There may be corporate negligence in this case, as Quadrangle Sunrise Senior Living Center potentially breached its duty of care by failing to address the complaints of abuse made by McCallister's family and dismissing them as products of her dementia. The resulting injuries and damages suffered by McCallister are evident from the video evidence. Causation can be established by showing that, but for the negligence of Quadrangle Sunrise Senior Living Center, McCallister would not have suffered the abuse and harm she did.
Quadrangle Sunrise Senior Living Center had a duty to use due care in providing a safe and appropriate environment for its residents, including McCallister. The duty of care required the facility to reasonably address and investigate any complaints of abuse or mistreatment made by residents or their families. In this case, the family of McCallister contacted Quadrangle administrators in March, reporting allegations of physical abuse. However, the facility failed to adequately respond to these complaints and instead dismissed them as products of McCallister's dementia, thus breaching the duty of care.
The standard of care in this situation would involve promptly investigating and addressing the allegations, ensuring the safety and well-being of the residents. Quadrangle Sunrise Senior Living Center's failure to take appropriate action amounts to a breach of duty.
The injuries and damages suffered by McCallister are evident from the video evidence obtained by her family. The video shows taunting, physical abuse, and the care managers blocking her escape from the room. These actions caused emotional distress, physical harm, and a violation of her rights as a care-dependent person, constituting actual damages.
Causation can be established by demonstrating that the negligence of Quadrangle Sunrise Senior Living Center was the direct cause of McCallister's injuries and damages. But for the facility's failure to address the complaints and take appropriate action, McCallister would not have suffered the abuse and harm she did. Furthermore, it was reasonably foreseeable that neglecting such complaints and allowing abusive behavior to continue could result in harm to the residents.
2) If the court found no direct corporate negligence, Quadrangle could still be held liable under the theory of vicarious liability or respondeat superior. Vicarious liability holds employers responsible for the wrongful acts committed by their employees within the scope of their employment. In this case, the care managers who taunted and abused McCallister were employees of Quadrangle Sunrise Senior Living Center. If their actions were deemed to be within the scope of their employment, Quadrangle could be held liable for their actions, even if the corporation itself was not directly negligent.
3) The parent company, Sunrise Senior Living of McLean, Va., could potentially be held liable for the negligence of Quadrangle Sunrise Senior Living Center under the theory of corporate liability. To establish this, it would need to be shown that Sunrise Senior Living, through its governing board, exercised control over the operations and policies of Quadrangle. If it can be proven that the parent company's governing board had the authority to establish protocols and procedures for addressing complaints of abuse, and failed to do so, resulting in the harm suffered by McCallister, the board could be held liable for the negligence of Quadrangle. However, it is important to consult with legal professionals to evaluate the specific circumstances and applicable laws in order to determine the viability of such a claim.
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This is the section for you if you were placed into group three. Answer these questions independently. Respond to 2 other students from the 2 other groups regarding their postings.
Sam is a new nurse working the day shift on a busy medical-surgical unit. He asks his UAP to walk the patient in Room 244 while he admits another patient. The patient in Room 244 is a postangioplasty, and it would be the first time he has ambulated since the procedure. Sam tells his UAP to walk the patient only to the nurse's station and back. He also says that if the patient's heart rate rises more than 20 beats/min above the resting rate, the UAP should stop, have the patient sit, and inform Sam immediately.
1. Did Sam appropriately delegate in this scenario? If not, which of the five rights of delegation was not followed? Why?
2. The aide misunderstands Sam's instructions and instead ambulates the patient in Room 234, who is 3 days post-hysterectomy and has been walking in the halls for 2 days. Where did the breakdown in communication occur?
3. Who would be accountable for the outcome if the UAP had ambulated the patient in Room 244 as Sam instructed and the patient was injured during ambulation? Would it be Sam, who directed the UAP to ambulate the patient in Room 244, or the UAP?
4. According to the Nursing Today book note for where would you find information on the right task to delegate?
1. Yes, Sam has appropriately delegated in this scenario. Sam has given clear instructions to the UAP to ambulate the patient only to the nurse's station and back. If the patient's heart rate rises more than 20 beats/min above the resting rate, the UAP should stop, have the patient sit, and inform Sam immediately.
Sam has also instructed the UAP to walk the patient in Room 244 while he admits another patient. Sam has followed all the rights of delegation.
2. The breakdown in communication has occurred because the UAP misunderstood Sam's instructions. The UAP ambulated the patient in Room 234, who is 3 days post-hysterectomy and has been walking in the halls for 2 days. Sam had instructed to ambulate the patient in Room 244, but the UAP ambulated the patient in Room 234.
3. The UAP would be accountable for the outcome if he had ambulated the patient in Room 244 as Sam instructed, and the patient was injured during ambulation. The UAP would be accountable because he misunderstood Sam's instructions, and he has not followed the instructions properly. The UAP should follow the instructions given by the RN or the healthcare provider and provide quality care to the patient.
4. Information on the right task to delegate can be found in the Nursing Today book note for delegation. According to the Nursing Today book note, delegating the right task to the right person is essential for providing quality care to the patient. A nurse should delegate the task that matches the education, training, and experience of the UAP. The nurse should also consider the complexity and potential risk associated with the task while delegating. The nurse should delegate the task according to the state law and organizational policy.
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Define
- Black Box Warning
- Teratogenicity
- Toxic dose
- Lethal Doses
- Carcinogenicity
It's important to note that these definitions provide a general understanding of the terms, but specific details and considerations may vary depending on the context and the specific substances.
1. Black Box Warning: A black box warning is the strongest warning issued by the U.S. Food and Drug Administration (FDA) for prescription drugs. It is used to alert healthcare providers and patients about serious or potentially life-threatening risks associated with the use of a particular medication.
The warning is called a black box warning because it is presented in a black-bordered box at the top of the drug's prescribing information.
2. Teratogenicity: Teratogenicity refers to the ability of a substance, such as a drug or chemical, to cause birth defects or developmental abnormalities in a developing fetus when it is exposed to the substance during pregnancy. Teratogenic substances have the potential to interfere with normal fetal development and can lead to structural or functional abnormalities in the newborn.
3. Toxic dose: The toxic dose of a medication or substance refers to the amount or concentration at which it becomes harmful or toxic to the body. It is the dose at which adverse effects or toxicity can occur. The toxic dose may vary depending on the specific substance and individual factors such as age, weight, and overall health.
4. Lethal Doses: Lethal doses refer to the doses of a substance that are expected to cause death in a certain percentage of individuals or in a specific population. Lethal dose values are often determined through experiments or observations in animal models or, in some cases, from documented human cases. The lethal dose can vary depending on the substance and the route of administration.
