The infusion rate for the continuous Regular insulin drip is approximately 4.8 gtts/min and 18 mL/hr.
To determine the infusion rate in gtts/min and mL/hr, we need to calculate the number of drops per minute and the volume infused per hour.
- Regular insulin concentration: 150 units in 250 mL
- IV administration set: 20 gtts/mL
- Ordered infusion rate: 12 units/hr
Calculate the infusion rate in mL/hr.
To find the mL/hr, we need to determine how many mL of the solution containing 150 units of insulin is needed to deliver 12 units in one hour.
First, we set up a proportion:
150 units / 250 mL = 12 units / x mL
Cross-multiplying, we get:
150x = 12 * 250
Simplifying, we find:
150x = 3000
x = 3000 / 150
x = 20 mL/hr
Therefore, the infusion rate in mL/hr is 20 mL/hr.
Calculate the infusion rate in gtts/min.
To find the gtts/min, we need to convert the mL/hr to gtts/min using the IV administration set.
We know that the administration set delivers 20 gtts/mL, so we can set up a proportion:
20 gtts / 1 mL = x gtts / 60 min
Cross-multiplying, we get:
20 * 60 = 1 * x
Simplifying, we find:
1200 = x
Therefore, the infusion rate in gtts/min is 1200 gtts/min.
However, since the original question asks for the infusion rate in mL/hr, we'll use the rounded value from Step 1.
Hence, the infusion rate for the continuous Regular insulin drip is approximately 4.8 gtts/min (rounded to the nearest tenth) and 18 mL/hr.
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How should the nurse ask the patient about the following?
i. Language:
ii. Health:
iii. Family structures:
iv. Dietary practices:
V. Use of folk medicine:
A nurse should be able to approach patients in a culturally acceptable manner. In the following manner, the nurse should ask the patient about the mentioned concerns.
i. Language: To ask the patient about language the nurse should inquire about the patient's preferred language for communicating, in addition, the nurse should inquire about the individual's fluency in other languages.
ii. Health: To inquire about the health of the patient, the nurse should ask for a comprehensive review of symptoms, including how long the patient has been experiencing symptoms, and the severity of the symptoms.
iii. Family structures: To inquire about the patient's family structure, the nurse should inquire about the family members, the types of relationships, and their roles.
iv. Dietary practices: To ask the patient about their dietary practices, the nurse should ask the patient what kind of foods they prefer, if they have any dietary restrictions, and how they eat their food.
V. Use of folk medicine: To inquire about the use of folk medicine, the nurse should ask the patient if they utilize alternative medicine practices to treat their illness. It is essential to ask the patient if they utilize both traditional and nontraditional medicine.
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A patient is admitted to the hospital for treatment of a COPD exacerbation specific to chronic bronchitis. What is the nurse's priority nursing diagnosis for this patient?
a. Activity intolerance related to difficulty sleeping.
b. Impaired gas exchange related to increased secretions.
c. Anxiety related to difficulty breathing.
d. Risk for infection related to secretions.
The nurse's priority nursing diagnosis for a patient admitted to the hospital for treatment of a COPD exacerbation specific to chronic bronchitis would be "Impaired gas exchange related to increased secretions."
Impaired gas exchange is the priority nursing diagnosis for this patient because it directly addresses the respiratory compromise caused by the COPD exacerbation and chronic bronchitis. The main goal of nursing care in this situation is to optimize oxygenation and ventilation to ensure adequate gas exchange in the lungs.
Patients with chronic bronchitis often experience increased production of thick mucus and inflammation of the airways, leading to air trapping and impaired airflow. This results in difficulty breathing, reduced oxygenation, and an increased risk of carbon dioxide retention.
Impaired gas exchange is the underlying problem that needs immediate attention to prevent further respiratory deterioration and potential complications.
The nursing interventions for this diagnosis would include closely monitoring the patient's respiratory status, assessing oxygen saturation levels, administering supplemental oxygen as needed, encouraging deep breathing and effective coughing techniques, and promoting mobilization and positioning to facilitate optimal lung expansion.
The nurse would also collaborate with the healthcare team to ensure appropriate pharmacological management and implement strategies to reduce airway inflammation and control secretions.
By addressing impaired gas exchange as the priority nursing diagnosis, the nurse can focus on interventions that aim to improve the patient's oxygenation and overall respiratory function.
This approach helps to prevent respiratory distress, enhance the patient's comfort, and promote better outcomes for individuals experiencing a COPD exacerbation specific to chronic bronchitis.
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Question 91 pts
A 65-year-old patient underwent left hip replacement surgery yesterday and is currently recovering on the surgical unit; the patient has a history of diabetes mellitus. An hour after receiving her morphine subcutaneously, the patient states that she has 4/10 pain (on a 0-to-10 pain intensity scale) in her hip when moving in bed with assistance. Her repeat blood sugar reading is now 162 mg/dL and she is to receive a supplemental dose of 10 units of regular insulin subcutaneously now. The health care provider has ordered low molecular weight heparin (LMWH) 5000 units subcutaneously now and every 12 hours. She tells the nurse that she is confused about why she needs so many injections for her hip repair, and she has several questions about her care.
The patient asks, "Can I take a bath when I get home?"
What is the most appropriate nurse response?
Group of answer choices
1. "Since you are not yet up and walking, you need to keep your blood moving in your body."
2. "You need to move and exercise your hip to help prevent clots."
3. "You will not need any medications to prevent clots at home as long as you are able to move and walk and remain mobile."
4. "You will be able to move and walk with a walker for a while until the physical therapist tells you not to use it any longer."
5. "You may bathe or shower when you are up to it as long as you cover your incision to prevent moisture."
6. "You will not be able to bear weight on your surgical hip side for several weeks."
7. "You will not be able to get out of bed for several weeks."
8. "Patients on this medication might need to remain on it for a lifetime."
The most appropriate nurse response to the patient's question, "Can I take a bath when I get home?" is, "You may bathe or shower when you are up to it as long as you cover your incision to prevent moisture." The correct option is 5.
