Questions
1- Discuss how the statement “First do no harm” impacts your chosen profession. Read the following...

1- Discuss how the statement “First do no harm” impacts your chosen profession.

Read the following case study and answer the questions given:

Tony, a 91- year-old veteran of World War II, has lived in a big city all of his life and has used Veterans Administration (VA) facilities for health care that are free under his VA coverage. He also has a small residence in another nearby state where he spends weekends. One weekend, while in this nearby state, Tony fell and cut his arm and hit his head. A neighbor applied a pressure dressing to his bleeding arm and then took him to a nearby emergency room. The ER started an IV and sutured the cut on his arm. The ER also administered an EKG, which detected a heart problem. Tony was then admitted to the hospital. When she returned home, the neighbor who had taken Tony to the hospital noticed that she had blood on her clothing.

When the neighbor visited Tony the next day in the hospital, she found that he was on isolation and all visitors had to wear gowns and masks. She asked the nurse why he was on isolation. The nurse asked for, and Tony gave, permission to discuss his situation with the neighbor The nurse then told the neighbor that Tony had tested positive for MRSA.

  1. Did the nurse do anything wrong by telling the neighbor about Tony’s condition since the patient gave his permission?
  2. Should the ER nurse have cautioned the neighbor about the possibility of MRSA if she saw the blood on the neighbor’s clothing?

In: Nursing

PRINCIPLE of the FETAL SCREEN (Rosette Test): A red cell suspension (EDTA) from the D-negative mother...

PRINCIPLE of the FETAL SCREEN (Rosette Test):

A red cell suspension (EDTA) from the D-negative mother is first incubated with a serum containing anti-D and then washed to remove all unbound antibody, as in the incubation and washing phases of the IAT for weak D. Instead of adding AHG to the washed cells, a weak suspension of enzyme treated D-positive red cells (indicator cells) is added. The cell mixture is centrifuged and examined microscopically for mixed-field agglutination. Since any minor population of D-positive indicator cells added after washing form clumps around the individual fetal cells leading to larger and more readily detected agglutinate. The clumping of the coated cells is referred to as rosetting. In most cases the fetal-maternal hemorrhage is insufficient to cause a positive test. In cases that are positive, a quantitative test (Kleinhauer-Betke stain) is required to determine whether the bleed was sufficient enough to warrant the administration of a larger dose of Rh Immune Globulin to the mother.

PRINCIPLE of the KLEINHAUER-BETKE ACID ELUTION:

The Kleihauer-Betke acid elution is the method used most frequently to quantify the number of fetal cells in the maternal circulation. This method is based on the fact that fetal hemoglobin is resistant to acid elution and adult hemoglobin is not. A blood smear is prepared from a postpartum maternal sample and exposed to an acid buffer. Hemoglobin from adult cells leaches into the buffer and leaves only stroma, whereas the fetal cells retain their hemoglobin. Smears are washed, stained and examined under oil immersion. Adult cells appear as “ghosts” and fetal cells appear pink. Results are reported as the percentage of fetal cells (number of fetal cells divided by the total cells counted). The volume (in milliliters of whole blood) of the fetal-maternal bleed is equal to the percentage of fetal cells multiplied by 50.

Antepartum RhIG:

Postpartum use of Rh immunoprophylaxis has reduced pregnancy-associated immunization to the D-antigen from approximately 13% to 1-2%. The risk is further decreased to 0.1% if RhIG is also given antepartum at 28 weeks gestation. Anti-D from RhIG can remain detectable for as long as 6 months. Antepartum RhIG is given at 28 weeks gestation based on the observation that, of women who develop anti-D during pregnancy, 92% do so at or after 28 weeks. Blood tests before injection should include ABO, Rh and antibody screen and identification if necessary. A D-negative woman who has antibodies other than anti-D is still a candidate for anti-D immunoprophylaxis.

RhIG Dosage Calculation:

mL fetal blood / 30 (mL/dose) = # of doses of RhIG required

Final dose = Required dose + one additional vial

  1. When is a mother a candidate for RhoGam?

In: Nursing

Question 2 Developmental appropriateness: what does your creation offer and how does it meet the developmental...

Question 2 Developmental appropriateness: what does your creation offer and how does it meet the developmental task of the age group identified?

In: Nursing

It will soon be Thanksgiving and families gather for a feast. Identify 10 foods that can...

It will soon be Thanksgiving and families gather for a feast. Identify 10 foods that can be possible sources of contamination that could occur before, during, or after the meal and why. What practices could minimize the risk of food-borne illness for the event?


In: Nursing

Identify some of the main barriers to the implementation of an occupational health and safety program...

Identify some of the main barriers to the implementation of an occupational health and safety program in most organizations, as well as strategies to break through these barriers

You can include topics such as resistance to change as well as traditional management concerns.

In: Nursing

NURSING SITUATION # 3 On a busy day in a clinical department, patient X's drug kardex...