5. Carcinogenicity: Carcinogenicity refers to the ability of a substance to cause or promote the development of cancer. Carcinogens are substances that can initiate or contribute to the development of cancerous cells in the body. Exposure to carcinogens, such as certain chemicals, drugs, or environmental factors, increases the risk of developing cancer over time.
It's important to note that these definitions provide a general understanding of the terms, but specific details and considerations may vary depending on the context and the specific substances or medications involved.
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What is Kentucky's reporting requirements for reporting
unprofessional or unsafe practices to the board of nurses and when
it would be appropriate to report such behavior.
The requirements for reporting unprofessional or unsafe practices to the board of nurses include risk to patient safety, violation of ethical standards & failure to meet professional standards.
Reporting such behavior to the board may be appropriate in the situations:
When the behavior poses a risk to patient safety:If you witness or become aware of any unprofessional or unsafe practices that could potentially harm patients, it is important to report them to the board. This includes situations where a nurse's actions or behaviors may compromise the quality of care provided.
Violation of ethical standards:If a nurse engages in unethical conduct, such as breaching patient confidentiality, engaging in fraudulent activities, or exhibiting unprofessional behavior, it may be appropriate to report these violations to the board.
Failure to meet professional standards:If a nurse consistently demonstrates a lack of competence or fails to adhere to the established standards of nursing practice, reporting to the board may be necessary to ensure patient safety and maintain the integrity of the profession.
It is important to note that each case may have unique circumstances, and it is crucial to consider the specific details and context of the situation before deciding whether reporting is appropriate. Consulting with a supervisor, legal counsel, or the Kentucky Board of Nursing can provide guidance and clarification on the reporting requirements and process in Kentucky.
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A physician has ordered methylprednisolone 300mg IV q 4 h. The vial label reads: Solu-Medrol 500 mg Act-O-Vial System (Single-Use Vial) - Each 4mL (when mixed) contains methylprednisolone sodium succinate equivalent to 500mg methylprednisolone How much methylprednisolone (in mL) will this patient require per dose? (Round to the nearest tenth)
Methylprednisolone 300mg IV q 4 h is equivalent to 2.4mL (when mixed) Solu-Medrol (500mg/4mL).
Methylprednisolone is a corticosteroid that is used to treat arthritis, blood disorders, severe allergic reactions, certain cancers, eye conditions, skin/kidney/intestinal/lung diseases, and immune system disorders. It decreases your body's natural defensive response and reduces symptoms like swelling and allergic-type reactions. A physician has ordered methylprednisolone 300mg IV q 4 h.
The vial label reads: Solu-Medrol 500 mg Act-O-Vial System (Single-Use Vial) - Each 4mL (when mixed) contains methylprednisolone sodium succinate equivalent to 500mg methylprednisolone.
Therefore, for each 300mg dose of methylprednisolone, 2.4mL of Solu-Medrol (500mg/4mL) will be required, rounded to the nearest tenth.
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Why does treatment of schizophrenia with typical antipsychotic
drugs induce Parkinson’s Disease-like symptoms?
The treatment of schizophrenia with typical antipsychotic drugs induces Parkinson’s Disease-like symptoms because these drugs inhibit the activity of the neurotransmitter dopamine in the brain.
This can lead to a deficiency of dopamine, which is involved in the regulation of movement and other functions
.Therefore, when dopamine levels are lowered, motor symptoms such as tremors, rigidity, and bradykinesia (slowness of movement) can occur, similar to those observed in Parkinson’s disease.
In addition, some typical antipsychotic drugs can block other neurotransmitter receptors, including acetylcholine and histamine receptors, which can also contribute to Parkinson’s Disease-like symptoms.
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write a paragraph about each of the 11 body systems explaining
what it is, how it works, and its functions/ capabilities
The body is a complex machine that has 11 different body systems. Each of these body systems works together to keep the body running efficiently. In this essay, I will be explaining each of the 11 body systems, how they work and their functions/capabilities.
1. The digestive system: This system is responsible for breaking down food into nutrients that can be absorbed by the body. It begins in the mouth, where food is chewed and mixed with saliva, and ends in the intestines, where nutrients are absorbed. The digestive system also eliminates waste from the body.
2. The respiratory system: This system is responsible for taking in oxygen and expelling carbon dioxide. Oxygen is taken in through the nose or mouth and travels through the trachea to the lungs. The lungs then exchange oxygen for carbon dioxide and exhale it out.
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What, according to your textbook, is a robust and useful theory?
What goes into creating a theory?
What is the difference between a theory and an idea?
Human nature is a broader concept than personality. The assumptions about human nature are reflected in the theories you will read. Looking at the list of six "dimensions for a concept of humanity" in the first chapter of your textbook (Feist et al., 2021), explain one of the dimensions in your own words and give an example.
One dimension of human nature mentioned in the textbook is "individual differences." This dimension recognizes that individuals vary in their thoughts, emotions, behaviors, and characteristics. It acknowledges the uniqueness of each person and emphasizes the importance of considering these individual differences in understanding human behavior.
According to the textbook, a robust and useful theory is one that is based on empirical evidence, provides a comprehensive explanation of phenomena, and has practical applications. Such a theory is supported by multiple research studies and has been tested and validated across different contexts and populations. It should offer insights into the underlying mechanisms and processes involved, allowing for predictions and interventions.
Creating a theory involves several steps. It typically begins with observation and the identification of patterns or relationships in data. From there, researchers develop hypotheses and formulate predictions based on existing knowledge and theories. These hypotheses are then tested through empirical research, using various research methods such as experiments, surveys, or qualitative analysis. The results of these studies are analyzed, and conclusions are drawn, which contribute to the development and refinement of the theory. The process of theory creation is iterative, as new evidence and ideas emerge, leading to further modifications and expansions of the theory.
The main difference between a theory and an idea lies in their level of development and empirical support. An idea is a concept or notion that has not been extensively tested or validated through research. It is often a starting point for further exploration and inquiry. In contrast, a theory is a well-established and systematically organized set of principles or explanations supported by empirical evidence and research. It provides a framework for understanding and predicting phenomena.
For example, some individuals may have a more introverted personality, preferring solitude and reflection, while others may be more extraverted, seeking social interactions and stimulation. Recognizing and considering these individual differences helps explain why people respond differently to various situations and interventions, and it highlights the need for personalized approaches in psychology and related fields.
