The female b la dder is a muscular, balloon-shaped organ that sits at the bottom of the p el vis, behind the pu bic bone, and in front of the rec tum. It is separated from the ut erus and the va gina by connective tissue.
During pregnancy, the u te rus grows significantly, putting pressure on the b lad der and shifting it upwards towards the abdomen and the belly button. This phenomenon is called "bla d der displacement" or "uterine prolapse" in some instances, as the uterus exerts more pressure on the p el vic region. This can cause a range of symptoms, including frequent urination, urinary incontinence, and an increased risk of urinary tract infections. Pregnant women are also more prone to bladder infections due to the increased pressure on the bl ad der. As the baby drops into the pelvis, the pressure on the b la dder may decrease slightly. However, this is not always the case. The bladder may be pushed to the side of the pe l vis, which can lead to further pressure and discomfort. Overall, during the last month of pregnancy, the bla dder may be under significant stress due to the pressure from the growing u te rus. As a result, it is essential for pregnant women to drink plenty of water and empty their bladder frequently to prevent any complications.
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Visceral wound management Discuss what a "visceral wound" is (including blunt abdominal injury and surgical dehiscence) . Outline the nursing care considerations for these wounds, including strategies for assessment and treatment, and any health professionals who may be involved in the management of these wounds. Edit Header Your response should be between 300-400 words in length.
Visceral wounds management requires extensive nursing care and a range of professionals to monitor and manage the wound and the individual. Surgical dehiscence and blunt abdominal injury are two types of visceral wounds that require proper management.
A visceral wound is a wound that occurs to an organ within the abdominal cavity. It may also occur when a person has undergone surgery, and the sutures on the incision area come apart, causing the wound to reopen. Blunt abdominal injury can also result in visceral wound. Such wounds are typically accompanied by internal bleeding, which can be fatal if left untreated.
Nursing care considerations : The management of visceral wounds requires extensive nursing care and the involvement of a range of professionals. The first consideration is the monitoring of vital signs, which involves taking regular blood pressure and pulse readings, as well as monitoring respiration and body temperature. Secondly, it's essential to assess the wound, such as the location, depth, and size.
A range of health professionals are involved in the management of visceral wounds. These include nurses, who monitor the wound, change the dressing, and administer medication. They also collaborate with other health professionals to develop a comprehensive care plan. A surgeon may be required to treat surgical dehiscence, and a radiologist may be needed to identify the extent of internal bleeding using imaging scans.
Conclusion : Visceral wounds require extensive nursing care and a range of professionals to monitor and manage the wound and the individual. Nursing care considerations involve monitoring vital signs, assessing the wound, and managing pain.
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Emerald Green 30-year-old female was admitted for TBI you're falling off of her four wheeler. She has a history of borderline hypertension, polynephritis, bipolar type 1, diabetes type 2. She is alert to person only. She cannot Express words but understands when you talk to her. Just weakness on the left side upper and lower extremities. He says her pain is three out of 10 and it's in her head as a headache. She's taking oxycodone 20 mg 4 hours PRN. She has a 5-year-old child and a 7 year old child. My husband works over the road and does not miss it often. Her and her mother had a good relationship with her mother visits every day brings the children to see her. She is a two assist with a walker and only can ambulate 5 ft. The last lab values were white blood count elevated red blood count normal lipid panel normal analysis showed two plus white blood cell count specific gravity 0.145. cheese assistance with dressing bathing and grooming. Vital signs temperature 101.1 blood pressure 128/ 80 post 88 respirations 20 O2 saturation 98% on RA. Patient currently on thinking liquids and has healing trach incision on neck. Trach remove 3 days ago. Patience is a Seventh-Day Adventist. Your mother practices as a Jehovah witness and it's very upset with the staff when they gave what to her when she was admitted her trauma. About them going against her religious practices.
Read scenario above and answer the following questions:
What is your initial plan for this patient when you're planning the plan of care?
What assessments should you do on this patient and what kind of assessment would you be expected to find?
What medications would you expect this patient to be on?
The initial plan for the patient when planning the plan of care should include interventions to prevent infection, monitor vital signs, assist with ADLs as needed, etc. The assessments that should be done on this patient include neurological assessment, cardiovascular assessment, etc. The medications that this patient is expected to be on are oxycodone and antibiotics.
1. The initial plan for the patient when planning the plan of care should include the following:
Implement interventions to prevent infection.Monitor vital signs and report signs of fever.Assist with activities of daily living (ADLs) as needed.Monitor the incision site and report any signs of infection or delayed healing.Ensure that the patient has appropriate pain relief and observe for signs of opioid toxicity.Provide emotional support and counseling as needed.2. The following assessments should be done on this patient:
Neurological assessment: Assess the patient's level of consciousness, orientation, cognition, speech, and motor function.Cardiovascular assessment: Assess the patient's heart rate, rhythm, blood pressure, and peripheral pulses.Respiratory assessment: Assess the patient's respiratory rate, rhythm, depth, and oxygen saturation.Gastrointestinal assessment: Assess the patient's bowel sounds, appetite, and hydration status.Genitourinary assessment: Assess the patient's urinary output, color, and clarity of urine, and any signs of infection.Skin assessment: Assess the patient's skin integrity, wound healing, and any signs of infection or pressure ulcers.3. The medications that this patient is expected to be on are:
Oxycodone 20 mg every 4 hours PRN: This is for pain relief.Antibiotics: This is to prevent or treat any infection that may be present.To know more about activities of daily living (ADLs), refer to the link below:
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eloborate three treatment diabetis mellitus type 2
Diabetes mellitus type 2 is a condition that occurs when the pancreas produces insufficient insulin or the body becomes resistant to the insulin that is produced. The following are three treatment options for type 2 diabetes mellitus:
1. Lifestyle Changes: This is a critical component of the treatment of type 2 diabetes mellitus. The following are some of the essential lifestyle changes: Engage in regular exercise such as swimming, running, brisk walking, yoga, and strength training. Reduce your weight: It can improve insulin sensitivity and reduce blood sugar levels. Quit smoking: This can lower your risk of developing type 2 diabetes or reduce complications if you already have it. Eat a well-balanced diet: Emphasize fruits, vegetables, whole grains, lean protein, and low-fat dairy products.
2. Oral Medications: There are many different classes of oral medications available for the treatment of type 2 diabetes. The following are some of the options available:Metformin: It lowers glucose production in the liver and increases insulin sensitivity.
3. Insulin Therapy: If oral medications are insufficient to manage blood glucose levels, insulin therapy may be needed. The following are some of the insulin therapy options available: Basal insulin.
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Which of the following substances are components of the blood plasma? O Platelets O All of these substances are components of blood plasma None of these substances are components of blood plasma O Leukocytes O Erythrocytes
Platelets, leukocytes, erythrocytes all of these substances are components of blood plasma.
