maintain the dignity of the client, the body should be covered with a towel or sheet except for the area being washed. To ensure that the client is comfortable, it is advisable to make sure they are adequately covered after the bath is complete.
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MS II: Cardiovascular disorder case study: HF
Scenario: An 82-year-old woman with a history of chronic heart failure is in the Emergency Department with increased dyspnea, extreme fatigue, and a non-productive cough. She states that she can hardly walk to the bathroom from her bedroom without having to stop to rest. Her lower legs are swollen with 3+ edema, and she states that she has gained about 8 pounds over the past few days. When questioned about her medications, she states, "I have been skipping my fluid pill because I hate having to go to the bathroom so much. I get so short of breath."
Vital signs: Temperature 99.9°F (37.7°C), Pulse 110/bpm and regular, Respirations 28/min, Blood Pressure 188/98 mm Hg.
She is admitted to the telemetry unit with a diagnosis of exacerbation of heart failure, and given prophylactic anticoagulant therapy, aggressive diuretic therapy, as well as an ACE inhibitor. After a week, the nurse documents the following assessment findings.
NGN Item Type: Matrix
For each assessment finding, use an X to indicate whether the interventions were Effective (helped to meet expected outcomes), Ineffective (did not help to meet expected outcomes), or Unrelated (not related to the expected outcomes).
Assessment Finding
Effective
Ineffective
Unrelated
Edema in the lower legs is measured at 3+ bilaterally.
Patient can walk to the bathroom and back without becoming fatigued and short of breath.
Patient states that she will take her diuretic every morning by 9 AM.
Body temperature maintained at 99°F (37.2°C) or below.
Weight has increased by 2.2 kg in 2 days.
Patient can balance physical activity with periods of rest to avoid over-exertion.
The patient reports no chest pain with exertion.
The patient’s morning blood pressure is 180/94.
Rationale: Explain your reasons for your decisions
What diagnostic test/procedure should be included in this patient’s care?
An echocardiogram uses ultrasound to evaluate the structure and function of the heart, including assessing the ejection fraction (a measure of the heart's pumping ability),
Based on the provided information, the patient is experiencing exacerbation of heart failure with symptoms such as increased dyspnea, extreme fatigue, non-productive cough, significant lower extremity edema, and weight gain. The nurse is assessing the effectiveness of interventions implemented during the patient's hospital stay.
Assessment Finding | Effective | Ineffective | Unrelated
--- | --- | --- | ---
Edema in the lower legs is measured at 3+ bilaterally. | X | |
Patient can walk to the bathroom and back without becoming fatigued and short of breath. | | X |
Patient states that she will take her diuretic every morning by 9 AM. | X | |
Body temperature maintained at 99°F (37.2°C) or below. | X | |
Weight has increased by 2.2 kg in 2 days. | | X |
Patient can balance physical activity with periods of rest to avoid over-exertion. | X | |
The patient reports no chest pain with exertion. | X | |
The patient’s morning blood pressure is 180/94. | | X |
Rationale:
1. Edema in the lower legs is measured at 3+ bilaterally: This assessment finding is marked as effective because the intervention of aggressive diuretic therapy is aimed at reducing fluid retention and relieving edema.
2. Patient can walk to the bathroom and back without becoming fatigued and short of breath: This assessment finding is marked as ineffective because the patient is still experiencing fatigue and shortness of breath with exertion, indicating that the intervention has not completely relieved these symptoms.
3. Patient states that she will take her diuretic every morning by 9 AM: This assessment finding is marked as effective as the patient expresses compliance with the prescribed medication regimen, which is important for managing fluid retention and heart failure symptoms.
4. Body temperature maintained at 99°F (37.2°C) or below: This assessment finding is marked as effective as the patient's body temperature is within the expected range, indicating stability.
5. Weight has increased by 2.2 kg in 2 days: This assessment finding is marked as ineffective as the weight gain indicates ongoing fluid retention and inadequate response to diuretic therapy.
6. Patient can balance physical activity with periods of rest to avoid over-exertion: This assessment finding is marked as effective as the patient demonstrates the ability to manage physical activity and rest to prevent excessive exertion.
7. The patient reports no chest pain with exertion: This assessment finding is marked as effective as the absence of chest pain indicates improved cardiac function and reduced ischemia.
8. The patient’s morning blood pressure is 180/94: This assessment finding is marked as ineffective as the blood pressure reading is elevated, suggesting inadequate control of hypertension, which is important in managing heart failure.
Based on the information provided, an important diagnostic test/procedure that should be included in this patient's care is an echocardiogram.
An echocardiogram uses ultrasound to evaluate the structure and function of the heart, including assessing the ejection fraction (a measure of the heart's pumping ability), identifying any structural abnormalities, and evaluating the overall condition of the heart muscle.
This test will help determine the underlying cause and severity of the patient's heart failure and guide further management and treatment decisions.