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A client with elevated thyroxine is very anxious and agitated. The vita signs show blood
pressure 150/90 mmHg, the oral temperature is 103°F and the heart rate is 120 beats per minute.
Which of the following interventions should the nurse prioritize?
a) Place the client in cool environment away from high traffic areas
b) Administer a beta-adrenergic blocker intravenously
c) Place the client in NO status for a thyroidectomy procedure
d) Provide dark glasses to reduce glare and prevent irritation
a) Place the client in a cool environment away from high traffic areas.
Elevated thyroxine: Elevated thyroxine levels can indicate hyperthyroidism, a condition where the thyroid gland produces an excess amount of thyroid hormones.
Symptoms of hyperthyroidism include anxiety, agitation, increased body temperature, and increased heart rate.
Cooling environment: The nurse should prioritize placing the client in a cool environment away from high traffic areas. Hyperthyroidism can cause increased heat intolerance, and a cool environment.
It can help alleviate discomfort and prevent further elevation of body temperature.
High blood pressure: The client's elevated blood pressure of 150/90 mmHg indicates hypertension, which can be a result of increased sympathetic activity due to hyperthyroidism.
Placing the client in a cool environment can help lower blood pressure by reducing stress and promoting relaxation.
Intravenous beta-adrenergic blocker: While beta-adrenergic blockers may be used to manage symptoms of hyperthyroidism, administering them intravenously (option b) is not the priority in this scenario.
The client's elevated blood pressure alone does not necessitate immediate intravenous administration of a beta-blocker.
NO status for a thyroidectomy: The option to place the client in NO (nothing by mouth) status for a thyroidectomy procedure (option c) is not applicable in this situation. It is not mentioned or indicated that the client requires a thyroidectomy at this time.
Dark glasses: While providing dark glasses to reduce glare and prevent irritation (option d) may be helpful for eye-related symptoms associated with hyperthyroidism, such as photophobia or eye discomfort, it is not the priority intervention in this case.
In summary, in a client with elevated thyroxine, anxiety, agitation, and elevated vital signs, the nurse should prioritize placing the client in a cool environment away from high traffic areas.
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A 72-year-old male patient presents with low back pain. He is pale and tires easily. He states that he just plopped on his favorite chair and got sudden back pain that wraps around his back. His urinalysis reveals negative protein, SSA+2, increased ESR, and rouleaux formation. Which of the following is the most likely differentials? (Pick Two) a. Type II Diabetes b. Vertebral compression fracture c. Prostate cancer d. Large bowel adenocarcinoma e. Acute pancreatitis f. Kidney stone g. Viral hepatitis h. Multiple myeloma
The 72-year-old male patient presents with low back pain. He is pale and tires easily. He states that he just plopped on his favorite chair and got sudden back pain that wraps around his back. His urinalysis reveals negative protein, SSA+2, increased ESR, and rouleaux formation.
The most likely differentials for this case are vertebral compression fracture and multiple myeloma. These two diseases are the most likely ones based on the symptoms and the test results that the patient has provided.
Vertebral compression fracture: Vertebral compression fracture is the most common type of compression fracture, which happens when the front of a vertebra in the spine collapses. Vertebral compression fracture can happen due to sudden pressure on the spine such as from a fall or severe back strain.
The symptoms of vertebral compression fracture are back pain and stiffness, loss of height, kyphosis (humpback), and trouble breathing.
Multiple myeloma: Multiple myeloma is a cancer of the bone marrow cells that produce antibodies, also known as plasma cells. Multiple myeloma is a type of cancer that damages the bones, immune system, kidneys, and red blood cell count. The symptoms of multiple myeloma are bone pain, anemia, fatigue, frequent infections, weight loss, kidney damage, and nerve damage.
Therefore, vertebral compression fracture and multiple myeloma are the most likely differentials for this case.
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Which of the following is not a class of hormones? a) amines b) polypeptides c) steroids d) All of the above are classes of hormones.
Hormones are molecules produced by glands that are secreted directly into the bloodstream to regulate various physiological and behavioral activities in the body. There are three different types of hormones in the human body, which are: amines, polypeptides, and steroids. So, the answer is D) None of the above is not a class of hormones.
All three of the options given are classes of hormones, making option D the correct answer. Amines are derived from the amino acids tyrosine and tryptophan and include hormones like epinephrine, norepinephrine, and dopamine. Polypeptides are chains of amino acids, and examples include insulin and growth hormone. Steroids, on the other hand, are derived from cholesterol and include hormones like testosterone, estrogen, and cortisol. These three types of hormones are secreted in different ways and interact with different receptors in the body to elicit their effects.
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Order: kanamycin 15 mg/kg per day IV in 2 equally divided doses. How many mg will you administer to a patient who weighs 70 kg? 12 Find the BSA of a patient who weighs 80 kg and is 166 cm tall. 13 A patient weighing 100 lb must receive 15 mg/kg PO of a drug. How many 700 mg tablets will you administer? 350 mm
Kanamycin is an antibiotic used to treat severe bacterial infections and tuberculosis. This drug is not the drug of choice. This medication can be taken by mouth, injected into a vein, or injected into a muscle. Kanamycin belongs to the aminoglycoside group which works by inhibiting the production of proteins needed by bacteria to live.
To answer the following questions, you need to use the appropriate mathematical formulas.
Order kanamycin 15 mg/kg per day IV in 2 equally divided doses. How many mg will you administer to a patient who weighs 70 kg?
Answer To calculate the dose of kanamycin to give a patient, you need to multiply the patient's weight by the dose per kilogram. The dose per kilogram is 15 mg/kg per day. So, the total dose given is:
15 mg/kg x 70 kg = 1050 mg per day
Because the dose is divided into two administrations, the dose per administration is:
1050 mg / 2 = 525 mgSo you'd give 525 mg of kanamycin each time.
12 Find the BSA of a patient who weighs 80 kg and is 166 cm tall.
Answer: To calculate the patient's body surface area (BSA), you can use the Du Bois formula. This formula is:
BSA = 0.007184 x (body weight in kg)^0.425 x (height in cm)^0.725
So, the patient's BSA is:
BSA = 0.007184 x (80 kg)^0.425 x (166 cm)^0.725
BSA = 1.86 m^2
13 A patient weighing 100 lb must receive 15 mg/kg PO of a drug. How many 700 mg tablets will you administer?
Answer: To calculate the number of tablets given to a patient, you need to take a few steps:
1) Convert the patient's weight from pounds to kilograms. One pound is equal to 0.4536 kilograms. So, the patient's weight in kilograms is:
100 lb x 0.4536 kg/lb = 45.36 kg
2) Calculate the total dose required by the patient by multiplying the patient's body weight by the dose per kilogram. The dose per kilogram is 15 mg/kg. So, the total dose required is:
15 mg/kg x 45.36 kg = 680.4 mg3) Divide the total dose by the tablet strength to get the number of tablets administered. The strength of the tablets is 700 mg. So, the number of tablets given is:
680.4 mg / 700 mg = 0.97Since it is not possible to give a portion of the tablet, you should round the result up or down according to your doctor's or pharmacist's instructions. For example, if you round up the number of tablets given is:
1 tablet
About DosesDoses is the level of something that can affect an organism biologically; the greater the level, the greater the dose. In medicine, this term is usually reserved for the grades of drugs or other agents administered for therapeutic purposes.