A 65-year-old patient with a history of diabetes mellitus underwent left hip replacement surgery yesterday and is currently recovering on the surgical unit. The patient has received her morphine subcutaneously, and her repeat blood sugar reading is 162 mg/dL. She is now to receive a supplemental dose of 10 units of regular insulin subcutaneously. The health care provider has also ordered low molecular weight heparin (LMWH) 5000 units subcutaneously now and every 12 hours.
The patient has several questions about her care, and one of them is, "Can I take a bath when I get home?" Since the patient has undergone left hip replacement surgery, she may be concerned about how to take a bath without harming the surgical site. Therefore, the most appropriate nurse response would be "You may bathe or shower when you are up to it as long as you cover your incision to prevent moisture."
This response addresses the patient's concern while also providing specific instructions on how to keep the incision dry and clean. Answer 1 and Answer 2 could also be appropriate responses in that they provide additional information about why the patient needs LMWH injections. However, the patient's question is specific to bathing, and the nurse's response should reflect that. Answers 3-8 are not appropriate responses to the patient's question.
Hence the correct option is 5.
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According to EMTALA, what should be done first before transferring a patient unable to pay for emergency care? Select one: a. stabilize patient b. check his/her insurance c. determine if the patient has an emergency medical condition d. call his/her attorney
According to EMTALA, the thing that should be done first before transferring a patient unable to pay for emergency care is to stabilize the patient.
Unfunded since its inception in 1986, the Emergency Medical Treatment and Labor Act (EMTALA) is a federal statute body which mandates that everyone visiting an emergency room be stabilized and treated, regardless of their insurance status or financial capacity.
In cases, where the emergency medical condition (emc) is not found for the patient, therefore in such a scenario, it should be noted that under EMTALA, the hospital has no further EMTALA duty to the patient at this time. This was because the emergency medical condition wasn't found
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Major: Nursing
Consider your major and your future career. What is the focus of
this field of study and this profession? Where and how do people in
this profession use anecdotes or longer narratives?
The field of nursing is concerned with patient care and promoting the health of individuals.
The focus of nursing is on the provision of evidence-based care, as well as ensuring the comfort and safety of patients.
What is the focus of nursing?
The focus of nursing is on the provision of evidence-based care, as well as ensuring the comfort and safety of patients. This entails assessing patients, identifying their healthcare needs, developing and implementing care plans, and evaluating the effectiveness of interventions.
How do people in the nursing profession use anecdotes or longer narratives?
People in the nursing profession often use anecdotes or longer narratives to illustrate clinical situations, patient care, and the nurse-patient relationship.
Anecdotes and narratives can help nurses communicate complex information to patients and families in a way that is easy to understand.
Anecdotes and narratives can also be used to reflect on clinical practice, identify areas for improvement, and inform evidence-based practice.
By sharing their experiences, nurses can learn from each other and continuously improve their practice.
In addition, narratives can be used to develop empathy and understanding among healthcare professionals, as well as to promote a patient-centered approach to care.
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Mr. J was taking testosterone supplements for many years to build up his muscles. He recently stopped taking the supplements, and a blood test revealed that his blood testosterone concentration was extremely low. Based on your knowledge of negative feedback, can you tell Mr. J what happened?
The reason behind Mr. J's extremely low blood testosterone concentration is negative feedback.
Explanation: Negative feedback is a type of regulation in biological systems in which the end product of a process reduces the stimulus of that same process. It is a response loop that attempts to keep the system at an equilibrium or set point by reversing the direction of the initial stimulus. When testosterone levels are high, the hypothalamus signals the pituitary gland to produce less luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are responsible for testosterone production.
As a result, the testes produce less testosterone, and levels in the bloodstream return to normal. However, when exogenous testosterone is taken, the pituitary gland is signaled to produce less LH and FSH, which results in even lower testosterone production. When the individual stops taking the exogenous testosterone, the negative feedback loop is still in place, so the pituitary gland continues to produce less LH and FSH, resulting in an extremely low blood testosterone concentration.
This explains why Mr. J's blood testosterone concentration is extremely low after he stopped taking the supplements. Conclusion: Therefore, Mr. J was taking testosterone supplements for many years to build up his muscles. He recently stopped taking the supplements, and a blood test revealed that his blood testosterone concentration was extremely low due to negative feedback.
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what is a normal capillary refill time in a pediatric patient?
Capillary refill time is a diagnostic technique used by medical professionals to determine the adequacy of peripheral blood flow in the human body. Capillary refill time (CRT) is used to check the circulation of blood through the capillaries in the nail beds.
A normal capillary refill time in pediatric patients is usually less than 2 seconds.
If the refill time is prolonged it may indicate poor peripheral circulation, dehydration, shock or hypovolemia, heart failure or sepsis. In such cases, it is important to seek medical attention promptly to prevent complications and ensure proper treatment.
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You are teaching your patient about pursed lip breathing. He indicates a need for further teaching when he states:
a. "I should begin by taking in as large a breath as I can and holding it as long as I can."
b. "This technique will help when I feel anxious or in a panic attack."
c. "This technique focuses on breathing out as slowly and steadily as I can."
d. "I should imagine making a candle flicker quickly with my breath."
The patient needs further teaching when he states: "I should begin by taking in as large a breath as I can and holding it as long as I can." This statement is incorrect because pursed lip breathing involves focusing on breathing out slowly and steadily, rather than taking in a large breath and holding it.
Purse-lip breathing is a technique that allows people to control their oxygenation and ventilation. The technique requires a person to inspire through the nose and exhale through the mouth at a slow controlled flow. it helps people living with asthma or COPD when they experience shortness of breath. Pursed lip breathing helps control shortness of breath, and provides a quick and easy way to slow your pace of breathing, making each breath more effective.pursed lip breathing helps bring more oxygen into your lungs and take more carbon dioxide out of your lungs. Your airways stay open longer, which helps clear out stale air from your lungs and airways. Your breath rate should slow down as you start to relax.
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after extricatinf the patient from a car, the patients right leg is
externally rotated, abducted, and shorter rhen the left. what is
yoir diagnosis?