Blood plasma is the yellowish fluid component of blood that makes up about 55% of its total volume. It is composed of various substances, including platelets, leukocytes (white blood cells), and erythrocytes (red blood cells).
Platelets are small, disk-shaped cell fragments that play a crucial role in blood clotting. They are responsible for forming a clot to prevent excessive bleeding when a blood vessel is damaged. Platelets are abundant in blood plasma and are essential for the body's hemostatic mechanisms.
Leukocytes, or white blood cells, are an integral part of the immune system. They help defend the body against infectious agents, such as bacteria, viruses, and fungi. Leukocytes are present in blood plasma, and their main function is to recognize and destroy foreign substances or pathogens, contributing to the body's defense against infection.
Erythrocytes, or red blood cells, are the most abundant cells in blood plasma. Their primary function is to transport oxygen from the lungs to the body's tissues and carry carbon dioxide, a waste product, from the tissues back to the lungs for elimination. Erythrocytes contain hemoglobin, a protein that binds to oxygen and gives blood its red color.
In summary, all three substances platelets, leukocytes, and erythrocytes are components of blood plasma. They each have unique roles in maintaining the body's overall health and functioning.
Blood plasma is a complex mixture of water, proteins, electrolytes, hormones, waste products, and various other components. It serves as a vital medium for transporting nutrients, hormones, and waste materials throughout the body. Understanding the composition and functions of blood plasma is essential for comprehending the physiological processes occurring in the circulatory system.
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"Pharmacology type questions:
1. What are cell cycle-nonspecific drugs? And how do they
work?
2. What do you do if an antineoplastic drug extravasates during IV
infusion?
3. What is a dose-limiting factor
1. Cell cycle-nonspecific drugs are a group of antineoplastic drugs that work by disrupting cellular function in a non-cell cycle-dependent manner. These drugs are active against both proliferating and resting cancer cells, making them useful in treating tumors with low growth fractions.
Eg: Alkylating agents, platinum analogs, and nitrosureas.The mechanism of action of cell cycle-nonspecific drugs is thought to be a combination of DNA damage induction and the formation of protein and membrane adducts.
2. Extravasation management: Extravasation happens when an antineoplastic drug or another vesicant substance escapes from the vein into the surrounding tissue during an IV infusion, causing harm and tissue injury.To manage the situation if antineoplastic drugs extravasates during IV infusion, the following steps should be taken:
Stop the infusion immediately.Do not remove the cannula.Inject the recommended antidote, depending on the specific antineoplastic drug involved.Apply warmth or cool to the affected area as directed by the protocol.Notify the doctor in charge, as well as any relevant person or department, and fill out the mandatory documentation.3. Dose-limiting factor is a term used to describe a drug's toxicity level. The highest possible therapeutic dose of a drug is determined by the point at which toxicity becomes unbearable. As a result, dosage reduction or medication discontinuation is typically required when toxicity sets in, since it may result in serious side effects.
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Zahara Noor wants to create a presentation of different molecules that helped change the world, but she needs help in naming them, so that anyone is able to understand the molecules that she is talking about. Provide the name of the molecule described here:C3H8: A gas used for grilling and cooking purposes. Use the editor to format your answer Question 17 1 Point Use the editor to format your answer 1 Point Zahara Noor wants to create a presentation of different molecules that helped change the world, but she needs help in naming them, so that anyone is able to understand the molecules that she is talking about. Provide the name of the molecule described here:C4H10: The fluid found in lighters that is easily flammable.
Molecule described here is Propane for C3H8, and Butane for C4H10.
Zahara Noor is looking for help to create a presentation of different molecules that helped change the world. She wants to name them so that everyone can understand the molecules she is talking about.
Given below are the name of the molecules described here: C3H8:
Propane - A gas used for grilling and cooking purposes.
C4H10: Butane - The fluid found in lighters that is easily flammable.
Hence, the name of the molecule described here is Propane for C3H8, and Butane for C4H10.
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1. What are the types of parallel fiber arrangement? Provide an example for each type. 2. What are the type of pennate fiber arrangement? Provide an example for each type. 3. In general, what would be the order for largest to smallest physiological cross section area between Parallel, Unipennate, Bipennate, and Multipennate fiber arrangements Largest to Smallest= 4. Based on physiological cross section area, compare and contract parallel and pennate muscles. Which type would be able to produce higher velocity of movement? Which type would be better at producing powerful movements and generating force? Which type allow for a greater range of motion? 5. What types of sports or physical activity would a person with more type 1 fibers have an advantage over a person with more type 2 fibers? 6. Which muscle of the hip works to stabilize the pelvis when standing on one leg?
There are two types of parallel fiber arrangement such as strap muscles and fusiform muscle. Whereas, three types of pennate fiber arrangement exist including unipennate muscles, bipennate muscles and multipennate muscles. So far as, the order for the largest to smallest physiological cross-sectional area would be as Multipennate > Bipennate > Unipennate > Parallel.
Strap muscles: Muscles that have long, parallel fibers running the length of the muscle. Example: Sartorius muscle in the thigh.
Fusiform muscles: Muscles that have fibers that run parallel to the long axis of the muscle, tapering at both ends. Example: Biceps brachii muscle in the arm.
Types of pennate fiber arrangement:
Unipennate muscles: Muscles where the muscle fibers are arranged diagonally on only one side of the tendon. Example: Extensor digitorum longus muscle in the leg.
Bipennate muscles: Muscles where the muscle fibers are arranged diagonally on both sides of the tendon. Example: Rectus femoris muscle in the thigh.
Multipennate muscles: Muscles where the muscle fibers are arranged diagonally in multiple directions around multiple tendons. Example: Deltoid muscle in the shoulder.
Comparing parallel and pennate muscles based on physiological cross-sectional area:
Higher velocity of movement.
Producing powerful movements and generating force.
Greater range of motion.
A person with more type 1 fibers (slow-twitch fibers) would have an advantage in endurance activities that require sustained contractions over a long duration.
Examples include long-distance running, cycling, or marathon events. Type 1 fibers are more resistant to fatigue and are efficient in aerobic metabolism.
The muscle of the hip that works to stabilize the pelvis when standing on one leg is the Gluteus Medius muscle.
It is responsible for abduction and medial rotation of the hip and plays a crucial role in maintaining stability and balance during single-leg stance.
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A nurse is discussing various sexually transmitted diseases at a community sponsored event. All of the following are correct EXCEPT: O A> A distinguishing feature of Trichomoniasis infection is green foul-smelling vaginal discharge. O B. Chlamydia and gonorrhea can cause PID (pelvic inflammatory disease). C. The tertiary stage (Gumma formation) of syphilis is the most contagious of the three stages. D. Herpes simplex 2 can be found in either the mouth or genital area. E. The school nurse evaluates an 8th grade girl with a noticeable spinal deviation and one hip is higher than the other.