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Which of the following is NOT associated with Guillain-Barre Syndrome?
A. pseudohypertrophy of skeletal muscles
B. ascending flaccid paralysis
C. paresthesias and numbness
D• respiratory failure
The option that is NOT associated with Guillain-Barre Syndrome (GBS) is A. pseudohypertrophy of skeletal muscles.
What is Guillain-Barre Syndrome?Guillain-Barre Syndrome (GBS) is an autoimmune neurological condition that affects the peripheral nervous system. The immune system attacks healthy nerves in the peripheral nervous system, resulting in paralysis, muscle weakness, and other symptoms, in this syndrome. GBS is a rare condition that affects approximately one person per 100,000 people in the population. GBS can occur in anyone, regardless of their age or gender. It affects people of both sexes equally and can occur at any age, but it is more common in men than in women.
Guillain-Barre Syndrome symptoms include:Weakness in the legs, arms, or both Tingling or numbness in the legs and arms (paresthesias)Unsteadiness and incoordination Progressive muscle weakness, often leading to paralysis of the legs, arms, breathing muscles, and faceMuscles that feel tender to the touchMuscle cramping or twitching, particularly in the arms, legs, or tongueDifficulty with eye movements, facial movements, chewing, swallowing, or speaking in severe casesGBS is a medical emergency that can lead to respiratory failure if not treated immediately, which is why it's essential to seek medical attention as soon as symptoms arise. A few symptoms, such as pseudohypertrophy of skeletal muscles, are not associated with Guillain-Barre Syndrome.
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A nurse is caring for a patient with multiple complex diagnoses. Which of the bigge informatics in nursing practice? O The nurse reviews information on the patients diagnosis that is embed the w nursing interventions O The nurse documents the patients vital signs and lab results in the O The nurse reviews information about the patient's medical history assessment documentation O The nurse enters nursing care plan data into the election
In nursing practice, utilizing informatics plays a significant role in managing patients with complex diagnoses. Among the options provided.
The biggest informatics influence would likely be the nurse reviewing information about the patient's medical history and assessment documentation.
When caring for a patient with multiple complex diagnoses, reviewing information about the patient's medical history and assessment documentation is crucial for effective nursing practice. This aspect of informatics involves accessing and analyzing comprehensive patient data, including past medical conditions, treatments, and current assessment findings. By utilizing electronic health records (EHRs) or other digital platforms, nurses can access a wealth of information that aids in understanding the patient's health status, identifying patterns, and making informed clinical decisions.
Through the review of medical history and assessment documentation, nurses gain insights into the patient's previous and current health conditions, which enables them to tailor nursing interventions to the specific needs of the patient. This informatics influence enhances patient safety by ensuring that interventions are evidence-based, align with established protocols, and consider the individual's unique health profile.
While other options such as documenting vital signs and lab results or entering nursing care plan data into an electronic system are also important aspects of nursing informatics, they may not carry the same weight as reviewing medical history and assessment documentation. These activities contribute to data collection, organization, and communication, which are essential for continuity of care and interprofessional collaboration. However, the review of medical history and assessment documentation provides a broader context for understanding the patient's overall health and informs the development of a comprehensive care plan.
Overall, leveraging informatics in nursing practice through the thorough review of medical history and assessment documentation empowers nurses to make informed decisions, improve patient outcomes, and deliver holistic care to individuals with complex diagnoses. By utilizing technology and data, nurses can better understand the patient's unique health journey and provide personalized interventions that address their specific needs, ultimately enhancing the quality and safety of patient care.
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Explain why one means of detecting a vitamin K deficiency is to
measure how quickly prothrombin in the blood can form a clot.
Vitamin K deficiency is detected by measuring the time taken by prothrombin in the blood to form a clot. Vitamin K plays a major role in blood clotting, which is necessary for stopping bleeding after an injury. It activates the liver to produce proteins that are necessary for blood clotting, including prothrombin. When vitamin K levels in the body are low, prothrombin is not made correctly, it can lead to bleeding problems. So, measuring how quickly prothrombin in the blood can form a clot is an effective method of detecting a vitamin K deficiency.
Prothrombin is a protein produced in the liver that helps in blood clotting. When blood clotting occurs, a series of proteins known as clotting factors come together to form a clot. These clotting factors are released in response to an injury and are activated by a chain reaction known as the coagulation cascade. Prothrombin is one of these clotting factors.
In vitamin K deficiency, prothrombin is not made correctly, and the blood takes a longer time to clot. Therefore, measuring how quickly prothrombin in the blood can form a clot is a reliable way of detecting vitamin K deficiency. It is worth noting that this test only measures the speed of prothrombin formation and not the overall level of vitamin K in the body.
Vitamin K is necessary for the absorption of vitamin B12:
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Mr. Jones, a 70-year-old professor, is 7 days post–laparoscopic cholecystectomy. He denies any pain at the surgical site, but he is complaining of fatigue, heart palpitations, and some shortness of breath. He says the palpitations started 2 days ago and last a few minutes. He denies fever, chest pain, nausea, vomiting, and diaphoresis. Past medical history: anterior wall MI 3 years prior. Social history: drinks three to four glasses of liquor a day, which he has done for 20 years; quit smoking after MI 3 years ago. Medications: metoprolol 50 mg once daily; simvastatin 40 mg once daily; aspirin 81 mg once daily. He forgets to take his aspirin often and misses a dose of other medications about once a week. Allergies: no known drug allergies. Physical examination: vital signs—temperature 97.5°F; pulse 118/minute and irregular; respirations 20/minute; blood pressure 126/74 mmHg. General: alert and oriented. Neck: no jugular vein distention, no bruits. Cardiovascular system: irregular rhythm, no gallops or murmurs. Lungs: bibasilar, fine crackles. Skin: warm and dry with no edema, cyanosis. Other: 12-lead EKG with evidence of anterior wall MI and atrial fibrillation with a ventricular rate of 118. Answer the following questions: 1. What are possible reasons for Mr. Jones’s new-onset atrial fibrillation? 2. Describe atrial fibrillation. 3. What are risks associated with atrial fibrillation? 4. What is Mr. Jones’s CHA2DS2-VASc score? What are treatment recommendations based on this score?