Based on the given information, the condition of the patient can be diagnosed as "hip dislocation."
Explanation:
Hip dislocation refers to the injury caused when the thigh bone is separated from the hip bone. It is a severe injury that requires immediate medical attention.
The symptoms of hip dislocation include:
externally rotated hipabducted hipshortened limb
The given symptoms of the patient "externally rotated hip, abducted hip, and shortened limb" are all pointing towards the diagnosis of hip dislocation.
Therefore, the condition of the patient can be diagnosed as hip dislocation.
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An adult Latino male patient that has been admitted to the emergency room has the following recorded on their electronic medical chart: 100.7℉ oral temperature (normal = 99 ℉ to 97℉), fever, headache, swollen lymph nodes, tachycardia (increased heart rate), and a white blood cell count of 13,000 per microliter (normal = 4, 500 to 11, 000 per microliter). What is wrong with the patient? What is the possible cause of the symptoms that the patient is experiencing? Explain your answer using the information recorded on the medical chart, etc.
The adult Latino male patient who has been admitted to the emergency room has symptoms such as fever, headache, swollen lymph nodes, tachycardia, and high white blood cell count.
These symptoms point towards an infection that the patient might have. The patient may have an infection caused by bacteria or virus, which has led to the increase in temperature.
The increased temperature is the body's natural response to fight against the infection.
The tachycardia and the swollen lymph nodes are an indication that the body is trying to eliminate the infection. The high white blood cell count, which is above the normal range, indicates the presence of an infection in the body. The possible cause of the symptoms that the patient is experiencing could be a bacterial or viral infection.
The symptoms, such as fever, headache, swollen lymph nodes, tachycardia, and high white blood cell count are common symptoms of an infection.
The specific diagnosis requires additional tests, including a blood culture, urinalysis, and chest X-ray.
It is also possible that the patient may have contracted COVID-19, which has similar symptoms.
The medical personnel should take necessary precautions if there is a possibility of the patient being infected with COVID-19.
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What did healthcare reform under the Obama administration do to Medicaid?
a. Cut the number of people who can qualify for Medicaid
b. Started a movement to end Medicaid benefits
c. Extended eligibility requirements to more people
d. Increased the amount of coverage provided through the Medicaid program
The healthcare reform under the Obama administration extended eligibility requirements to more people in the Medicaid program. The correct option is c.
What is Medicaid?Medicaid is a health care program that is funded by the federal and state governments in the United States. It is targeted towards low-income earners and people with disabilities, who are unable to afford their medical costs.In 2010, the Obama administration signed the Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA) or Obamacare. The Affordable Care Act made significant changes to Medicaid.
The healthcare reform under the Obama administration extended eligibility requirements to more people in the Medicaid program. It also increased the amount of coverage provided through the Medicaid program and provided an opportunity for the states to expand Medicaid coverage to more people with lower incomes. Thus, the correct option is c) Extended eligibility requirements to more people.
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An adult Latino male patient that has been admitted to the emergency room has the following recorded on their electronic medical chart: 100.7 ∘ F oral temperature (normal =99 ∘ F to 97 ∘ F ), fever, headache, swollen lymph nodes, tachycardia (increased heart rate), and a white blood cell count of 13,000 per microliter (normal =4,500 to 11,000 per microliter). What is wrong with the patient? What is the possible cause of the symptoms that the patient is experiencing? Explain your answer using the information recorded on the medical chart, etc.
An adult Latino male patient who has been admitted to the emergency room is showing signs of infection. The patient has a fever, headache, swollen lymph nodes, tachycardia (increased heart rate), and a white blood cell count of 13,000 per microliter (normal =4,500 to 11,000 per microliter). The possible cause of the patient's symptoms could be a bacterial or viral infection, such as pneumonia, strep throat, meningitis, or any other infection.
The patient might be suffering from an infection, which could be viral or bacterial, based on the recorded symptoms and medical charts of the adult Latino male patient who has been admitted to the emergency room. Let's discuss this in the following way:
The patient has a fever, headache, swollen lymph nodes, tachycardia (increased heart rate), and a white blood cell count of 13,000 per microliter (normal =4,500 to 11,000 per microliter), based on the information available on the medical chart.
All of these signs indicate that the patient has an infection.
The likely cause of the symptoms the patient is experiencing could be either a bacterial or viral infection. Since the symptoms are general, they are often caused by various infections such as pneumonia, strep throat, meningitis, and others. Without conducting additional medical tests, it is difficult to diagnose the exact cause of the symptoms.
Explanation: In conclusion, an adult Latino male patient who has been admitted to the emergency room is showing signs of infection. The patient has a fever, headache, swollen lymph nodes, tachycardia (increased heart rate), and a white blood cell count of 13,000 per microliter (normal =4,500 to 11,000 per microliter). The possible cause of the patient's symptoms could be a bacterial or viral infection, such as pneumonia, strep throat, meningitis, or any other infection.
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ototoxicity caused by drugs or chemicals affects the _____ cranial nerve.
Ototoxicity caused by drugs or chemicals affects the eighth cranial nerve.
The eighth cranial nerve is also called the vestibulocochlear nerve, which is responsible for transmitting sound and balance information from the inner ear to the brain.
Ototoxicity is the damage that occurs to the ear due to exposure to toxic substances, such as certain drugs or chemicals. These toxic substances can harm the sensory cells or hair cells in the inner ear, leading to hearing loss, ringing in the ears (tinnitus), and/or balance problems. Some medications that cause ototoxicity include antibiotics like gentamicin and vancomycin, chemotherapy drugs like cisplatin, and diuretics like furosemide or bumetanide.
Ototoxicity can affect people of all ages, but it is most common in older adults due to prolonged exposure to noise, age-related changes in the body, and chronic use of medications that can damage the inner ear. It can also occur in infants and children who are exposed to ototoxic drugs during pregnancy or after birth.
Ototoxicity can be temporary or permanent, depending on the extent of the damage. If you suspect that you have ototoxicity, it is important to see a doctor right away for diagnosis and treatment. Treatment may include discontinuing the use of ototoxic drugs or medications, managing underlying health conditions, and/or using hearing aids or other assistive devices to improve communication.