NURSING

SITUATION # 3
On a busy day in a clinical department, patient X's drug kardex was placed in Patient Y's place. Patient Y had been admitted on the 11-11 AM shift and had only an intravenous solution ordered and was pending. of the doctor's evaluation in the morning. When the delivery was made on duty in the report, it was reported that patient X was discharged, but the doctor indicated that he take the oral medications he had ordered for breakfast before leaving. The nurse in charge was distracted by several calls from the patients in the rooms and did not notice that the kardex were reversed, so she proceeded with the administration of the medications. Patient Y received the medications from Patient X. When the error was identified, discharge from Patient X was delayed.

1. What error do you identify in the situation?
2. Which of the National Patient Safety Goals was not met?
3. What information does the nurse need to know before administering the ordered medications to the patient?
4. How could the error be prevented?
5. What ethical-legal repercussions could arise in this case?

In: Nursing

calculate the ml/hr flow rate : Infuse 500ml of 0.9% sodium chloride solution over 2.5 hours....

calculate the ml/hr flow rate : Infuse 500ml of 0.9% sodium chloride solution over 2.5 hours. round answer to the nearest tenth ml

In: Nursing

1, Which orders do you implement first? Why? •Ventilator settings: CMV/AC rate 12, TV 550 mL,...

1, Which orders do you implement first? Why?

•Ventilator settings: CMV/AC rate 12, TV 550 mL, PEEP +5, FiO2 100%.

•0.9% NS IV infusion 100 mL hour

•Insert urinary catheter

•Fentanyl IV infusion 10-125 mcg/hour. RASS goal -3 (Mod. Sedation)

•Dexmedetomidine IV infusion 0.2-1 mcg/kg/hour. RASS goal - 3 (Mod. Sedation)

•Norepinephrine IV infusion (0.5-30 mcg/min) to maintain MAP >65.

•Vasopressin 0.04 IV infusion

In: Nursing

Explain four (4) preventive strategies the Government of Canada is taking to reduce and/or eliminate COVID-19?

Explain four (4) preventive strategies the Government of Canada is taking to reduce and/or eliminate COVID-19?

In: Nursing

= 1)Select all of the following that are associated with an increased anion gap. lactic acidosis...

=

1)Select all of the following that are associated with an increased anion gap.

lactic acidosis

salicylate poisoning

multiple myeloma

ketoacidosis

2)Select all that would apply to Cushing'Syndrome.

increased sodium

decreased sodium

increased potassium

decreased potassium

increased chloride

decreased chloride

increased magnesium

decreased magnesium

3)Select all of the following that correctly apply to a patient with untreated iron deficiency.

increased TIBC

decreased TIBC

decreased serum iron

increased serum iron

increased serum ferritin

decreased serum ferritin

4)Select all of the following that are associated with an elevated total calcium level in serum.

liver disease

hyperparathyroidism

hypoparathyroidism

multiple myeloma

5)=

Select all of the following that will be significantly increased with hemolysis.

potassium

sodium

phosphorus

magnesium

In: Nursing

the healthcare provider ordered a medication to be given 25ml/hr the bag contains 500mg/500ml how many...

the healthcare provider ordered a medication to be given 25ml/hr the bag contains 500mg/500ml how many mg-min will the patient receive

In: Nursing

A physician orders 40 mEq of KCL added to one L of D5NS IV torun...

A physician orders 40 mEq of KCL added to one L of D5NS IV to run over 12 hours.

Potassium chloride for injection is available in 2 mEq/mL.

How many mL of KCl need to be added to the IV?

What is the total number of mL in the IV?

What is the flow rate in mL/hr?

How many mEq of KCl will the patient receive each hour?

In: Nursing

Ms. Yao age 27, developed a DVT in her left thigh after surgery to repair a...

Ms. Yao age 27, developed a DVT in her left thigh after surgery to repair a fractured right femur. She is receiving IV heparin and will transition to warfarin starting tomorrow.

1. Describe the pathophysiology of DVT. How does Ms. Yao's diagnosis relate to development of DVT?

2. Identify essential information you need to safety administer the medications prescribed

3. Develop a teaching for Ms. Yao

In: Nursing

A physician orders methylprednisolone succinate 500 mg in 150 ml NS to infuse over 2 hr....

A physician orders methylprednisolone succinate 500 mg in 150 ml NS to infuse over 2 hr. the drop factor is 20 gtt/ mL. how many gtts/min will be infused? how many grams of NaCL are found in the fluids ? if infused for 1 hour 15 minutes, how many grams of NaCL will be received by the patient? how many milligrams of the drug will be received in 1 hour 15 minutes?

In: Nursing

1: Infuse 1000 ml 0.45% Normal Saline at 150ml/hr. The infusion was started at 0800 and...

1: Infuse 1000 ml 0.45% Normal Saline at 150ml/hr. The infusion was started at 0800 and should completed at 1440. Current time is 1230. Is the IV ON TIME, EARLY OR LATE?

#2: Infuse 500 ml D5W at 75ml/hr and then TKO. The infusion was started at 0645. At what time should the flow rate be changed to TKO? The current time is 1205. Is the IV ON TIME, EARLY OR LATE?

3: Infuse 3000 ml LR at 50 ml/hr and then d/c. The infusion was started Monday at 1700. The first IV bag has completed and the second bag should have started Tuesday at __________? The current time is Wednesday 0800. Is the IV ON TIME, EARLY OR LATE?

In: Nursing