Possible reasons for Mr. Jones's new-onset atrial fibrillation include his history of myocardial infarction, age, and alcohol consumption.
Mr. Jones's new-onset atrial fibrillation can be attributed to several factors. Firstly, his history of anterior wall myocardial infarction increases his risk of developing arrhythmias. Secondly, his age of 70 years is also a risk factor for atrial fibrillation. Additionally, his chronic alcohol consumption, three to four glasses of liquor daily for 20 years, can contribute to the development of atrial fibrillation. Alcohol is known to disrupt normal cardiac electrical activity and increase the risk of arrhythmias. These factors collectively increase his susceptibility to atrial fibrillation in this case.
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Patterns of care and outcomes of outpatient percutaneous coronary intervention in the United States: Insights from Nationwide Ambulatory Surgery Sample
The article “Patterns of care and outcomes of outpatient percutaneous coronary intervention in the United States:
Insights from Nationwide Ambulatory Surgery Sample” by Shashidhar et al. examines the patterns of care and outcomes of outpatient percutaneous coronary intervention (PCI) in the United States using data from the Nationwide Ambulatory Surgery Sample (NASS) from 2011 to 2013.
The article states that there has been a steady increase in outpatient PCI procedures in the United States, with approximately 36% of all PCIs being performed in an outpatient setting in 2013. The majority of these procedures were performed in physician offices and non-hospital ambulatory surgery centers.
The study found that patients who received outpatient PCI were more likely to be younger, male, and have fewer comorbidities than those who received inpatient PCI. Patients who received outpatient PCI also had lower rates of in-hospital mortality, bleeding, and acute kidney injury, as well as shorter hospital stays and lower hospitalization costs.
However, the study also found that patients who received outpatient PCI had higher rates of 30-day readmissions and repeat revascularization procedures compared to those who received inpatient PCI. Additionally, the study found significant regional variation in the use of outpatient PCI, with the highest rates of outpatient PCI being performed in the Midwest and South regions of the United States.
In conclusion, outpatient PCI is a growing trend in the United States, with increasing numbers of procedures being performed in physician offices and non-hospital ambulatory surgery centers. While patients who receive outpatient PCI generally have better outcomes than those who receive inpatient PCI, there is also a higher risk of readmissions and repeat revascularization procedures.
Regional variation in the use of outpatient PCI also highlights the need for further research to identify best practices and standardize care across the United States.
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a) Identify the meaning of a fragility hip fracture and the impact this can have on an elderly person. b) Describe the specific situation in this case study. c) Using the Framework of Ethical Decision
The recovery process can be challenging, and individuals may experience pain, decreased mobility, loss of independence, and an increased risk of complications such as infections or blood clots. The overall impact can include a reduced quality of life, increased dependency on others, and a higher likelihood of long-term disability or mortality.
a) A fragility hip fracture refers to a broken hip bone that occurs as a result of minimal trauma or a fall from a standing height. It typically affects elderly individuals who have weakened bones due to conditions such as osteoporosis. Fragility hip fractures can have a significant impact on an elderly person's physical, emotional, and social well-being.
b) Specific Case Study: Mr. Johnson is an 80-year-old retired teacher living alone in a two-story house. He has a history of osteoporosis and has experienced several falls in the past due to his weakened bones. Unfortunately, one day while climbing the stairs, he loses his balance and falls, resulting in a fragility hip fracture. He is rushed to the hospital, where he undergoes surgery to repair the fracture.
c) Framework of Ethical Decision: When faced with ethical decisions related to the care of an elderly person with a fragility hip fracture, it is essential to consider several factors:
Autonomy: Respect Mr. Johnson's autonomy by involving him in decision-making regarding his treatment, rehabilitation, and long-term care options.
Beneficence: Ensure that the decisions made prioritize Mr. Johnson's well-being and aim to maximize his overall quality of life.
Non-maleficence: Take steps to prevent further harm to Mr. Johnson, considering the increased vulnerability and potential complications associated with fragility hip fractures.
Justice: Ensure fair and equitable access to healthcare services and resources for Mr. Johnson, taking into account his individual needs, preferences, and available support systems.
Dignity: Treat Mr. Johnson with respect, empathy, and dignity throughout his care journey.
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Jose, who is a new immigrant to Canada, is very happy because he and his family will no longer need to worry about how they will pay medical bills. This indicates that Jose is aware of which principle of medicare? O Comprehensiveness O Universality Accessibility Portability 1 pts
Jose, who is a new immigrant to Canada, is very happy because he and his family will no longer need to worry about how they will pay medical bills. This indicates that Jose is aware of the principle of universality of Medicare.
The principle of Universality of Medicare refers to the fact that all insured residents of a province or territory are entitled to the same level of health care irrespective of their financial situation, medical background, and geographic location.
Medicare must be administered, guided, and delivered in a way that does not differentiate among citizens in terms of their health requirements or health services. Medicare must, therefore, be designed in a manner that ensures that the accessibility of healthcare services is fair and equal
he principle of comprehensiveness indicates that Medicare should include all medically necessary services that are prescribed by a physician. This includes hospital care, physician services, laboratory and diagnostic services, and many other services.
The principle of portability indicates that people who move from one province or territory to another are entitled to continue their Medicare coverage. The principle of accessibility indicates that all Canadians should have reasonable access to medical care without financial or other barriers.
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Nurses are taught to, "do no harm." Discuss how medical
professionals who were involved in the Tuskegee study did or did
not adhere to this golden rule?
The medical professionals involved in the Tuskegee study did not adhere to the principle of "do no harm."
The Tuskegee study, conducted between 1932 and 1972, involved withholding treatment from African American men with syphilis to observe the natural progression of the disease.
This study violated several ethical principles, including informed consent, respect for autonomy, and beneficence.
The medical professionals involved failed to provide proper medical care and knowingly allowed harm to be inflicted upon the participants by withholding effective treatment.
By intentionally withholding treatment and concealing information from the participants, the medical professionals violated the fundamental principle of "do no harm." They not only failed to provide the necessary medical intervention but also prolonged the suffering of the participants and allowed the progression of a potentially deadly disease.