The option that is incorrect while discussing various sexually transmitted diseases at a community-sponsored event is (C) The tertiary stage (Gumma formation) of syphilis is the most contagious of the three stages.
The tertiary stage (Gumma formation) of syphilis is the least contagious of the three stages, and it is not correct to say it is the most contagious. In the first two stages, the infectious stage, syphilis is highly contagious. During the first phase of the illness, it is most likely to be spread through sexual activity.
Because the sores or rashes appear in areas that come into touch with sexual fluids, such as the genitals, anus, and mouth, the illness is transmitted via direct touch with these sites. Late-stage syphilis, including the tertiary stage, is much less contagious because it is mainly internal. Syphilis is a sexually transmitted disease (STD) caused by Treponema pallidum bacteria.
This disease is passed from one person to another via direct contact with a syphilis sore, which can be found on the external genitalia, vagina, anus, or rectum, and, in rare cases, on the lips or in the mouth (in the case of oral syphilis). Hence, the correct answer is option (C).
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LEARNING OBJECTIVES CHAPTER 10 IDENTIFYING AND APPLYING LANGUAGES OF LOVE Identify and apply the languages of love in specific situations Reflect on the impact of using love languages. INSTRUCTIONS For each of the situations below, offer examples of how the languages of love might be applied and reflect on what the impact might be of using love languages. 1. John and Daphne have been married for six months. He's in school full time during the day and works full time at night. Daphne works full time days and commutes an hour each way to her job. On the weekends, they're both extremely tired and John needs time to study. Lately they've been fighting about little things and John is afraid that the "honeymoon" is truly over. He could express his love to Daphne by (give specific examples for each of the love languages): Words of affection: Quality time: Gifts: Acts of Service: Physical touch: Which love language or combination of love languages do you think would be the most effective for John use? Why? 2.Cecilia and Jerry have been in a dating relationship for three years. Jerry is divorced and has two young children who he takes care of every other weekend. Jerry has expressed feelings of love for Cecilia, but he's nervous about making another long term commitment. After three years, Cecelia is ready for a commitment. She would like to have children of her own and is anxious about "wasting her time" with a man who doesn't want what she wants. For a while, Cecelia has been showing her discontent by picking lots of fights about small things. But she does love him and still has hopes for the future. She would like to express her love to Jerry and see if they can deepen their commitment (give specific examples for each of the love languages): Words of affection: Quality time: Gifts: Acts of Service: Physical touch: Adapted from Adler & Proctor, Looking Out, Looking In, Student Activities Manual, 15th ed Which love language or combination of love languages do you think would be the most effective for Cecilia to use? Why? 3.Jane and Samantha have been in a committed romantic relationship for more than 10 years. The state in which they 3.Jane and Samantha have been in a committed romantic relationship for more than 10 years. The state in which they live has recently passed a law making it legal for them to marry. They happily set a date for their wedding, but since that time Jane and Samantha have had many arguments. Jane has been feeling very depressed because many of her family members are against her getting married and have told her that they will not attend. Samantha's family has been very supportive and are actively participating in planning the big event. Jane has withdrawn from participating in the preparations. Instead of fighting, Samantha would like to reconnect with Jane and engage her in their wedding plans in a positive way. (give specific examples for each of the love languages): Words of affection: Quality time: Gifts: Acts of Service: Physical touch: Which love language or combination of love languages do you think would be the most effective for Samantha to use? Why? 4.Using your romantic relationship or the romantic relationship of someone close to you, share expressions of love (give specific examples for each of the love languages): Words of affection: X Quality time: Gifts: Acts of Service: Physical touch: Which love language or combination of love languages do you think would be the most effective to use?
The love languages of John and Daphne are:
Words of affectionQuality timeGiftsWhat is love languagesWords of love: John seem express his cherish to Daphne by taking off small notes or sending content messages all through the day, communicating his appreciation for her difficult work and commitment.
Quality time: John might arrange a extraordinary date night where they can spend continuous time together, such as going for a walk, having a excursion, or observing a motion picture at domestic.
Blessings: John might astonish Daphne with little astute endowments, such as her favorite nibble, a book she's been needing to perused, or a unwinding shower set.
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How many mL of a 15% w/v solution can be made from 300 g of dextrose? PCMC
300 mL of a 15% w/v solution can be made from 300 g of dextrose.
To find the number of mL of a 15% w/v solution that can be made from 300 g of dextrose, we need to follow the steps below. Step 1: Convert the given mass of dextrose into grams.300 g of dextrose = 300 × 1000 mg of dextrose (since 1 g = 1000 mg)= 300000 mg of dextrose Step 2: Calculate the mass of dextrose that will be required to make 150 mL of a 15% w/v solution.
We know that a 15% w/v solution means there are 15 g of dextrose in 100 mL of solution. Therefore, to make 150 mL of a 15% w/v solution, we would need:(15 g/100 mL) × 150 mL= 22.5 g of dextrose Step 3: Use the formula for percentage w/v to calculate the amount of dextrose that can be dissolved in 150 mL of water.15% w/v = (mass of solute/volume of solution in mL) × 100 Rearranging this formula gives: mass of solute = (percentage w/v × volume of solution in mL) / 100mass of solute = (15 × 150) / 100mass of solute = 22.5 g Step 4: Use the mass of dextrose from step 2 to calculate the volume of water needed to make 150 mL of a 15% w/v solution. Let x be the volume of water needed. Then, mass of dextrose + mass of water = total mass of solution22.5 g + x g = 150 g We know that 1 mL of water has a mass of 1 g.
Therefore, x g = 150 g - 22.5 gx = (150 - 22.5) gx = 127.5 g = 127.5 mL (since 1 mL of water has a mass of 1 g)So, 127.5 mL of water is needed to make 150 mL of a 15% w/v solution. Now, let's find how many mL of a 15% w/v solution can be made from 300 g of dextrose. We already found out that 22.5 g of dextrose are needed to make 150 mL of a 15% w/v solution. Therefore, to make 300 g of dextrose we would need 2 × 150 mL = 300 mL of a 15% w/v solution. Thus, 300 mL of a 15% w/v solution can be made from 300 g of dextrose. Answer: 300.
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Patients in the chronic phase of SCI are likely to
experience:
B. Decreased fat mass
A. Increased energy needs
C. Decreased lean body"
Patients in the chronic phase of Spinal Cord Injury (SCI) are likely to experience decreased fat mass and decreased lean body. However, there may be an increase in energy needs for these patients.
There are two types of spinal cord injuries, complete and incomplete. A complete spinal cord injury is when there is a total loss of all motor and sensory function below the level of injury. On the other hand, an incomplete spinal cord injury is when there is some level of function below the level of injury. A person with SCI may have to deal with lifelong complications.