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Top Case 2 H.L is a 46-year-old man who is relatively healthy but obese (weight: 250 lb; height: 5 ft, 9 in). He comes to the clinic to see the nurse practitioner with the following statement: "I must have pulled something in my right leg. I was walking when I felt some soreness in my lower right leg, and now there is some swelling. It really hurts to walk." He states that he is a self-employed developer of computer software programs. Reports sitting for hours at the computer with few breaks. Occasionally remembers to exercise feet and lower legs. Right calf pain and swelling began 3 days ago. Reports discomfort increases when walking. Swelling and pain improve when the leg is elevated. Reports no color or temperature changes in his arms or left leg, and no pain in the left leg. but reports having mild to moderate pain in the right lower leg, especially when he is up and moving around. States he has taken acetaminophen 1,000 mg 2-3 times per day to relieve leg pain. He has hypertension and hyperlipidemia, both controlled by medication. Has had no angina since his coronary artery bypass graft (CABG) 5 years ago. He developed pulmonary embolism following surgery. No other previous surgeries on veins or arteries. Nonsmoker and drinks occasionally and exercises by walking a few blocks most days. Denies problems with sexual activity. 7. Identify a minimum of three subjective cues (risk factors) that are clinically significant and provide a brief rationale for each cue 8. Based on the clinically significant data, what health condition is the client experiencing 9. Using your words, describe the pathophysiology consistent with this condition 10. What objective signs will you anticipate on inspection and palpation 11. Discuss one health promotion teaching 12. Based on the information, discuss one older adult's consideration
Based on the provided information, the client is experiencing symptoms and risk factors that are clinically significant for deep vein thrombosis (DVT), a condition characterized by the formation of blood clots in the deep veins, usually in the lower extremities.
1. Subjective cues (risk factors):
a. Prolonged sitting with few breaks: The client's sedentary occupation and prolonged sitting increase the risk of DVT. Immobility slows down blood flow, promoting the formation of blood clots.
b. Obesity: The client's weight of 250 lb and height of 5 ft, 9 in indicate obesity. Obesity is a risk factor for DVT as it can impair blood circulation and increase the strain on the veins.
c. Previous pulmonary embolism: The client's history of developing pulmonary embolism following coronary artery bypass graft (CABG) surgery suggests a higher risk for recurrent thrombosis.
8. Based on the clinically significant data, the client is experiencing deep vein thrombosis (DVT), which is the formation of blood clots in the deep veins, commonly in the legs.
9. Pathophysiology consistent with DVT:
The prolonged sitting and obesity contribute to reduced blood flow and stasis in the deep veins of the lower leg. This stagnant blood flow predisposes to the formation of blood clots, which can obstruct the veins and cause symptoms such as pain, swelling, and tenderness.
10. Objective signs anticipated on inspection and palpation may include:
- Swelling and edema in the affected leg, especially in the calf area.
- Warmth and erythema (redness) over the affected area.
- Tenderness or pain on palpation of the calf muscles or along the course of the affected vein.
- Possible visible or palpable cord-like structure (thrombosed vein) in the affected leg.
11. Health promotion teaching:
It is important to educate the client about the importance of regular movement and avoiding prolonged periods of sitting. Encouraging frequent breaks, leg exercises, and calf muscle contractions during prolonged sitting can help improve blood circulation and reduce the risk of DVT.
12. Older adult's consideration:
Older adults may have an increased risk of DVT due to age-related factors such as decreased mobility, changes in blood clotting mechanisms, and comorbidities. Careful monitoring and appropriate preventive measures should be taken to reduce the risk of DVT in older adults.
In conclusion, the client in the case study is presenting with subjective cues and risk factors suggestive of deep vein thrombosis (DVT), including prolonged sitting, obesity, and a history of pulmonary embolism. The pathophysiology of DVT involves reduced blood flow and stasis in the deep veins, leading to the formation of blood clots.
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A prician report to the nurse? cud sequenual compression device to a patient. Which of the following should the
technician report to the nurse?
A. Discoloration to the extremity
B. Palpable pulse in the extremity
C.
Extremity is warm to touch
D. Decrease in edema to the extremity
As per the given question, a prician report to the nurse about sequential compression device to a patient, the technician should report A. Discoloration to the extremity to the nurse.
Sequenual Compression Device (SCD) is a device that helps prevent blood clots in the legs of a patient. It is usually given to those who have undergone surgery or who are critically ill. The SCD machine pumps up and deflates the leg cuffs to prevent blood from accumulating and causing clots.
The technician should report discoloration of the extremity to the nurse immediately because it can indicate a lack of blood flow to the area. When blood flow is impeded, oxygen and nutrients cannot reach the tissues, which can lead to tissue damage or even necrosis. Discoloration to the extremity may also indicate that the SCD device is too tight, which can also lead to further complications. Therefore, the technician must report the discoloration to the nurse without any delay.