This disregard for the well-being and dignity of the individuals involved demonstrates a clear violation of the ethical obligations that medical professionals have to prioritize patient welfare and prevent harm.
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How long can a person with T2DM go without medication before
developing CKD stage 5 or any kidney issues?
There is no exact time frame for how long a person with T2DM can go without medication before developing CKD stage 5 or any kidney issues.
The duration of the development of kidney disease is subject to multiple factors. Maintaining healthy blood sugar and blood pressure levels, adopting a healthy lifestyle, quitting smoking, and following a well-balanced diet can help to reduce or delay the risk of kidney disease in people with T2DM.
Therefore, it's highly recommended to take medication prescribed by the doctor, adhere to a healthy lifestyle, and get regular check-ups to monitor and detect any signs of kidney damage at an early stage, such as urine tests, kidney function tests, and blood tests. It's best to talk to a doctor or healthcare provider for personalized guidance and advice on how to manage T2DM and reduce the risk of kidney disease.
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A client with acute kidney injury has a urine specific gravity of 1.035, blood urea nitrogen (BUN) of 40 mg/dL, and creatinine of 1.2 mg/dL. Urinalysis reveals no protein. Blood pressure is 89/60, heart rate 120beats per minute, and respiratory rate 30 breaths per minute. Which of the
following is the cause of this acute kidney injury?
a) Glomerulonephritis
b) Muscle injury
c) Nephrotoxic
d) Hypovolemic shock
The cause of acute kidney injury in the client among the options given is hypovolemic shock. Acute kidney injury (AKI) is an episode of complex medical syndrome that results in sudden damage to the kidney, leading to a drop in functional losses, occurring over hours or days. AKI is seen as an abrupt decline in glomerular filtration, evidenced by an increase in BUN and serum creatinine concentration, decreased urine output, or both.
Hypovolemic shock occurs as a result of decreased intravascular volume due to blood or fluid loss causing a sudden decrease in blood pressure, thereby lowering blood flow to the kidneys and the amount of blood and fluid the kidneys receive. It happens when there is a loss of extracellular fluid, the fluid that is present outside the cell. This results in the inability of the kidneys to excrete toxic metabolites from the body, impairing the filtration process. The typical etiology is blood loss, vomiting, diarrhea, or excessive sweating. In the context of the question, the cause of acute kidney injury is hypovolemic shock. The given blood pressure (89/60 mm Hg), heart rate (120 beats per minute) and respiratory rate 30 beats per minute indicates hypovolemia or a decreased volume of circulating blood with jeopardized renal perfusion, leading to a decline in urine output. The urine specific gravity of 1.035 indicates concentrated urine, which is a typical response to reduced fluid intake or volume depletion. Blood urea nitrogen (BUN) of 40 mg/dL and creatinine of 1.2 mg/dL suggests potential AKI causing increased nitrogenous waste accumulation.
(A) Glomerulonephritis which is an inflammation of the glomerulus or the tiny blood vessels in the kidneys is not the cause of AKI due to the absence of protein in the urine analysis.
(B) Muscle injury is irrelevant.
(C) Nephrotoxicity refers to substances that can harm the kidneys, and although it can cause AKI, hypovolemia is a more likely cause in this scenario according to the clinical findings and laboratory values.
Thus, the correct answer is (D) hypovolemic shock.
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One important aspect of interprofessionalism is for all team members to have the ability and confidence to contribute to decisions about patient care regardless of hierarchy/profession-based boundaries.
How do hierarchies affect the delivery of patient care?
How can you be mindful of hierarchies or traditional boundaries between professions in the future?
One important aspect of interprofessionalism is for all team members to have the ability and confidence to contribute to decisions about patient care regardless of hierarchy/profession-based boundaries.
Hierarchies affect the delivery of patient care in the sense that these systems create certain professional expectations that a team member of a particular position should or should not do something. This ultimately creates an environment where the overall quality of care may be jeopardized if the healthcare worker does not feel comfortable sharing their thoughts. A lack of communication due to fear of crossing professional boundaries may lead to misunderstandings that could affect patient care negatively.
To be mindful of hierarchies or traditional boundaries between professions in the future, one may need to start by acknowledging the significant role of each member of the health team in patient care. One could respect each other's professions and value each other's input in patient care. Effective interprofessional collaboration requires an attitude of mutual respect for different professions and recognition of the value of diverse perspectives.
Thus, effective communication is the key to achieving better teamwork among professionals. One should keep in mind that no one profession is more important than the other and that the care of the patient is the primary focus of the healthcare team.
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Would a blood report for a drug that is not bound to plasma
proteins reflect what is present in the interstitial fluid? What is
the reasoning for your answer?
Blood reports are used to detect drugs or their metabolites present in the blood. However, the plasma proteins that are bound to drugs and their metabolites are not reported during the test.
As a result, a blood report for a drug that is not bound to plasma proteins will reflect what is present in the interstitial fluid. It is because the interstitial fluid is present in the spaces between cells and contains the drugs and their metabolites that have not yet entered the bloodstream. The blood report is used to determine the levels of drugs or their metabolites in the bloodstream at a particular point in time. Therefore, if a drug is not bound to plasma proteins, it is more likely to be present in the interstitial fluid than in the bloodstream. Consequently, a blood test for such a drug will show more accurate results for the amount of the drug or its metabolites present in the interstitial fluid than in the bloodstream.Answer:In summary, a blood report for a drug that is not bound to plasma proteins will reflect what is present in the interstitial fluid. The reason behind this is that interstitial fluid is present in the spaces between cells and contains drugs and their metabolites that have not yet entered the bloodstream. A blood test for such drugs will show more accurate results for the amount of the drug or its metabolites present in the interstitial fluid than in the bloodstream.
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10. An infant who weighs 22 lb is prescribed Ibuprofen 7.5mg/kg/dose prn for fever q8h. The safe therapeutic range is 5 to 8 mg/kg/dose. a. What are the minimum and maximum recommended dosages for the infant in mg? b. Is the dose safe and therapeutic? . Ans:
The minimum recommended dose for the infant is 49.5 mg/dose, and the maximum recommended dose is 79.2 mg/dose.
a. To calculate the minimum and maximum recommended dosage for the infant in mg:1 lb = 0.45 kgTherefore, the infant’s weight in kg is:22 lb × 0.45 kg/lb = 9.9 kg
To calculate the minimum recommended dose:
Minimum recommended dose = 5 mg/kg/dose × 9.9 kg= 49.5 mg/dose
To calculate the maximum recommended dose:
Maximum recommended dose = 8 mg/kg/dose × 9.9 kg= 79.2 mg/dose
Therefore, the minimum recommended dose for the infant is 49.5 mg/dose, and the maximum recommended dose is 79.2 mg/dose.
b. To determine whether the dose is safe and therapeutic:Infant’s prescribed dose = 7.5 mg/kg/doseTherefore, the infant’s prescribed dose = 7.5 mg/kg/dose × 9.9 kg = 74.25 mg/dose
Since the prescribed dose (74.25 mg/dose) falls within the safe therapeutic range (49.5 mg/dose to 79.2 mg/dose), the dose is both safe and therapeutic. Therefore, the dose prescribed is safe and therapeutic.