A person in the chronic phase of spinal cord injury is more likely to experience complications such as bladder infections, kidney stones, urinary tract infections, pressure sores, respiratory infections, pneumonia, and more. The muscle mass may decline, and there may be an increase in body fat due to a decrease in activity and metabolism. This is why it is essential to maintain a healthy weight by eating healthy and balanced diets and engaging in physical activity regularly.
Overall, it is essential to monitor patients with SCI for the development of complications and to manage these complications appropriately. A team of healthcare professionals should be involved in their care to ensure that they maintain a healthy lifestyle and avoid further complications.
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Scott is a 14 year old boy newly diagnosed with Type 1 diabetes. He needs to eat 80 - 100 grams of carbohydrate (CHO) at each meal and 15 grams of CHO at each snack. Using Carbohydrate Counting (see page 563 in textbook), help Scott plan 1 breakfast, 1 lunch, 1 dinner and 2 snacks that provide the correct amount of carbohydrate. Your menu should:
Be appropriate and appealing for a 14 year old boy.
include specific foods and portion sizes
specify the grams of CHO for each food and total for each meal/snack. To find CHO content of foods, you can use any of the following resources: Table 21-5 or Appendix A in your textbook; USDA FoodData Central. You are familiar with all of these. You may also use food labels or the MyPlate website.
We will provide Scott with a menu that specifies the grams of carbohydrates for each food and the total for each meal and snack, ensuring it is appropriate and appealing for his preferences and needs.
Menu for Scott:
1. Breakfast:
- 1 cup of oatmeal (30g CHO)
- 1 medium-sized banana (30g CHO)
- 1 cup of milk (12g CHO)
Total: 72g CHO
2. Lunch:
- Turkey sandwich: 2 slices of bread (30g CHO), 4 ounces of turkey (0g CHO), lettuce, and tomato
- 1 small apple (15g CHO)
- 1 cup of carrot sticks (8g CHO)
Total: 53g CHO
3. Dinner:
- Grilled chicken breast (0g CHO)
- 1 cup of cooked brown rice (45g CHO)
- 1 cup of steamed broccoli (10g CHO)
- 1 small dinner roll (15g CHO)
Total: 70g CHO
4. Snack 1:
- 1 medium-sized orange (15g CHO)
- 1 string cheese (0g CHO)
Total: 15g CHO
5. Snack 2:
- 1 cup of yogurt (30g CHO)
- 1 small granola bar (15g CHO)
Total: 45g CHO
By following this menu plan, Scott will be able to meet his carbohydrate requirements, with each meal providing 80-100 grams of CHO and each snack providing 15 grams of CHO.
It's important to note that the specified portion sizes and carbohydrate content may vary depending on the specific brand or preparation method used. Therefore, it's crucial to refer to food labels, reliable resources such as Table 21-5 or Appendix A in the textbook, USDA FoodData Central, or the MyPlate website to obtain accurate carbohydrate information.
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Browse the Healthy People 2030 website Data Sources and write 3 or more paragraph explaining the topic Cardiac Arrest Registry to Enhance Survival (CARES)
-Add any additional information or sources you choose
The Cardiac Arrest Registry to Enhance Survival (CARES) is an important initiative that is featured on the Healthy People 2030 website. The registry is designed to help healthcare professionals collect data on out-of-hospital cardiac arrests and improve outcomes for patients.
The CARES system is a standardized way for healthcare providers to collect and track data on patients who experience a sudden cardiac arrest. The registry can help healthcare providers to identify areas where care can be improved and can be used to develop new strategies for improving outcomes for cardiac arrest patients. The registry also allows healthcare providers to track patient outcomes over time, which can help to determine which interventions are most effective.
The registry allows healthcare providers to track patient outcomes over time, identify areas where care can be improved, and develop new strategies for improving outcomes for cardiac arrest patients. Through the CARES initiative, healthcare providers can better understand the causes and risk factors associated with sudden cardiac arrest, which can help to inform public health policies and guidelines for cardiac arrest prevention and treatment.
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What were the modes of transmission for the virus in the movie Contagion? If you were an epidemiologist assigned to this pandemic, on which specific link(s) in the chain of infection would you have focused?
The modes of transmission for the virus in the movie Contagion include coughing and sneezing, contact with surfaces, and direct contact.
The modes of transmission for the virus in the movie Contagion were coughing and sneezing, contact with surfaces, and direct contact. The virus could be transmitted when an infected person coughs or sneezes in the presence of others, causing respiratory droplets to spread from one person to another. Another mode of transmission was through contact with surfaces that were contaminated by the virus, such as door handles, tables, or any object used by the infected person. The virus could also be transmitted through direct contact with an infected person.
As an epidemiologist assigned to this pandemic, I would focus on the links in the chain of infection, including the mode of transmission, source of the infection, and susceptible host. I would work to prevent the virus from spreading further by promoting healthy practices such as proper hygiene, social distancing, and isolation of infected individuals. Moreover, I would identify the source of the virus and take appropriate measures to limit or eliminate the spread of the virus.
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The contributing factors of "retained surgical item"
(RSIs)? and suggestions to optimization of existing prevention
methods, such as the surgical count?
The contributing factors of "retained surgical item" (RSI) include human error, communication breakdown, distractions, inadequate staffing, fatigue, and lack of standardized protocols.
Other factors can include complex surgical procedures, emergency situations, and equipment malfunctions. These factors can lead to a failure in the surgical count process, which is one of the primary methods used to prevent RSIs. To optimize existing prevention methods such as the surgical count, several suggestions can be implemented. First, enhanced team communication and collaboration are crucial. Implementing standardized protocols, including preoperative briefings and postoperative debriefings, can improve communication and ensure everyone is aware of their responsibilities. Additionally, using technology-assisted systems like radiofrequency identification (RFID) and barcode scanning can enhance the accuracy of the surgical count and reduce human error. Regular training and education on RSI prevention, emphasizing the importance of the surgical count, and creating a culture of safety within the surgical team are also essential.
Furthermore, promoting a supportive and non-punitive environment where healthcare professionals can report near-miss incidents or potential RSI cases without fear of retribution can help identify system gaps and improve prevention strategies. By addressing these factors and implementing these suggestions, healthcare facilities can optimize the existing prevention methods for RSIs, ultimately reducing the occurrence of these preventable surgical errors.
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Identify the subjective statement:
The patient's vehicle was noted to have 2' of frontal intrusion damage
The patient's vehicle was noted to be in contact with the other vehicle's rear end.
