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PHC 312

• If you were the head of health communication unit at Saudi MOH, how will you improve the health communication strategies used now during COVID-19
• Give suggestions and/or recommendations

Briefly discuss the importance of citizen engagement in health communication

Briefly answer the question posed in a health education class: "How does smoking affect my lungs? Why does it increase my risk of developing COPD?" Again, full credit if in your own words. The book is an excellent resource about this, but you need to be able to explain it to a lay person!

Describe the different models of health information exchange architecture and your thoughts on the importance of accurate patient identification and privacy concerns.

how would integrate e-learning into patient teaching for the population you are caring for in the community?

how this would impact specific ethnic groups that are represented in the state of New York?

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PHC 271

Case Study (2)

A 52-year-old gentleman comes to your office with a history of intermittent difficulty swallowing solid food. His symptoms have been present for the past 5 years. He points to his supraclavicular notch when describing where the food feels stuck, although he can chew his food and transfer it into his posterior pharynx without difficulty. He does not choke or cough while eating. Drinking water will usually relieve his symptoms, although on several occasions he has self-induced vomiting. His symptoms are slightly worse now than they were several years ago, which prompted today's visit. Feeling any better and had ongoing fever and cough

According to the above case answer the following questions : ( in 1000 words)

1. What is the likely diagnosis of this case? Explain, how would you classify the disease clinically and mention all the clinical manifestation? Define the disease and what are the most common causes of this is disease likely in the patient?
2. Explain the pathophysiology of this disorder?
3. Are there any risk factors for the disease? If yes, then write down the common risk factors of the disease?
4. What lifestyle changes could make a difference for this patient?

5. Discuss the public health approaches in reducing and in the prevention of this health problem?

1.What are the most important epidemiologic and demographic issues that face health systems and what are the implications of those issues for health care costs?

2. What are some of the most important steps that can be taken to improve the effectiveness and efficiency of weaker health systems? What is the role of the health care sector in improving the delivery of health care?

How can conflict in the workplace affect the quality of care for the clients? Describe examples and techniques you have seen.

You are a nurse manager for a 30-bed pediatric unit in a large urban hospital. According to the patient classification system used by the hospital, the level of acuity of pediatric patients on your unit is con­sistently very high, and the patient census averages 26. The only pediatric oncologist in town practices at your hospital and has told you in the past that he preferred to have his patients admitted to your unit because of the quality of nursing care provided, thus the unit always has a high number of pediatric patients with cancer. Additionally, two pediatric sur­geons have told you that they prefer the care pro­vided in your unit versus that at the other hospital in town. However, recently, there has been an in­crease in the number of complaints from families—twice in the past week—and one of the physicians has come to your office to talk about patient care problems. You also sense increased tension and dissatisfaction among the RNs because you have had to fill some vacant RN positions with LVNs or nursing assistants.

As you analyze the problem, you note the following facts:

• The current staff mix is 40% RNs, 30% LVNs, and 30% nursing assistants.

• One year ago, the staff mix was 60% RNs, 20% LVNs, and 20% nursing assistants, but this has changed because of the nursing short­age and hospital budget cuts.

• Quality management studies indicate that the length of stay (LOS) for your unit has increased and is now 3 days longer than the DRG allowable, and readmissions have increased over the past 6 months.

• The common theme of family member complaints is that "no one seems to know what is going on with my child's case".

• The common theme of recent physician comments is that "I can never find a nurse who knows what is going on".

In the past, the unit used the primary nursing care delivery model, but with the changes in staff mix, the unit went to a team nursing model. How­ever, when you review how assignments have been made over the past month, you find that the charge nurse has been assigning patient care according to tasks. When you ask her about the change in assignment patterns, she states that this was done because they have been so busy and short-staffed, assignment by tasks seems to be the only way to get everything done.

1. How would the nurse manager evaluate and decide which patient care delivery system would be best for the patients, staff, physicians, and other team members, as well as being cost-effec­tive and utilizing the current staffing mix?

1. Who should be involved in evaluating and making decisions about nursing care delivery models?

1. What factors related to staffing might have positively and/or negatively affected the cost-effectiveness of care provided on this pediatric unit?

1. How could you make a case to the vice president of nursing for an increase in the number of RNs to staff the pediatric unit?