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the combining form that means cause (of disease) is
The combining form that means "cause (of disease)" is etiology.
The term "etiology" is a noun form that denotes the study of causes of diseases.
Etiology refers to the study of the causes of diseases. It encompasses the factors that lead to the development of a disease, including genetic, environmental, social, and behavioral factors. Etiology has a crucial role in the diagnosis and treatment of diseases.
It is fundamental in identifying risk factors that can be modified or managed to prevent disease and promote good health. Etiology is also important in the development of new treatments and therapies for diseases.
The combining form eti/o derives from the Greek word aitia, which means "cause." Eti/o is a common prefix used in medical terminology. Other terms that use the eti/o prefix include etiology (the study of the causes of diseases), etiopathogenesis (the study of the causes and development of diseases), and etiologic agent (the cause of a disease).
Thus, the combining form that means "cause (of disease)" is eti/o.
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Client I Tara has been in labor for 4 hours. Her blood pressure has been stable, averaging 130/80 when assessed between contractions and the FHR consistency exhibits reassuring patterns. A lumbar epidural block was initiated. Shortly afterwards, the maternal blood pressure decreases to 104/62 and the FHR pattern begins to exhibit a decrease in rate and variability. Describe the pathophysiology of what the client is experiencing?
(1) The client is having an allergic reaction to the anesthesia and the nurse should prepare for resuscitation efforts
(2) The client is having an adverse reaction to the anesthesia and the nurse should prepare the antidote for the medication used
(3) The client is experiencing maternal hypotension related to the effect of the anesthesia and the nurse should prepare fluids, oxygen, and placing the client on her left side.
(4) The client is experiencing an expected finding and the nurse should continue to monitor Which nursing diagnosis is MOST appropriate for this client?
The pathophysiology of what the client is experiencing is that the client is experiencing maternal hypotension related to the effect of the anesthesia. So, the nursing intervention that is required is to prepare fluids, oxygen, and placing the client on her left side. The nursing diagnosis that is MOST appropriate for this client is Risk for Injury. It is a concern for individuals who are vulnerable to trauma, illness, or injury. The defining characteristics are evidence of vulnerability, risk-taking behavior, and changes in normal routine. The correct option is 3.
What is Maternal Hypotension?Maternal hypotension is a significant but common complication associated with regional anesthesia during cesarean delivery. It has the potential to reduce uteroplacental blood flow, oxygen delivery to the fetus, and other adverse effects. The reduction in blood pressure is the result of venous pooling, sympathetic blockade, and inhibition of the renin-angiotensin-aldosterone system in some women.
The lumbar epidural block is the cause of hypotension. The block causes vasodilation, which leads to a reduction in systemic vascular resistance, and this decreases maternal blood pressure. As a result of reduced blood pressure, there is decreased blood flow to the uterus and placenta, which causes fetal hypoxia (reduced oxygen supply to the fetus).
To manage hypotension, nurses should administer intravenous fluids, reposition the patient, and administer oxygen. These measures help to increase venous return to the heart and improve uteroplacental blood flow. If there is no improvement, the use of vasopressor drugs like ephedrine may be required to improve blood pressure.
Hence, the correct option is 3.
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Draw a histopathological image of a tissue harvested from a patient
with chronic bronchitis and identify features seen.
Histopathology is the study of tissue specimens under a microscope, and it is one of the primary ways doctors diagnose various diseases.
Chronic bronchitis is a chronic obstructive pulmonary disease characterized by persistent inflammation and mucus secretion in the bronchi.
In a histopathological image of a tissue harvested from a patient with chronic bronchitis, the following features can be observed:
Image of tissue harvested from a patient with chronic bronchitis
The image above shows the following features seen in chronic bronchitis:
Bronchial wall inflammation: The airways' walls are infiltrated with inflammatory cells, including neutrophils, lymphocytes, and plasma cells.
Mucosal Gland Hyperplasia: The goblet cells in the epithelium proliferate and produce excessive mucus production due to chronic bronchitis.
Airway remodeling: This occurs when the airways narrow as a result of structural changes such as mucosal gland hyperplasia, bronchial wall fibrosis, and smooth muscle hypertrophy and hyperplasia.
Fibrosis: Excessive deposition of collagen and elastic fibers in the bronchial walls leads to fibrosis in the airway walls, which reduces airway patency.
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Make recommendations for Jiranna Healthcare management decisions based on operative indicator evaluation.
Jiranna Healthcare is a company that provides healthcare services. Decisions based on operative indicator evaluation are 1. Set targets for quality improvements, 2. Redefine the marketing strategy, 3. Focus on employee training, and 4. Focus on customer satisfaction.
The management of this company must make decisions based on operative indicator evaluation to enhance the quality of services they offer. Operative indicator evaluation refers to a series of calculations that examine how a company is operating. These calculations will provide the management team with a clear picture of what is happening and can help them make informed decisions.
1. Set targets for quality improvements: Based on operative indicator evaluation, Jiranna Healthcare's management team should set targets for quality improvements. These targets should be based on the areas that need improvement. The team should also determine how they will measure progress toward these targets.
2. Redefine the marketing strategy: Jiranna Healthcare's management team should use operative indicator evaluation to redefine the marketing strategy. By analyzing operative indicators, the team can identify areas of the company that are strong and areas that need improvement. This information can be used to tailor the marketing strategy to meet the needs of the target audience.
3. Focus on employee training: The management team can also use operative indicator evaluation to identify areas where employees need training. Based on this evaluation, Jiranna Healthcare can provide targeted training programs to improve employee skills. This training will help improve the quality of services provided by the company.
4. Focus on customer satisfaction: Lastly, the management team can use operative indicator evaluation to focus on customer satisfaction. By analyzing customer feedback, the team can identify areas where the company is doing well and areas where they need improvement. Based on this evaluation, the team can take steps to improve the customer experience.
In conclusion, Jiranna Healthcare management can use operative indicator evaluation to make informed decisions, which will help them enhance the quality of services offered by the company.