The patient's vehicle rear-ended the other vehicle with approximately 2' of frontal intrusion damage created
The patient's vehicle has 2' of crumpling on the front end and is resting against the rear end of the other vehicle
Question 3 of 10
Identify the subjective statement:
The patient displayed a circular burn on the inside of his thigh, approximately 1/2 the diameter of a dime
Upon examination the patient has a round wound that appears to be a burn approximately the width of a pen
The patient displayed a small circular burn of about 1/3" on the inside of his thigh
The patient has a cigarette burn to the inside of the thigh
The subjective statement in the given options is: "The patient has a cigarette burn to the inside of the thigh."
A subjective statement is one that includes personal opinions, interpretations, or value judgments rather than objective facts. In this case, all the other statements provide objective descriptions of the patient's condition or the vehicles involved in an incident.
However, the statement "The patient has a cigarette burn to the inside of the thigh" is subjective because it involves an interpretation of the nature of the injury. Whether the burn is actually caused by a cigarette or not is a subjective conclusion that requires further investigation or confirmation.
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Chapter 14, Risk of Infectious and Communicable Diseases
Case Study # 2
A public health nurse is asked to investigate the number of cases of HPV in women in the community. The public health nurse needs to put a series of educational programs together. (Learning Objective: 7)
a. What is the estimation of sexually active men and women acquiring genital HPV infection in their lifetime?
b. What is the difference between the two groups of genital HPV?
c. What recommendations has the CDC put forth about HPV vaccines?
d. What age group has the highest prevalence of HPV?
a. It is estimated that 75% of sexually active men and women will acquire genital HPV infection in their lifetime.
But, the majority of these infections will be asymptomatic and self-limited, and about 10% of men and 5% of women will develop persistent HPV infections that may progress to cancer. b. The two groups of genital HPV are low-risk types and high-risk types. Low-risk types cause genital warts, while high-risk types cause cancer. c. The CDC has recommended HPV vaccines for all females and males aged 9-26 years. Three doses of the vaccine are given over six months. The vaccine is recommended to be given before the onset of sexual activity when the person is not exposed to the virus. Vaccination may also be offered to males aged 22 to 26 years who have not been vaccinated before. d. The highest prevalence of HPV is in young adults aged 15 to 24 years. HPV is the most common sexually transmitted disease in the United States, and about 14 million people are infected with the virus every year.
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To help with the novel disease a new vaccine was developed. In a experimental study a group of
400 people were randomized to either the treatment group (received the vaccine) or the control group
(placebo). 200 children took the experimental medication and 10 developed the disease after 2 months.
Among the 200 who were in the control group and took the placebo, 45 developed malaria over that
same period.
Additionally, A new test was also developed to help screen for the new disease quicker. The gold
standard test was the PCR test and was used to confirm if the new rapid screening test was accurate.
When the new screening test was used it found that 22 people had a positive result and 55 had a
negative result. Of the 22 who were positive on the screener the confirmatory PCR test found that 20 of
them were true positives. Of the 55 who were negative on the screener 43 of them were confirmed to
be true negatives on the confirmatory PCR test.
YOU MUST SHOW YOUR WORK
Please calculate and interpret the following:
1. Relative risk of the new vaccine (leave as a decimal)
2. Efficacy of the new vaccine (convert to a %)
3. Sensitivity of the new screener test (convert to a %)
4. Specificity of the new screener test (convert to a %)
5. Positive Predictive Value of the new screener test (convert to a %)
6. Negative Predictive Value of the new screener test (convert to a %)
1. Relative risk of the new vaccine:Relative risk (RR) = (attack rate in the treatment group) ÷ (attack rate in the control group) = (10 ÷ 200) ÷ (45 ÷ 200) = 0.22RR = 0.22The relative risk of the new vaccine is 0.22.2.
Efficacy of the new vaccine:Efficacy = (1 - RR) × 100 = (1 - 0.22) × 100 = 78%Efficacy = 78%Therefore, the efficacy of the new vaccine is 78%.3. Sensitivity of the new screener test:Sensitivity = (true positives) ÷ (true positives + false negatives) = 20 ÷ (20 + 2) = 20 ÷ 22Sensitivity = 91%Sensitivity = 91%Thus, the sensitivity of the new screener test is 91%.4. Specificity of the new screener test:Specificity = (true negatives) ÷ (true negatives + false positives) = 43 ÷ (43 + 12) = 43 ÷ 55Specificity = 78%
Therefore, the specificity of the new screener test is 78%.5. Positive Predictive Value of the new screener test:Positive Predictive Value (PPV) = (true positives) ÷ (true positives + false positives) = 20 ÷ (20 + 12) = 20 ÷ 32Positive Predictive Value = 62.5%Therefore, the Positive Predictive Value of the new screener test is 62.5%.6.
Negative Predictive Value of the new screener test:Negative Predictive Value (NPV) = (true negatives) ÷ (true negatives + false negatives) = 43 ÷ (43 + 2) = 43 ÷ 45Negative Predictive Value = 95.6%Thus, the Negative Predictive Value of the new screener test is 95.6%.
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Decreased ECF (extracellular) volume would result in
A) sympathetic output from the cardiovascular control center to increase.
B) parasympathetic output from the cardiovascular control center to increase.
C) the force of ventricular contraction to decrease.
D) arteriolar vasodilation.
E) A and D are correct.
Decreased extracellular fluid (ECF) volume would result in Sympathetic output from the cardiovascular control center to increase and Arteriolar vasodilation.
Explanation: Decreased extracellular fluid (ECF) volume would result in a decrease in blood volume, decrease in blood pressure and a decrease in blood flow to the kidneys and brain. The effect is sensed by the baroreceptors in the carotid and aortic arch, which send signals to the cardiovascular control center in the medulla oblongata. The cardiovascular control center responds by increasing sympathetic output and decreasing parasympathetic output, which leads to an increase in heart rate, force of ventricular contraction, arteriolar vasoconstriction and venous constriction, and release of aldosterone and antidiuretic hormone.
The increase in heart rate and force of ventricular contraction helps to maintain cardiac output, while the arteriolar vasoconstriction and venous constriction help to increase peripheral resistance and return venous blood to the heart. The release of aldosterone and antidiuretic hormone helps to increase sodium and water reabsorption by the kidneys, which helps to increase blood volume and blood pressure.
Arteriolar vasoconstriction increases peripheral resistance, and venoconstriction increases venous return to the heart, which increase cardiac output. Thus, options A and E are correct. Arteriolar vasodilation is incorrect. So, option E is incorrect.
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Under COVID-19 pandemic, the demand for COVID-19 Rapid Test Kit greatly increased. A trader purchased a batch of the rapid test kit and would like to conduct an inspection to secure the product quality before released to market. The information of the product is as listed below:
Product name: Trusty COVID-19 Rapid Test Kit
Supplier: The Best Medical Co.