1. How could clinical pathways be used to improve the quality and cost-effectiveness of care on this unit?

Patient is a 68 year old male with hx of CVA (no residuals), HTN, IDDM (type 2), COPD, asthma, CHF, CKD (stage 3), last seen in the ED on 10/4/20 for evaluation of altered mental status. He was admitted with dx of right foot gangrene. He was discharged in 10/20/20. On 10/22/20 the patient presented to ED again via AMR from restorative care center for complaints of SOB, hypoxia, and was found to have evidence of pneumonia. He was placed on oxygen 2L via nasal cannula at facility with O2 sat in the 80's. Started on diuretics. Pt was downgraded on 10/29, upgraded on 10/31 due to acute hypoxic hypercapnic respiratory failure and increasing anemia (hgb <7).

Physical findings: Pt is 253 lbs. VSS. On telemetry reading 109-111 HR. Falls precaution. Bedside commode with assist. Scrotal swelling. Skin is cool, dry; 2+ bilateral LE edema, bilateral lower extremity cellulitis, right lower extremity wound--  pressure ulcer to right heel extending unto left posterior ankle with good granulation tissue, no purulent drainage; pressure ulcer to left posterior calf with good granulation tissue, also no purulent drainage. Dressings changed per orders. On q2hr turn. Respirations labored. Crackles to all lobes, decreased breath sounds to right lower lobe. Pt has intermittent coughing, small, clear sputum (uses yankauer suction independently). Encouraging pt to deep breathe and cough. On consistent carb diet (chopped).

Medications:

Budenoside INH

Novolog Flx Pen (None were administered throughout shift; providers parameter)

Levalbuterol HCL Nebulizer

Tamsulosin HCL PO daily

Potassium Chloride PO daily

Furosemide IV daily

Levoflaxicin PO Q48hr

Guaifenesin PO BID

Pantoprazole PO BID

Zinc Oxide 1 applic. TP BID to sacrum

Febuxostat PO daily

Nystatin PO QID (swish and swallow)

Labs: (only noted the abnormal)

WBC: 3.16L

Hgb: 8.0L

Hct: 27.1L

MCH: 25.3L

MCHC: 29.5L

RDW: 19.9H

Neutrophils: 74.9H

Lymph: 12.3L

Mono: 10.6H

ABG PO2: 78L

BUN: 42H

Creatinine: 1.95H

AfAM 40L

NonAfAM 34L

Glucose: 166H (Average: providers parameter)

Calcium: 8.4L

Platelet count: 292 (normal)

Question:

- Labs: (discussed how the labs relates to the patient’s specific condition).

Discuss the difference between innate and adaptive immune responses. Be sure to include first, second, and third lines of defense. (USLO 7.1)

Give feedback regarding other factors in Lewin’s three steps that should be considered when contemplating the change

to be implemented in the workplace is to be off or come in late the day following your call shift

cholinergic antagonist are contraindicated I MG, tachy-dysrhythmias, MI, glaucoma, prostatic hypertrophy, hyperthyroidism, pregnancy and lactation. why is cholinergic antagonist contraindicated and what is the mechanism and disease pathophysiology.

1, What are the role of the RN in the ER setting. What skills are utilized? What tasks are performed?

2.How is the role of the RN in the ER setting the same as, or different from, the role of the RN in the inpatient setting? For example like assessment

From the article, "African American Complementary, Alternative, and Integrative Health" submit a minimum of 25 important questions/concepts AND the correct answers that could possibly be on your last quiz of the semester (see chapters 1 and 2 format). Essentially, you are creating your own study guide.

A 75-year-old patient at a licensed healthcare provider care center suffered from diabetes, dementia, coronary artery disease, immobile decubitus ulcers (bedsores), and was unable to walk, talk, or feed herself. Her physician prescribed a daily whirlpool bath as a medical treatment for the decubitus ulcers. The facility did not have a whirlpool, so she was given a regular daily bath. A certified nursing assistant prepared a bath for the patient and placed her in hot water that was 138 degrees and that subsequently caused severe burns from which she died three days later.

A wrongful death action was brought. Parties settled before trial for $1.5 million. Although the vignette is based on this case, do not consult the case for additional facts. Answer each question based on the facts presented in the vignette.

ANSWER ALL QUESTIONS AND DO NOT PROVIDE ANSWERS THAT IS ALREADY ON CHEGG

1. Does the apology statute apply to this case? Yes or No? Why?
2. How could the patient’s death have been prevented? How could a safer environment have been provided as it relates to caring and communication?
3. Are all of the elements of negligence present in this case?
4. Discuss the breaches of the standard of care.