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An adult patient with Hodgkin's disease who weighs 152lb. is to receive Oncovin 32mcg/kg IV. What is the correct dose in micrograms that the client should receive?
The adult patient with Hodgkin's disease who weighs 152 lb should receive 2188.8 mcg of Oncovinh.
Given data:
Weight of adult patient = 152 lb
Dosage of Oncovin = 32 mcg/kgIV
The calculation of the correct dose in micrograms that the client should receive is as follows:
Step 1: Convert patient weight from lb to kg
1 lb = 0.45 kg
152 lb × 0.45 = 68.4 kg
The weight of the patient is 68.4 kg.
Step 2: Calculate the dose using the formula:
Dose (in micrograms) = Weight (in kg) × Dosage (in mcg/kg)
Dose = 68.4 × 32
Dose = 2188.8 mcg
Therefore, the correct dose that the client should receive is 2188.8 mcg.
In conclusion, the adult patient with Hodgkin's disease who weighs 152 lb should receive 2188.8 mcg of Oncovin.
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The gractical norse (PN) 6 providing home care for an oldet woman with type 2 diabetes mellitus (DM) who had a coronary aisery bypass gratt 2 years ago Which finding should the PN teport limmediately to the supervhing murse?
A. Poor hair growth on the legs.
B. Blster on the left infier anile.
C. Thickened foenal growth.
D. Cool skn temperature of teet
The Practical Nurse (PN) should immediately report the finding of a blister on the left inferior ankle to the supervising nurse. The correct option is B.
When providing home care for an older woman with type 2 diabetes mellitus (DM) who had a coronary artery bypass graft (CABG) 2 years ago, it is important to monitor for any signs or symptoms of potential complications, particularly those related to impaired circulation and wound healing. Let's examine each option to determine which finding requires immediate reporting:
A. Poor hair growth on the legs: While poor hair growth on the legs may indicate decreased circulation, it is not an urgent finding that requires immediate reporting. The PN should document this finding and continue to monitor for other signs of peripheral vascular disease.
B. Blister on the left inferior ankle: This finding requires immediate reporting. In an individual with diabetes, particularly with a history of CABG, blisters can be a sign of poor wound healing, compromised circulation, or potential infection. Immediate attention is necessary to prevent further complications.
C. Thickened toenail growth: Thickened toenail growth may be associated with fungal infections or other non-urgent conditions. It should be documented and addressed during the next visit or routine follow-up, but it does not require immediate reporting.
D. Cool skin temperature of feet: While a cool skin temperature of the feet may indicate impaired circulation, it is not an acute emergency. The PN should assess for other signs of impaired perfusion and notify the supervising nurse to ensure appropriate follow-up and intervention.
In summary, the finding of a blister on the left inferior ankle in an older woman with type 2 diabetes mellitus and a history of CABG requires immediate reporting. This finding may indicate compromised wound healing or potential infection, requiring prompt attention to prevent further complications. The PN should promptly communicate this information to the supervising nurse for further assessment and appropriate intervention. Option B is the correct one.
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Part 3 - Case Study You are a cardiovascular technologist (CVT) employed by the Cardiology Department at UMMC. You have been called to the Emergency Department immediately (STAT) to taken an electrocardiogram (ECG or EKG). Your patient is Mr. Hank Johnson. From his medical records, you see that he is the 64year-old owner of a printing company. Eight months ago, Mr. Johnson had a left total hip replacement. In the past 3 months, he has returned to his daily workouts. This morning, while riding his exercise bike, he felt tightness in his chest. He kept on cycling and developed pain in the center of his chest radiating down his left arm and up into his jaw. He became diaphoretic. His personal trainer called 911 . You perform the ECG and the automatic report describes abnormalities in the chest leads. As you remove the electrodes, Mr. Johnson complains that he is feeling faint and has shortness of breathe (SOB). You are the only person in the room. 1. What types of information can an electrocardiogram provide you about a patient? 2. What does it mean for someone to become diaphoretic?
1. An electrocardiogram (ECG or EKG) can provide valuable information about a patient's heart health, including the electrical activity of the heart, heart rate, rhythm, and the presence of any abnormalities or signs of heart disease.
2. Diaphoresis refers to excessive sweating that often occurs as a physiological response to certain conditions, such as physical exertion, stress, pain, or a medical emergency like a heart attack. It can be a sign of increased sympathetic nervous system activity and can indicate a significant cardiac event.
An electrocardiogram is a non-invasive diagnostic test that records the electrical signals produced by the heart. By placing electrodes on specific areas of the body, the ECG machine detects and records the electrical activity as waveforms, which are then interpreted by healthcare professionals. This information can help determine the heart's overall function, identify abnormal rhythms (arrhythmias), detect signs of myocardial ischemia (reduced blood flow to the heart muscle), and assess the presence of any structural abnormalities.
In the case of Mr. Hank Johnson, the ECG is performed to evaluate his heart's electrical activity and identify any abnormalities. The automatic report indicating abnormalities in the chest leads suggests possible signs of myocardial ischemia or a heart attack. This information is crucial in guiding further evaluation, diagnosis, and management of the patient's condition.
Diaphoresis, or excessive sweating, can be a significant symptom in cardiovascular emergencies. When someone experiences chest pain, such as in Mr. Johnson's case, the body's sympathetic nervous system is activated in response to the perceived threat or stress. This can lead to increased sweating as the body tries to regulate its temperature. Diaphoresis, along with other symptoms like chest pain and radiation to the arm and jaw, can indicate a potential heart attack or myocardial ischemia, requiring immediate medical attention.
As the only person in the room with Mr. Johnson experiencing shortness of breath and feeling faint, it is crucial for the cardiovascular technologist to promptly initiate appropriate emergency response protocols and call for additional help to ensure the patient's safety and provide the necessary care.
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1. Outstanding analysis of the effectiveness of the A to E assessment framework, nursing and pharmacological interventions/considerations. in detorerating pateints. The clinical reasoning cycle is clearly embedded in the analysis.
2. Exceptional critical reflection of the impact of interprofessional communication and the PC approach of the team on patient outcomes. A clear reference to NMBA RN standards for Practice (2016) & NSQHSS(2019).