Batch size: 10000 boxes
Lot number: 202205
Expiry Date: Apr 2024
The inspection is implemented under the ANSI /ASQ Z1.4 standard, general inspection level II, single sampling plan with AQL for critical, major and minor defects are 0.065, 0.65 and 6.5 respectively.
a) Identify 3 quality characteristics for rapid test kit and assign the corresponding defect level with reason.
b) With the quality characteristics elaborated above, prepare a checklist for the inspection.
a) The 3 quality characteristics for COVID-19 rapid test kit are: accuracy, sensitivity and specificity. b) Checklist for the inspection: Boxes in the batch, Lot number and expiry date, Accuracy of the test kit, Sensitivity of the test kit, Specificity of the test kit,
Accuracy: The accuracy of the Trusty COVID-19 Rapid Test Kit must be tested with the help of standards that are set by the regulatory authorities. Inaccurate results can put people's lives at risk, particularly when they are dealing with a pandemic like COVID-19. Therefore, the AQL for critical defects is set at 0.065.
Sensitivity: The Trusty COVID-19 Rapid Test Kit's sensitivity should also be tested with the help of standards that are set by the regulatory authorities. Sensitivity is the minimum amount of viral load that the test kit can detect. If the kit is not sensitive enough, it may not detect the virus in the patient, leading to a false negative result. Therefore, the AQL for major defects is set at 0.65.
Specificity: The Trusty COVID-19 Rapid Test Kit must not give false positive results because they can lead to unnecessary panic and further testing that is unnecessary. Specificity is the ability of the test kit to detect only the virus and nothing else. Therefore, the AQL for minor defects is set at 6.5.
b) Quality checklist for Trusty COVID-19 Rapid Test Kit inspection: A checklist that can be used to inspect the Trusty COVID-19 Rapid Test Kit includes the following elements: Items to be inspected:
Boxes in the batch, Lot number and expiry date, Accuracy of the test kit, Sensitivity of the test kit, Specificity of the test kit, Checkpoints for inspection:
Verify that the boxes in the batch match the delivery note,
Verify that the lot number and expiry date on the boxes match the delivery note,
Verify that the accuracy of the test kit is as per the standard test,
Verify that the sensitivity of the test kit is as per the standard test,
Verify that the specificity of the test kit is as per the standard test,
Verify that there are no critical, major or minor defects in the test kits in the batch,
Conduct a random inspection of boxes in the batch to ensure that the test kits are working properly.
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Discuss what patient teaching the nurse can do that does not
involve medication? Why is this important?
Patient teaching that does not involve medication plays a crucial role in nursing care. It encompasses disease management, health promotion, self-care techniques, safety measures, and emotional support.
Patient teaching is an essential aspect of nursing care that goes beyond medication administration. By providing education and empowering patients with knowledge, nurses can enhance patient outcomes and promote self-management. Here are a few examples of patient teaching that does not involve medication:
Disease management: Nurses can educate patients about their specific condition, including its causes, symptoms, and potential complications. They can teach patients about lifestyle modifications, such as diet and exercise, that can help manage or prevent the progression of their condition.
Health promotion: Nurses can provide information on healthy behaviors, such as smoking cessation, stress management, and maintaining a balanced diet. They can discuss the importance of regular screenings, immunizations, and preventive care to help patients maintain optimal health.
Self-care techniques: Nurses can teach patients about self-care practices, such as wound care, proper hygiene, and the use of medical devices or assistive devices. Patients can learn how to manage their own conditions and perform activities of daily living more effectively.
Safety measures: Nurses can educate patients about safety precautions and injury prevention strategies. This may include guidance on fall prevention, home safety modifications, and the correct use of mobility aids or assistive devices.
Emotional support: Nurses can provide counseling and emotional support to patients and their families, especially in challenging situations or during end-of-life care. They can offer guidance on coping mechanisms, stress reduction techniques, and resources for additional support.
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a nurse is assessing a family's interactions with a local recreational soccer league their daughter participates in, their synagogue, their children's private school community, and their neighborhood. which tool would be best for the nurse to use?
In addition, the nurse can use the tool to evaluate the effectiveness of the plan of care over time. The Family APGAR tool is an effective tool for assessing family functioning and identifying areas for improvement in families.
A nurse that is assessing a family's interactions with a local recreational soccer league, their synagogue, their children's private school community, and their neighborhood would use the Family APGAR tool. Family APGAR stands for Adaptability, Partnership, Growth, Affection, and Resolve. This tool is commonly used to evaluate family functioning. A nurse can use the tool to determine if the family is functioning well or if there are any issues that need to be addressed. The Family APGAR tool is made up of five sections, each representing an area of family functioning.
The nurse asks the family members questions about each of these sections and scores their responses. If the score is high, it means that the family is functioning well in that area. If the score is low, it means that there are issues that need to be addressed.The tool is helpful in identifying any problems that may be affecting the family's interactions with the soccer league, synagogue, private school community, and neighborhood. The nurse can then use the results of the assessment to develop a plan of care to help the family address these issues.
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A prime mover (agonist) is the name given to a muscle producing the majority of the ____________ during a joint movement.
A prime mover, also called an agonist, is a muscle that is primarily responsible for generating the force required for joint movement. When it contracts, it produces a concentric contraction, shortening and tightening the muscle fibers. This movement is essential for generating the force required for the joint to move through its range of motion.
Prime movers work together with other muscle groups, such as synergists and antagonists, to create a coordinated movement. The prime mover works by creating the initial movement, while the synergists work to stabilize the joint, and the antagonists work to slow down or stop the movement.
There are various muscles in our body, which work as prime movers or agonists. For instance, the biceps are prime movers in elbow flexion, while the triceps are prime movers in elbow extension. The quadriceps are prime movers in knee extension, while the hamstrings are prime movers in knee flexion.
The pectoralis major is a prime mover in shoulder flexion, while the latissimus dorsi is a prime mover in shoulder extension. The prime mover or agonist is an essential muscle that generates the majority of the force during joint movement. Without it, it would be challenging to produce coordinated movements and execute daily activities like walking, running, and lifting objects.
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Please code the following scenarios, assigning ICD-10-CM diagnosis codes only:
** Use your Official Coding Guidelines for things like sequencing overdoses and coding CHF with hypertension- these are important guidelines that will come up on the CCA exam also.
Connor Smith was admitted at 17 days of age with a high temperature. Connor also has an atrial septal heart defect and will be followed up with cardiology after discharge. A cause of the temperature was not found and the physician listed a final diagnosis of fever.
Based on the information provided, the assigned ICD-10-CM diagnosis code is R50.9 for fever.
The scenario states that Connor was admitted with a high temperature, but a specific cause for the fever was not identified. Therefore, the unspecified code R50.9 is appropriate in this case. It is important to follow the Official Coding Guidelines, which recommend using the most specific code available.