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Patient: Maria
Gender: Female
Age: 35
Ethnicity: Central America
Setting: Inpatient hospital psychiatric unit
Spiritual /Religious: Catholic
Cultural Considerations: Hispanic culture, rural Nicaraguan
Socioeconomic: Raised by poor parents; now upper middle class
Medications: Birth control, Lithium Carbonate (Eskalith), Olanzapine (Zyprexa)
Client Profile
Maria is a 35-year-old married female born and raised in a small village in Nicaragua, Central America. Her parents are poor. Her husband is a university professor who is serving as a Peace Corps worker when they met. She has been in the United States for two years and speaks a little English but requires Spanish for clear understanding. They have a 4-year-old daughter. Maria has been diagnosed with Bipolar 1 and takes Lithium Carbonate. Recently she stopped taking her lithium and has been staying up all night and eating very little. She is dressing and behaving in a sexually proactive manner and going on spending sprees buying things she does not need and cannot afford (motorcycle that she does not know how to ride and drum set that she does not know how to play). Her husband decides she is out of control and calls Maria’s provider who suggests admission to the psychiatric unit of the hospital.
Case Study
During the admission process, the nurse observes that Maria is dressed in a short and tight-fitting dress. Her speech is clear but sprinkled with profanity as she moves rapidly from topic to topic. At the nurse’s request, Maria sits down, then jumps up and moves about the room.
Maria’s husband says that Maria has stopped taking her lithium and has not been sleeping or eating enough. He describes her extravagant purchases, some of which were returned or given away to strangers (Maria gave her drum set to a man she met in a bar). The husband explains that Maria has put the family in serious debt and states she is unfit to care for their child. With her husband translating for her, Maria objects to being admitted to the hospital, but then agrees to admission. The husband expresses concern about her sexually provocative behavior and states he fears that she will get sexually involved with other clients.
After the first meal after admission, Maria is in the dinning room with the other clients. Instead of eating, Maria carries napkins to, and talks to, all the other clients and ignores the food. Staff members have told Maria several times to sit down and eat, and she has not complied.
The nurse asks the dietitian to prepare a sandwich and a banana for Maria. After the clients are finished with lunch, the nurse suggests Maria go to her room to wash her face and hands. The psychiatrists-ordered pregnancy test comes back negative. The psychiatrist orders Lithium, Zyprexa, and birth control pills.
At medication time, the nurse gives Maria her medication and then examines Maria’s mouth. The nurse does some teaching about the medications with Maria, who becomes upset when she learns she has been prescribed birth control and says she will not take it as it is not allowed in her religion.
The nurse notices that Maria is irritable and verbally hostile at times as well as inappropriate during her first days on the unit. During one encounter with Maria, the nurse senses great hostile energy coming from Maria, who says, "You think you so smart! You don’t know nothing!" Sometimes Maria is demanding or threatening. For example, she demands that the nurse send someone to the store to pick up items for her and take her credit card to pay for them. Maria continues to dress and talk in a sexually proactive manner. She asks the male nurse, who passes medications in the early morning, to perform some sexual acts with her. At one-point Maria is intrusive with another client in the day room and the client is threatening to harm Maria. The nurse observes that both clients are loud, and their behavior is escalating.
After one month, during a meeting of the psychiatric treatment team, the provider discusses Maria’s past psychiatric history, which includes two episodes of depression and one of mania. He offers a diagnosis of Bipolar 1, Manic episode for Maria. He orders that blood be drawn for a Lithium level. The Lithium level comes back as 1.5.
Questions
Why did the nurse ask the dietitian to prepare a sandwich and a banana for Maria, and why did the nurse take Maria to her room?
The nurse asked the dietitian to prepare a meal for Maria because she was not eating and took her to her room to ensure she could eat without distractions.
The nurse asked the dietitian to prepare a sandwich and a banana for Maria because she observed that Maria did not eat during the meal in the dining room and instead engaged in socializing with other clients. It was important to ensure that Maria received some nourishment to meet her dietary needs. The nurse took Maria to her room to wash her face and hands likely because Maria was not complying with staff members' instructions to sit down and eat.
By taking her to her room, the nurse created a more controlled environment where Maria could focus on personal hygiene and potentially eat the prepared meal without distractions or disruptions from other clients. This would help address Maria's lack of eating and ensure her well-being and nutritional needs were being met while in the psychiatric unit.
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You will get down vote if you copy the answer from other
questions or get it wrong
Which of the following codes is used for submitting claims for services provided by Physicians? A. LOINC B. CPT C. ICD-CM D. SNOMED-CT
The correct code used for submitting claims for services provided by physicians is B. CPT (Current Procedural Terminology).
CPT codes are a standardized system developed and maintained by the American Medical Association (AMA). These codes are used to describe medical, surgical, and diagnostic services provided by healthcare professionals, including physicians. CPT codes provide a detailed and specific way to document and bill for procedures, surgeries, evaluations, and other medical services. They allow for accurate identification and communication of the services rendered, facilitating claims submission and reimbursement processes.
CPT codes are regularly updated to accommodate new procedures and technologies, ensuring accurate coding and billing for physician services.
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