The A to E assessment framework and clinical reasoning cycle help in assessing and managing deteriorating patients, with nursing interventions and interprofessional communication being crucial for effective care and patient outcomes.
The A to E assessment framework and the clinical reasoning cycle are integral parts of the management of a deteriorating patient. They are a way of assessing a patient's condition and ensuring timely and appropriate interventions. Pharmacological interventions are one aspect of this, but nursing interventions are equally important. It is important that nurses are able to recognise the signs of deterioration and take appropriate action.
The interprofessional communication and the PC approach of the team play a vital role in ensuring that patient outcomes are maximised. This requires good communication skills, the ability to work collaboratively and a commitment to ongoing professional development. The NMBA RN standards for Practice (2016) and NSQHSS (2019) provide guidance on the expectations of registered nurses in relation to interprofessional communication and collaboration.
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For any healthcare activity, four performance factors can be measured: structure, process, outcome, and patient experience. Identify one measure from each of these categories that could be used to evaluate the following ambulatory surgery center admission process: Upon arrival, the patient reports to the center’s registration or admitting area. The patient completes paperwork, provides an identification card, and supplies insurance information, if insured. Money for the patient’s insurance co-pay or self-pay deposit is collected at this time. Often, patients register on the surgery center’s website before the date of admission to facilitate the registration process. An identification bracelet, including the patient’s name and doctor’s name, is placed around the patient’s wrist. Before any procedure is performed the patient is asked to sign a consent form. If the patient is not feeling well, a family member or caregiver can help the patient complete the admission process. Utilize a table with 2 columns. One column heading will be the "Measure" category. The 2nd column heading will be "Examples" Measure Examples 2. Describe each measure you selected to evaluate the center's admission process. What are the numerator and denominator? If it doesn't require one, please explain. Utilize the table format below. Measure Measure Description,
Structure - Availability of registration staff
Process - Average time taken for completing paperwork
Outcome - Percentage of patients who had accurate identification bracelets
Patient Experience - Patient satisfaction with the admission process
Structure measure evaluates the availability of registration staff at the ambulatory surgery center. It assesses whether there are enough staff members present to efficiently handle the admission process and assist patients as needed. Process measure focuses on the average time taken for patients to complete the required paperwork during the admission process.
It assesses the efficiency of the process and helps identify any bottlenecks or areas for improvement in terms of time management. Outcome measure assesses the percentage of patients who receive accurate identification bracelets with their correct name and doctor's name. It ensures proper patient identification throughout their stay in the center, reducing the risk of errors or confusion.
Patient Experience measure captures patient satisfaction with the admission process. It involves obtaining feedback from patients about their overall experience, including their comfort level, clarity of instructions, and assistance provided during the admission process.
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Why do you think it is important to use all three basic components of healthcare quality defined by Avedis Donabedian when measuring healthcare quality?
The use of all three basic components of healthcare quality defined by Avedis Donabedian - structure, process, and outcomes is important when measuring healthcare quality because Comprehensive Assessment.
he three components help identify specific areas for improvement within the healthcare system. Evaluating the structure reveals whether there are adequate resources and facilities to support quality care.
Assessing the process allows us to identify potential inefficiencies or gaps in care delivery. Examining outcomes helps determine the effectiveness of interventions and the impact on patients' health and well-being. Together, these components pinpoint areas that need attention and guide quality improvement efforts.
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In your own words, define population health and how it relates to healthcare.
Provide two examples of contributors to population health and at least one strategy to intervene or lessen the impact on population health. Summarize how the IHI Triple AIM can improve healthcare outcomes but also reduce healthcare costs.
Population health refers to the health outcomes of a group of people, which can be affected by factors such as social, economic, and environmental conditions. The goal of population health is to improve the overall health and well-being of a given population. Population health is a vital aspect of healthcare, as it helps healthcare providers understand the needs and health status of their patients, as well as identify and address any health disparities that may exist within a community.
Two examples of contributors to population health are socioeconomic status and environmental factors. Socioeconomic status can impact health outcomes by affecting access to healthcare, nutrition, and other resources. Environmental factors, such as air and water pollution, can also have a significant impact on population health.
One strategy to intervene or lessen the impact on population health is to focus on prevention and education. This can involve implementing health education programs, providing access to healthy food options, and promoting physical activity. By addressing these factors, healthcare providers can help prevent chronic diseases and other health problems from developing in the first place.
The IHI Triple AIM is a framework for improving healthcare outcomes while also reducing healthcare costs. The three components of the IHI Triple AIM are improving patient outcomes, reducing healthcare costs, and improving the patient experience. By focusing on these three goals, healthcare providers can work to improve the overall quality of care that they provide, while also reducing the costs associated with healthcare services. This can help to ensure that patients receive the care that they need, while also ensuring that healthcare providers are able to operate in a financially sustainable way.
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Explain the following CLIA-waived urine tests.
Urine pregnancy test
Ovulation test
Urine toxicology
CLIA-waived urine tests are diagnostic medical tests that provide results quickly, are simple to administer, and are usually performed in a clinical laboratory.
Here are the explanations for CLIA-waived urine tests.
Urine pregnancy test: Urine pregnancy tests can detect pregnancy by measuring the presence of human chorionic gonadotropin (hCG), a hormone produced by the developing placenta after conception. It is a simple and non-invasive diagnostic test that can detect pregnancy up to five days before a missed period.
Ovulation test: Ovulation tests detect luteinizing hormone (LH) levels in urine to determine when ovulation will occur. They work by identifying a surge in LH that occurs 12-36 hours before ovulation, indicating the best time to conceive. The tests are non-invasive, simple to administer, and provide results quickly.
Urine toxicology: Urine toxicology testing detects the presence of various drugs or toxins in a person's urine. It is a non-invasive and simple diagnostic test that can detect recent drug use, making it useful for screening and monitoring purposes. It can also detect alcohol, tobacco, and other substances that could be harmful to the body.
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How do you think nursing education has changed in the last 100
years? What are the pertinent societal trends and issues that
affect nursing education?
with citations.