However, in situations where a definitive cause cannot be determined, an unspecified code is used. It is mentioned that Connor also has an atrial septal heart defect, but no further details or documentation regarding this condition are provided.
Therefore, the focus is on the symptom of fever, and the code R50.9 accurately reflects the final diagnosis based on the available information.
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The nurse is filling out an incident report after an older adult client fell while attempting to transfer this person from bed to a commode. Which health problem-should the nurse consider when client falls occer? A. Bradypnea. B. Palpitations. C. Primary hypertension. D. Orthostatic hypotension
When a nurse is filling out an incident report after an older adult client fell while attempting to transfer this person from bed to a commode, the nurse should consider orthostatic hypotension as the health problem the client is suffering from.
Orthostatic hypotension is a medical condition characterized by a decrease in blood pressure that occurs when a person stands up from a sitting or lying down position. It is most common in older adults.
Its symptoms include dizziness, lightheadedness, and falls. When a client falls in such a situation, it is essential to consider orthostatic hypotension as one of the probable causes of the fall. Therefore, the answer is option D. Orthostatic hypotension.
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Mr. Cervantes is a 68-year-old male patient who comes to your office complaining of increased left knee pain for the past 3 to 4 months. He has had no history of recent injury. An x-ray done less than 4 months ago showed degenerative osteoarthritic changes. He has a full range of motion and denies any recent swelling, pedal edema, temperature change, or discoloration. In Spain, Mr. Cervantes competed in many marathons since he was 19 years young. He was diagnosed with osteoarthritis of his left knee more than 10 years ago. He has decreased his weekly running, but the pain is persistent and is affecting his daily activities. He has been using over-the-counter NSAIDs on and off, but states they are no longer working and wants something "stronger." His vital signs are all stable (within appropriate parameters) and his history is free of fever, chills, or rashes. He reports feeling healthy other than the knee pain.
1. How would you approach the management of this patient?
2. What education/adherence, monitoring, and follow-up do you plan?
1. Approach to the Management of Mr. Cervantes diagnosed with degenerative osteoarthritic changes:
- Conduct a thorough physical examination of the left knee, assessing for tenderness, swelling, joint stability, and range of motion.
- Consider ordering additional diagnostic tests such as MRI or joint aspiration if deemed necessary.
- Review the previous x-ray and medical history to confirm the diagnosis of degenerative osteoarthritis in the left knee.
- Evaluate Mr. Cervantes' current level of pain and its impact on his daily activities using validated pain assessment tools.
- Discuss non-pharmacological treatment options such as weight management, physical therapy, and joint-strengthening exercises to improve symptoms and functionality.
- Assess Mr. Cervantes' functional and mobility needs to determine the appropriate assistive devices (e.g., knee brace, cane) that may alleviate symptoms.
- Evaluate his current medication regimen, including over-the-counter NSAIDs, to ensure appropriate use and assess for any potential drug interactions or contraindications.
- Consider prescribing stronger pain medications, such as oral or topical analgesics, if conservative measures are not providing adequate relief.
2. Planned Education/Adherence, Monitoring, and Follow-Up:
- Provide Mr. Cervantes with education about osteoarthritis, including its chronic nature and the importance of long-term management.
- Discuss the potential risks and benefits of various treatment options, including medications, and involve him in shared decision-making.
- Emphasize the importance of adherence to prescribed treatments and the need to report any adverse effects promptly.
- Instruct Mr. Cervantes on proper use and potential side effects of any prescribed medications.
- Encourage regular follow-up visits to monitor treatment effectiveness, adjust the management plan as needed, and address any concerns or questions.
- Schedule regular assessments to evaluate pain levels, functional improvement, and overall quality of life.
- Discuss strategies for self-care, such as applying heat or cold packs, maintaining a healthy weight, and engaging in low-impact exercises to support joint health.
- Collaborate with a multidisciplinary team, including physical therapists and orthopedic specialists, for further evaluation and treatment recommendations if necessary.
It is important to note that the above recommendations are general in nature and may vary depending on the specific clinical judgment, preferences of the healthcare provider, and available resources.
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1. What changes have you seen (if you are a practicing nurse) or have you heard about (if you are a nursing student with no practice experience) in clinical nursing practice within the past 2 years? How do these changes impact your ability to provide safe, effective nursing care to patients and families?
2. What areas of professional nursing practice do you see expanding based on current changes to government funding of health care?
3. What has been your personal experience as a patient or family member of a patient with the current changes in hospital care?
4. What changes in professional practice do you foresee occurring as a result of increased governmental influences in health care delivery?
5. What strategies may be helpful for nurses to cope with current and future changes in health care delivery? Design a plan for helping current and future professional nurses. Determine the feasibility of this plan.
Changes seen or heard in clinical nursing practice within the past 2 years include the use of new technologies to improve patient outcomes, changes in health care policies and regulations, and increased emphasis on interprofessional collaboration.
1. These changes have impacted the ability of nurses to provide safe and effective care by requiring nurses to continuously update their skills and knowledge. Nurses must also be able to work closely with other health care professionals to provide coordinated care to patients.
2. Areas of professional nursing practice that are expanding based on current changes to government funding of health care include care coordination, population health management, and patient education. These areas are all essential to improving patient outcomes and reducing health care costs.
3. Personal experiences as a patient or family member of a patient with the current changes in hospital care may vary, but many people report feeling that the quality of care has improved due to the increased emphasis on patient safety and satisfaction.
4. Changes in professional practice that may occur as a result of increased governmental influences in health care delivery include increased emphasis on evidence-based practice, improved patient safety, and greater accountability for health care outcomes.
5. Strategies that may be helpful for nurses to cope with current and future changes in health care delivery include staying up-to-date with the latest research and technologies, building strong relationships with other health care professionals, and participating in continuing education programs. A plan for helping current and future professional nurses might include a mentoring program that pairs experienced nurses with new graduates or students. The feasibility of this plan would depend on the availability of experienced nurses to participate in the program and the resources needed to support the program.
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Changes seen or heard in clinical nursing practice within the past 2 years include the use of new technologies to improve patient outcomes, changes in health care policies and regulations, and increased emphasis on interprofessional collaboration.
1. These changes have impacted the ability of nurses to provide safe and effective care by requiring nurses to continuously update their skills and knowledge. Nurses must also be able to work closely with other health care professionals to provide coordinated care to patients.
2. Areas of professional nursing practice that are expanding based on current changes to government funding of health care include care coordination, population health management, and patient education. These areas are all essential to improving patient outcomes and reducing health care costs.
3. Personal experiences as a patient or family member of a patient with the current changes in hospital care may vary, but many people report feeling that the quality of care has improved due to the increased emphasis on patient safety and satisfaction.