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49. A nurse is caring for an older adult patient with severe visual impairment. The nurse identifies that the client is at increased risk for, which of the following? Select all that apply a) Increase independence b) Depression and isolation c) Falls and injuries d) Medication errors 50. A nurse is caring for a group of patients, which of the following patients is at a higher risk for falls? a) A client with allergic conjunctivitis b) A client with acute Meniere's attack c) A client with presbycusis d) A client with unilateral cataract 20. A client with elevated thyroxine is very anxious and agitated. The vita signs show blood pressure 150/90 mmHg, the oral temperature is 103°F and the heart rate is 120 beats per minute. Which of the following interventions should the nurse prioritize? a) Place the client in cool environment away from high traffic areas b) Administer a beta-adrenergic blocker intravenously I c) Place the client in NPO status for a thyroidectomy procedure d) Provide dark glasses to reduce glare and prevent irritation 21. A client with a syndrome of inappropriate antidiuretic hormone (SIADH) is lethargic, confused, and complaining of muscle spam. The serum sodium 110 mEq/L which of the following interventions should the nurse prioritize? a) Initiate both seizure and fail precaution b) Start the 3% sodium chloride 3% infusion c) Fluid restriction of 800 ml per day d) Administer furosemide intravenously 23. A nurse is caring for a client with a syndrome of inappropriate antidiuretic hormone (SIADH), has a serum sodium 130 mEq/L, which of the following is the appropriate intervention for this client? a) Recheck serum sodium level b) Monitor the manifestations of dehydration c) Fluid restriction of 1 liter per day d) Encourage to increase oral intake 13. A client with acute adrenal insufficiency has a blood pressure of 86/40 mmHg, heart rate 115 beats per minute. Temperature 101.5-degree Fahrenheit. IV bolus initiated, which of the following should the nurse prioritize? a) Start vasopressor intravenously b) Begin regular insulin intravenously c) Taper corticosteroid therapy d) Administer desmopressin acetate
The nurse recognizes that the older adult patient with severe visual impairment is at an increased risk for depression and isolation, falls and injuries, and medication errors, options b, c & d are correct.
Visual impairment can significantly impact a person's quality of life, leading to feelings of depression and isolation. Difficulty in engaging in social activities and decreased independence can contribute to these psychological challenges.
Visual impairment increases the risk of falls and injuries due to impaired depth perception, reduced visual field, and difficulty identifying hazards in the environment. It can make it challenging for the patient to accurately read medication labels, distinguish between different medications, and administer the correct dosage, increasing the risk of medication errors, options b, c & d are correct.
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The question is inappropriate; the correct question is:
A nurse is caring for an older adult patient with severe visual impairment. The nurse identifies that the client is at increased risk for, which of the following? Select all that apply
a) Increase independence
b) Depression and isolation
c) Falls and injuries
d) Medication errors
1.which statement are true regarding chemical agent in the workplace? Choose all that apply.
Many chemicals in the workplace have not been tested for possible carcinogenic causation.
The chemical level considered safe may not be safe for everyone and the chemical may have cumulative effects.
A chemical which has already been determined to be non-carcinogenic could become carcinogenic when combined with another chemical.
Hepatitis B and C and HIV are example of chemical agents.
2.Why is it important to occupational nurse for a car manufacturer to frequently hold health promotion classes and screenings for the truck drivers employed with the company?
As the agent in the epidemiological triangle, truck drivers are most susceptible to occupational hazards.
Truck driver is the occupation with most days off from work force injuries.
The North American industry classification system (NAICS) list truck drivers most susceptible to occupational hazards.
Truck drivers are least likely of all workers to adhere to the use of personal protective equipment.
3.Which situation is the best example of how land can affect the health of individual and communities? Choose all that apply.
Cockroaches have been associated with asthma.
b. Lack of greenspace and parks have been associated with obesity.
c. Mudslides and flooding has been associated with injury and loss of life.
d. Fertilizer used on crops has been associated with cancer.
4.Which would be a secondary prevention strategy related to infectious disease intervention?
Safe food handling practices in the home.
Inspection of areas restaurants.
Immunoglobulin injection after hepatitis A exposure
Regulation and inspection of municipal water supplies.
Chemical agents in the workplace often lack comprehensive testing for carcinogenic causation due to resource constraints. Additionally, the safety levels defined may not be universally safe, as individuals can have varying sensitivities and cumulative effects can occur over time. Certain chemicals may even become carcinogenic when combined. However, it is important to clarify that hepatitis B, hepatitis C, and HIV are viral infections, not chemical agents.
For an occupational nurse in a car manufacturing company, conducting health promotion classes and screenings for truck drivers is crucial. Truck drivers face various hazards, including long hours of driving, ergonomic issues, and stress. Health promotion classes can educate them on managing these risks and promoting well-being. Regular screenings can detect early signs of occupation-related health problems such as musculoskeletal issues and fatigue. Addressing health concerns and promoting wellness among truck drivers can enhance productivity, reduce absenteeism, and improve job satisfaction.
Land can significantly impact health. Examples include cockroaches triggering asthma, limited greenspace contributing to obesity, mudslides and flooding causing injuries and displacements, and fertilizer contamination leading to potential cancer risks.
In terms of infectious disease intervention, a secondary prevention approach involves administering immunoglobulin injections after hepatitis A exposure to prevent or mitigate infection. Primary prevention strategies encompass safe food handling practices, restaurant inspections, and regulating municipal water supplies.
In conclusion, acknowledging the limitations of chemical testing, individual susceptibility, and chemical interactions is vital. Health promotion classes and screenings for truck drivers help address occupation-specific risks. Understanding how land affects health outcomes enables appropriate prevention strategies. Implementing secondary prevention measures like immunoglobulin injections can contribute to overall well-being.
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after 5 years of unprotected intercourse, a childless couple comes to the fertility clinic. the husband tells the nurse
After 5 years of unprotected intercourse, a childless couple comes to the fertility clinic. The husband tells the nurse, "We have been trying to conceive a baby for the past 5 years, but we have been unsuccessful."