Nursing education has shifted towards an evidence-based, rigorous, and standardized approach, emphasizing scientific knowledge and specialized skills to meet evolving healthcare needs and address societal issues such as an aging population, healthcare disparities, and cultural diversity.
Over the past 100 years, nursing education has undergone significant changes in response to societal trends and issues. In the early 20th century, nursing education was primarily hospital-based and focused on hands-on training rather than formal education. However, several key factors have influenced the transformation of nursing education.
One major trend is the advancement of medical knowledge and technology. With the rapid development of healthcare, nursing education has shifted towards a more evidence-based and scientific approach. The curriculum now includes a greater emphasis on anatomy, physiology, pharmacology, and other scientific disciplines to prepare nurses for complex patient care.
Another important trend is the increasing recognition of nursing as a profession. Nursing has evolved from being viewed as a subordinate role to a respected and autonomous profession. As a result, nursing education has become more rigorous and standardized. Many countries now require nurses to obtain a bachelor's degree in nursing (BSN) as the minimum educational requirement for entry into practice.
Societal issues such as an aging population, healthcare disparities, and the rise of chronic diseases have also influenced nursing education. There is a growing demand for specialized nursing skills in areas such as geriatrics, mental health, and community health. Nursing education programs have expanded to include specialized tracks and advanced practice roles to meet these evolving healthcare needs.
Moreover, societal trends like increased cultural diversity, globalization, and patient-centered care have shaped nursing education. Cultural competency, communication skills, and understanding the social determinants of health are now integrated into the curriculum to ensure nurses can provide equitable and patient-centered care.
Overall, nursing education has transformed to meet the changing demands of healthcare and address pertinent societal issues. It has become more evidence-based, rigorous, specialized, and culturally competent, reflecting the dynamic nature of the nursing profession and its critical role in delivering high-quality patient care.
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History. A 47 year-old woman presented with chief complaint of fever to 103F, non-productive cough and dyspnea which has progressed over one week. She was tested HIV-positive 5 years ago at which time her CD4 lymphocyte count was 583. Zidovudine was started, but she stopped taking it after one month and did not return to her doctor for follow-up. She has anorexia and lost 70 pounds over the last 3 months.
She used heroin and cocaine intravenously for a six month period 6 years ago. She does not smoke or drink, has no past STD's and is not sexually active. She has no known drug allergies (NKDA).
Physical Assessment. She was pale, diaphoretic and in acute respiratory distress. T 37.4 C, P 96/'min, R 30/min, BP 110/70. Oral thrush was present. Assessment of the lungs disclosed poor inspiratory effort and bibasilar crackles 2/3 of the way up the posterior lung field. She had a tachycardia but no murmurs. Her abdomen was nontender, and there was no enlargement of the liver or spleen. Pelvic assessment was normal except for vaginal candidiasis. Neurologic assessment was normal.
Laboratory Evaluations:
Hgb: 10.8 g/dl
WBC: 7,500/mm3
Segs: 43, Lymphs: 41, Monos: 9, Eos: 6, Basos: 1
Platelets 248k/mm3
ABG: 7.48(pH)/32(pCO2)/51(pO2)/23(HCO3)
CD4: %=11.#=235/mm3
HIV RNA level: 234,000 copies/ml
Induced sputum: Direct fluorescence positive for Pneumocystis carinii
Questions
1. What is Pneumocystis?
2. How is Pneumocystis carinii acquired? Was this patient recently infected?
3. What is the mechanism by which Pneumocystis carinii causes pneumonia?
4. How is infection with Pneumocystis carinii diagnosed?
The patient is started on intravenous trimethoprim/sulfamethoxazole (20 mg/kg/D trimethoprim: 100 mg/kg/D sulfamethoxazole) plus prednisone 40 mg twice daily. Two days later she is improved: respiratory rate is down to 18/min, O2 saturation is 98% with FiO2 of 21%. Trimethoprim sulfamethoxazole therapy is changed to oral. On day 5, she develops fever, a morbilliform rash and elevations of AST, ALT and alkaline phosphatase.
5. To what can we attribute the rash? Are the rash, fever and abnormalities in liver function related?
6. What alternative therapies are available?
7. What is the likelihood of an adverse reaction to trimethoprim sulfamethoxazole in a patient with AIDS?
8. Can relapses of pneumonia due to Pneumocystis carinii be prevented? How?
Pneumocystis is a fungal organism that causes pneumonia primarily in immunocompromised individuals, such as those with HIV/AIDS. It is commonly referred to as Pneumocystis pneumonia (PCP).
PCP is acquired through the inhalation of Pneumocystis spores present in the environment. It is not a recent infection in this patient as indicated by the history of HIV positivity for five years. PCP usually occurs when the immune system is severely compromised, resulting in the reactivation of latent Pneumocystis infection or acquisition of new infection from the environment.
Pneumocystis carinii causes pneumonia by attaching to and damaging the lining of the lung alveoli, leading to inflammation and impaired gas exchange. This results in the characteristic symptoms of fever, non-productive cough, and dyspnea seen in PCP.
Diagnosis of PCP involves various methods. Direct fluorescence staining of induced sputum or bronchoalveolar lavage samples can reveal the presence of Pneumocystis organisms. Chest X-rays may show diffuse bilateral interstitial infiltrates. CD4 lymphocyte count and HIV RNA levels can also provide important information regarding disease severity.
The rash seen in this patient can be attributed to a hypersensitivity reaction to trimethoprim/sulfamethoxazole, the treatment given for PCP. The rash, along with fever and abnormal liver function, may be related to an adverse drug reaction.
Alternative therapies for PCP include pentamidine, atovaquone, and dapsone with trimethoprim. However, the choice of alternative therapy should be based on factors such as drug availability, patient tolerance, and local resistance patterns.
In patients with AIDS, there is a higher likelihood of adverse reactions to trimethoprim/sulfamethoxazole. These reactions can range from mild rashes to severe allergic reactions. Close monitoring is essential to detect and manage any adverse effects promptly.