4. Changes in professional practice that may occur as a result of increased governmental influences in health care delivery include increased emphasis on evidence-based practice, improved patient safety, and greater accountability for health care outcomes.
5. Strategies that may be helpful for nurses to cope with current and future changes in health care delivery include staying up-to-date with the latest research and technologies, building strong relationships with other health care professionals, and participating in continuing education programs. A plan for helping current and future professional nurses might include a mentoring program that pairs experienced nurses with new graduates or students. The feasibility of this plan would depend on the availability of experienced nurses to participate in the program and the resources needed to support the program.
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Discuss the importance of taking prescribed medication for a
pediatric client with a cardiovascular disorder.
It is crucial to take prescribed medication for a pediatric client with a cardiovascular disorder. Cardiac diseases can significantly impact the growth and development of children. Treatment plans are designed to address specific issues related to the disorder.
The appropriate medication helps maintain a stable environment within the body, ensuring the body gets the necessary nutrients and oxygen for growth and development. This is particularly critical for children, whose bodies are growing and developing.
There are several reasons why taking prescribed medication is important for a pediatric client with a cardiovascular disorder. Firstly, medication can help reduce symptoms such as chest pain, shortness of breath, and dizziness, and improve the child's overall well-being. It is essential to note that taking medication as directed is the most effective way to manage the symptoms of cardiac disease. Secondly, medication can help prevent long-term damage to the heart, which can lead to significant health issues later in life. By taking medication as directed, the pediatric patient can reduce their chances of developing severe cardiac problems later in life.
Lastly, taking medication as directed can help reduce hospitalizations, missed school days, and emergency room visits. It also ensures that the child's disease is being managed correctly and helps prevent further complications. In summary, taking medication as directed is vital to a pediatric client with a cardiovascular disorder. It helps manage symptoms, prevents long-term damage to the heart, and reduces hospitalizations and missed school days. Therefore, it is crucial to take prescribed medication for pediatric patients with a cardiovascular disorder.
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You have a 75, year-old woman who lives in a group home she has physiological and psychological issues. As an LPN what nursing intervention within your scope of practice can you perform to help, her take better care of her health.
As an LPN, I am a licensed practical nurse who provides direct patient care under the supervision of a registered nurse or physician. My scope of practice includes performing a wide range of nursing interventions to promote the health, well-being, and safety of patients.
As an LPN, I can perform the following nursing interventions within my scope of practice to help the 75-year-old woman take better care of her health:
Conduct a comprehensive assessment of her physical and psychological health: This includes taking her vital signs, assessing her mobility, looking for signs of infection, and asking about her symptoms and medical history.
Develop a care plan: Based on the assessment, I will develop a care plan that outlines specific nursing interventions that are necessary to address her health needs. This plan should be tailored to her specific needs and should be reviewed and updated regularly.
Administer medications: As an LPN, I can administer medications as prescribed by the woman's physician and as authorized by the state's Board of Nursing.
Monitor vital signs: I will monitor the woman's vital signs, such as her blood pressure, heart rate, and respiratory rate, on a regular basis to detect any changes or abnormalities.
Assist with activities of daily living (ADLs): I will assist the woman with activities such as bathing, dressing, grooming, and using the bathroom.
Assess for signs of pressure ulcers: I will assess the woman for signs of pressure ulcers and document them in her medical record.
Assess for fall risk: I will assess the woman for fall risk and implement interventions to prevent falls, such as providing supervision and assistive devices.
Provide education: I will provide the woman with education on her health conditions, medications, and self-care practices, such as proper nutrition, exercise, and pain management.
Document care: I will document all nursing interventions and assessments in the woman's medical record to ensure continuity of care.
Collaborate with other healthcare professionals: I will collaborate with other healthcare professionals, such as the woman's physician, therapists, and social workers, to ensure that her care is coordinated and comprehensive.
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Rosiane is a 50-year-old Rwandan woman (born in the month of May) who arrived in Australia 18 years ago as refugee. She arrived with her husband (Lonji) and their 3 daughters (aged 12, 10 and 8 years) as refugees from Cogo where they had fled following The Rwandan crisis in 1994.
They have settled well into Australian life; their family has been very important to them and has now grown to include 2 grandchildren with another grandchild due in 6 months’ time
Rosiane and Lonji are practising Muslim’s (Sunni) and are both very active in the local African community. Rosiane is currently working 4 days per week in Lonji’s Home Cleaning business to help meet their financial needs however this has become increasingly challenging for her as she has recently become unwell.
She presented to her GP, Dr White, 2 months ago with increasing fatigue, shortness of breath, mild confusion and hardening of the Right Breast with ‘peau d’orange’ (orange dimpling) causing pain and discomfort in her breast.
Dr White referred Rosiane to Mr Sheal, a Surgical Oncologist who completed a full physical examination and undertook the following investigations:
R) Breast ultrasound
R breast fine needle biopsy
Sentinel lymph node biopsy
CBC, LFT, GFR, HBV, HCV
IHC test (ImmunoHistoChemistry) for HER2 Gene
MRI L) and R) Breast, Chest and Head
Chest X-ray
On review of all the findings Mr Sheal confirms that Rosiane has stage 4 Advanced R) Breast Cancer with lymph, lung + brain metastases. Mr Sheal discusses the diagnosis with Rosiane and Lonji and explains that approaches to treatment were now not curable but rather palliative in intent.
You are the GP Practice nurse assisting Rosiane through these early stages of diagnosis and follow-up tests.
QUESTION 1: Discuss four (4) key elements of a ‘palliative approach to care’ in relation to Rosiane.
QUESTION 2: Describe how you would complete a holistic assessment on Rosiane?
Question 1: Four essential elements of a 'palliative approach to care' in relation to Rosiane are provided below: The main aim of palliative care is to alleviate the suffering that Rosiane is currently experiencing in conjunction with cancer treatment.
It is a multidisciplinary approach that takes into account the patient's social, psychological, and religious needs, as well as her medical needs. Palliative treatment is available to anyone with a life-limiting illness, regardless of their age, race, or creed. This type of care seeks to achieve a comfortable and dignified life for Rosiane, with symptom control as its main objective. Finally, palliative care is used to support family and friends as they care for Rosiane.
It will make a substantial difference in the quality of life for Rosiane as well as her family. Question 2To complete a holistic assessment on Rosiane, the nurse should take the following steps:
First and foremost, assess Rosiane's current situation, which includes her physical, emotional, and mental states. Examine her general health, including her vital signs (blood pressure, heart rate, respiratory rate, and temperature), level of pain, and any other symptoms she is experiencing. Check Rosiane's medical history, including her current medications and allergies, as well as her social and spiritual history.
Check for any environmental hazards in her home and encourage her to seek assistance from her friends and family members. Finally, provide support and guidance to Rosiane's family members and refer them to counselling or support services if required.
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