The nurse would then begin by collecting information on the couple’s medical history, sexual history, and lifestyle habits to determine any factors that might be causing infertility. The nurse will then conduct a physical examination to check for any abnormalities that may be causing infertility.
The nurse would also collect semen and blood samples from the husband and urine and blood samples from the wife to test for any medical conditions that could be affecting fertility. In cases where infertility is caused by medical conditions such as endometriosis or uterine fibroids, the couple may be referred to a specialist for further treatment.
In cases where the cause of infertility is unknown, the couple may be advised to try assisted reproductive technologies such as in vitro fertilization (IVF) or intrauterine insemination (IUI).
The nurse will then discuss the couple's options and provide them with the necessary information and support to make an informed decision about their treatment plan. The nurse will also offer emotional support to the couple throughout the process as infertility can be emotionally challenging.
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10- What is the bicarbonate buffer system? How does the amount of blood CO2 affect the system? 11. How is net filtration pressure calculated? 12. Trace the flow of blood starting from the right atrium. 13. Draw the main parts of the male reproductive system.
10- The bicarbonate buffer system is a vital buffer system present in the human body. This buffer system helps in regulating the pH of the blood. It works by converting the excess hydrogen ions (H+) present in the blood into carbonic acid (H2CO3), which then dissociates into bicarbonate ions (HCO3-) and hydrogen ions (H+).
The bicarbonate ions then act as a buffer to balance the pH by binding with the extra H+ ions in the blood. If there is an increase in the amount of blood CO2, the bicarbonate buffer system works to counteract it by increasing the amount of H2CO3 formed, which then dissociates into HCO3- and H+.
11. Net filtration pressure (NFP) is the difference between the forces that promote filtration and the forces that oppose it. It is calculated using the following formula:
NFP = (HPc - HPif) - (OPc - OPif)
Where HPc is the hydrostatic pressure of blood in the capillary, HPif is the hydrostatic pressure of interstitial fluid, OPc is the osmotic pressure of blood in the capillary, and OPif is the osmotic pressure of interstitial fluid.
12. The flow of blood starting from the right atrium is as follows:
Right atrium → Tricuspid valve → Right ventricle → Pulmonary valve → Pulmonary artery → Lungs → Pulmonary vein → Left atrium → Mitral valve → Left ventricle → Aortic valve → Aorta
13. The main parts of the male reproductive system include the following:
- Testes: These are the primary male reproductive organs that produce sperm and testosterone.
- Epididymis: This is a coiled tube that connects the testes to the vas deferens. It stores and transports mature sperm.
- Vas deferens: This is a long, muscular tube that carries sperm from the epididymis to the urethra.
- Seminal vesicles: These are glands that produce a fluid that nourishes and protects sperm.
- Prostate gland: This is a gland that produces a fluid that makes up semen and helps nourish and protect sperm.
- Bulbourethral gland: This is a gland that produces a fluid that lubricates the urethra and helps to neutralize any acidity remaining in the urethra.
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When typing directions for pediatric medications, which of the following are examples of how to write the dose?
a)
Give 1 teaspoon (5 mL) three times a day.
b)
Give 1 tablespoon three times a day.
c)
Give 5 mL three times a day.
d)
Give 1 teaspoon three times a day.
When typing directions for pediatric medications, "give 1 teaspoon (5 mL) three times a day" and "give 5 mL three times a day" are two examples of how to write the dose.
The pediatric medication dosage is generally written in terms of milliliters (mL), and it's important to know the exact milliliter amount of the medication being given. Because children come in various shapes and sizes, the dose of medication is generally determined by weight or age.
It is recommended that medication be administered in the precise amounts directed by a doctor or pediatrician. A typical pediatric dosage for many medications is determined based on the child's age and weight. In general, pediatric medications are administered in milliliters (mL). Thus, "Give 1 teaspoon (5 mL) three times a day" and "Give 5 mL three times a day" are two examples of how to write the dose.
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Step 1 Read the case to formulate a priority nursing diagnosis
Step 2 Describe why you chose that diagnosis you did and the reason behind it (include cluster data support, method of prioritization, and Maslow hierarchy)
Mrs. K is a 68-year-old woman who presented to the emergency department with shortness of breath. She is unable to walk to her mailbox without becoming very winded.
Her assessment is as follows:
Neuro: A&O x 4, anxious
Cardiac: HR 105 bpm, bounding pulse, jugular venous distention (JVD),
Respiratory: crackles, dry cough, dyspnea on exertion (DOE)
GI: BS normoactive in all 4 quadrants, LBM yesterday
GU: decreased urine output
Peripheral/neurovascular: +3 pitting edema in bilateral lower extremities
Vitals:
T: 98.2 Oral
HR: 105 bpm apically
RR: 24
POX: 87% on RA, 93% on 2LPM nasal cannula
BP: 143/89 left arm
Weight: 185 lb (last visit to PCP in September she was 176 lb)
Labs:
Na: 130 mEq/L
K: 3.6 mEq/L
Mg: 2.2 mEq/L
Cl: 100 mEq/L
Ca: 8.6 mEq/L
She was diagnosed with heart failure and admitted to the med/Surg unit.
One priority nursing diagnosis for Mrs. K would be Ineffective Breathing Pattern.
Mrs. K is 68 years old and presented to the emergency department with shortness of breath. She was diagnosed with heart failure and admitted to the med/Surg unit. From her assessment, her Neuro reveals that she is anxious, cardiac reveals an elevated heart rate, bounding pulse, and jugular venous distention (JVD), Respiratory shows crackles, dry cough, and dyspnea on exertion (DOE), GU reports decreased urine output and peripheral/neurovascular exhibits +3 pitting edema in bilateral lower extremities. Her vital signs also report low oxygen saturation levels.
Ineffective Breathing Pattern is defined as "inspiration and/or expiration that does not provide adequate ventilation." This diagnosis would be appropriate as it describes Mrs. K's shortness of breath and her other respiratory symptoms. Shortness of breath, along with crackles and dry cough, supports this diagnosis. She also has decreased oxygen saturation, which is a priority concern.
The method of prioritization can be based on Maslow's hierarchy of needs, which is a pyramid of physiological, safety, love/belonging, esteem, and self-actualization needs that are needed for humans to progress. Oxygen is necessary for survival, which falls under the physiological needs category of Maslow's hierarchy of needs. Therefore, it is vital to prioritize Mrs. K's breathing pattern as it will address her oxygenation needs and support her respiratory status.
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