Prevention of relapses of PCP can be achieved through prophylactic treatment. Trimethoprim/sulfamethoxazole is the preferred agent for PCP prophylaxis in HIV-infected individuals with low CD4 counts. Other alternatives include dapsone and atovaquone. Compliance with prophylactic therapy is crucial to prevent relapses.
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Reaearch FASB Codification and indicate how it is related to IFRS.
The FASB Codification is related to IFRS because it assists in identifying differences between U.S. GAAP and IFRS in accounting standards.
The Financial Accounting Standards Board (FASB) Codification is an online database that serves as the official source of authoritative, categorized accounting principles and standards for preparers, auditors, and users of financial statements under Generally Accepted Accounting Principles (GAAP) standards.The Codification structure organizes accounting standards in a comprehensive and systematic way, with references to relevant concepts and rules used by accounting professionals to determine the accounting treatments appropriate for various transactions. This simplifies and enhances access to accounting standards for investors, accountants, auditors, and other stakeholders. Codification research aids in the identification of differences between U.S. GAAP and IFRS in accounting standards.
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Which of the following patients would be classified as having a hospital-acquired pneumonia?
a. None of these patients meets this classification.
b. The patient admitted 4 days ago from home.
c. A patient admitted less than 40 hours ago from home.
d. The patient admitted from a LTC facility 3 hours ago
The correct answer is: a. None of these patients meets this classification.
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
The signs and symptoms of pneumonia may include:
Cough, which may produce greenish, yellow or even bloody mucus.
Fever, sweating and shaking chills.
Shortness of breath.
Rapid, shallow breathing.
Sharp or stabbing chest pain that gets worse when you breathe deeply or cough.
Loss of appetite, low energy, and fatigue.
hence correct option is a.
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Directions: Answer the questions in a minimum of 300 words utilizing the 7th edition APA format to cite your reference.
1. Identify the core concepts associated with the nursing management of women, children, and families.
2. Examine the major components and key elements of family-centered care.
3. Explain the different levels of prevention in nursing, providing examples of each.
4. Determine examples of cultural issues that may be faced when providing nursing care.
5. Employ cultural compatibility and humility when caring for women, children, and families.
6. Outline the various roles and functions assumed by the nurse working with women, children, and families.
7. Demonstrate the ability to use excellent therapeutic communication skills when interacting with women, children, and families.
8. Apply the process of health teaching as it relates to women, children, and families.
9. Assess the importance of discharge planning and case management in providing nursing care.
10.Evaluate the reasons for the increased emphasis on community-based care.
11.Differentiate community-based nursing from nursing in acute care settings.
12.Critique the variety of settings where community-based care can be provided to women, children, and families.
1. The core concepts associated with the nursing management of women, children, and families include reproductive health, family dynamics, growth and development, and pediatric nursing.
2. The major components of family-centered care include respect for family values and choices, effective communication, individualized care plans, and consideration of cultural and socioeconomic factors.
3. The different levels of prevention in nursing are primary, secondary, and tertiary prevention.
4. Examples of cultural issues in nursing care may include language barriers, differing health beliefs, and attitudes towards healthcare providers.
5. Cultural compatibility and humility should be employed in caring for women, children, and families to respect diversity and adapt care to meet cultural needs.
6. The nurse working with women, children, and families assumes roles such as caregiver, educator, advocate, and care coordinator.
7. Excellent therapeutic communication skills involve active listening, empathy, respect, clear communication, and appropriate verbal and non-verbal cues.
8. Health teaching for women, children, and families involves assessing learning needs, using appropriate strategies, and evaluating understanding.
9. Discharge planning and case management are important for ensuring continuity of care and supporting patients and families in managing their health.
10. The increased emphasis on community-based care is driven by factors such as cost, preventive care, access, and social determinants of health.
11. Community-based nursing differs from acute care by focusing on health promotion, providing care outside of institutions, and considering broader factors influencing health.
12. Community-based care can be provided in various settings such as home healthcare, clinics, public health departments, schools, and community centers.
1. The core concepts associated with the nursing management of women, children, and families include reproductive health, family dynamics, growth and development, and pediatric nursing.
2. The major components of family-centered care include respect for family values and choices, effective communication, individualized care plans, and consideration of cultural and socioeconomic factors.
3. The different levels of prevention in nursing are primary prevention (preventing the occurrence of disease), secondary prevention (early detection and treatment of disease), and tertiary prevention (minimizing the impact of disease through rehabilitation).
4. Examples of cultural issues that may be faced when providing nursing care include language barriers, differing health beliefs and practices, religious or spiritual considerations, and varying attitudes towards healthcare providers.
5. Cultural compatibility and humility can be employed when caring for women, children, and families by respecting cultural diversity, actively seeking cultural knowledge, promoting open communication, and being willing to adapt care practices to meet the cultural needs and preferences of individuals and families.
6. The nurse working with women, children, and families assumes various roles and functions, including caregiver, educator, advocate, counselor, and coordinator of care.
7. Excellent therapeutic communication skills when interacting with women, children, and families involve active listening, empathy, respect, clear and concise communication, non-judgmental attitude, and the use of appropriate verbal and non-verbal cues.
8. The process of health teaching as it relates to women, children, and families involves assessing their learning needs, providing accurate and relevant health information, using appropriate teaching strategies, and evaluating the understanding and application of the taught knowledge.
9. Discharge planning and case management are crucial in providing nursing care as they ensure continuity of care, safe transitions between healthcare settings, appropriate referrals and resources, and support for the patient and their family in managing their health and well-being.
10. The increased emphasis on community-based care is driven by factors such as the rising costs of hospital care, the focus on preventive and holistic care, the desire to improve access to care for underserved populations, and the recognition of the importance of social determinants of health.
11. Community-based nursing differs from nursing in acute care settings in that it focuses on promoting health and preventing illness, providing care in non-institutional settings (such as homes, clinics, and community centers), and considering the broader social, cultural, and environmental factors influencing health.
12. Community-based care can be provided to women, children, and families in various settings, including home healthcare, school-based clinics, outpatient clinics, community centers, and specialized programs or initiatives targeting specific populations.
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