A home care patient is experiencing pain secondary to surgery for head and neck cancer. She takes a liquid narcotic in suspension form. Her doctor ordered 2 teaspoons q. 4 hours, PRN for pain and gave orders to the home health nurse to titrate the dose to the patient’s pain level. The nurse is to report on the patient’s pain level and response to the analgesics every week. Given the patient’s condition and level of pain and previous response to analgesics, there is no fear of addiction in this patient. The nurse has explained the treatment plan to the patient, and she concurs with the analgesia plan. However, the patient will not measure the amount of medication she takes each time. Every time the nurse visits, the patient reports that she takes a “couple of swigs” and that it relieves the pain. She does not see the need to make a detailed record of her use of medication because the system she is using works. Design a program that will be agreeable to this patient and still meet the nursing need of documenting episodes of pain and how much medication was needed for relief of pain. You must consider your legal and ethical role as a nurse and the ideal of patient autonomy.

What are nursing care issues around racism and LGBTQ? What are nurse's professional or personal boundaries as it relates to nursing therapeutics.?

Orthopedic Nursing

Patient Scenario

Mary Jane is an 81-year-old woman was admitted to hospital after a simple fall, complaining of hip pain and inability to walk. The affected right leg appeared internally rotated. Passive motion was painful, and active movement was impossible secondary to pain. The patient has several chronic medical problems including as DM, Hypertension and Ischemic Heart Disease. Treatment in the Accident and Emergency Department was centered around her diagnosis of a fractured right femur. She lives in a nursing home, although she was independently ambulant. She has now been admitted to your Orthopedic Unit for further management.

Chief Concern:

• Severe, sharp pain on movement 9/10
• Inability to bear weight, sit-up or ambulate

PHH (Past Health History):

• appendectomy age 15, fractured clavicle age 19.
• laminectomy (L4‐5) 17 years ago due to a work-related injury.

Medications History:

• acetaminophen 500 mg PO q6h
• Insulin 70/30 12units SC, AM and PM
• Enalapril 10mg PO BD
• Atenolol 25mg PO OD
• Aspirin 81mg PO OD
• Calcium 600mg PO OD

Physical Exam:

• BP 160/94 P 103 regular R 24 T 37.2
• Conscious and alert but appears anxious, GCS 13/15
• Height 188 cm, weight 118 kg
• IVF in progress, 0.9% Nacl to left anti-cubital fossa
• Skeletal Traction to right leg with 15 pounds weights in place
• Urinary catheter in situ, on free drainage
• TED stocking in place to left lower limb

Social History:

• Trinidadian born, graduated form 5 high school
• worked on an assembly line in manufacturing company; is physically demanding
• smokes 1pk/day x 18 years, occasional marijuana use; drinks beer ~ 2/week.
• recently lost a long‐time friend at the nursing home to cancer
• spouse died 8 years ago (MI)
• no children, 1 sister alive she lives abroad

Family History

• Mother died of heart disease
• Father died of prostate cancer

Assignment Question

1. prepare a nursing care plan for Mrs. Jane, including (utilize 2 actual and 1 potential nursing diagnosis, assessment, 2 actual and 1 potential nursing diagnosis, desired outcome, nursing interventions, and evacuation).

Explain the significance of CLIA waved testing. DISCUSS CLIA waived microbiology tests that are done in a healthcare setting. Provide examples

Question:

For each area below, discuss the legal aspects (surrounding both the legislation or assessment tools) and its relevance to the aged care sector.

1.Aged Care Funding Instrument (ACFI)

2. Aged care risk classification system

3. Code of Ethics for Nurses in Australia

4. Code of Conduct for Nurses (NMBA)

5.Residential care quality assessment (RESCAREQA)

Your textbook explains the three major explanations for the continuing wage gap between men and women in the paid labor force: human capital theory, the dual labor market, and gender segregation.

In your discussion post, answer the following questions:

• Find an example of a successful effort to narrow the wage gap — either a government policy or a private company that addressed the issue with its own internal policies. Summarize the strategies or methods involved and the effects those strategies or methods produced.
• Could these same strategies or methods be effective across all areas of the labor force?
• What is one possible reason the wage gap has not narrowed across all jobs?

Write one summary reflective journal entry. APA format is not required. This is intended to be affective and creative. The journal builds upon the experience of the course and what has been learned from the self-assessment to the end of the course. Journal (Minimal 500 words)Select a caring moment in which you were engaged and write about your experience. Why was this caring moment significant? How did you express the holistic philosophy and caritas process? Observe a place in the facility you are in and assess the environment as a healing space. How would you describe that space in terms of its potential to heal? How would you enhance this healing space with what you have learned in this course?

List two factors that can influence the body's ability to absorb minerals found in food. Briefly describe and provide an example of each.

Discuss how HIPAA protects the privacy and confidentiality of patient information

.What do you value personally and professionally? Articulate your beliefs and values into your personal philosophy of nursing.

Trauma is a major healthcare and economic concern because of the loss of life, the societal burden in terms of lost productivity, increased disability of persons, as well as the consumption of healthcare resources. MVCs and homicide are the leading cause of death for individuals 15-24 years of age. A second peak in trauma related incidence occurs at the age of 35-54 and is related to poisonings from prescriptions and/or illegal drugs are the leading cause of unintentional death followed by MVCs for this age group. The third peak is for individuals 65 years related to falls and MVCs.

Individuals with traumatic injury need a lot of support from many individuals.

• Explain the meaning of the "golden hour"?
• Explain the role pastoral services on a trauma team?
• Why is it important to have security officers as part of the trauma team?
• Why is it important to participate in debriefings after significant trauma events or disasters?

Trauma is a major healthcare and economic concern because of the loss of life, the societal burden in terms of lost productivity, increased disability of persons, as well as the consumption of healthcare resources. MVCs and homicide are the leading cause of death for individuals 15-24 years of age. A second peak in trauma related incidence occurs at the age of 35-54 and is related to poisonings from prescriptions and/or illegal drugs are the leading cause of unintentional death followed by MVCs for this age group. The third peak is for individuals 65 years related to falls and MVCs.

Individuals with traumatic injury need a lot of support from many individuals.

• Explain the meaning of the "golden hour"?
• Explain the role pastoral services on a trauma team?

Task Description:  Create a referral letter for the following patient using Microsoft word & Full Block Style .

Patient: Lisa Duck

Dentist: Dr. Harry DDS, M.S  Address ...

Radiograph Findings: Impacted third molars, mild bone loss around max and mandibular molars. Fractured amalgam on the mandibular left first molar

Oral Examination Findings: Confirmed mild periodontitis, fractured amalgam, Class III Mobility on 37 electrical shock like pain that radiates to his lower lip when tooth clenched.

57. A nurse is caring for a client following a cardiac catheterization who has hives and urticaria following administration of IV contrast dye. Which of the following medications should the nurse plan to administer?

A.         Diphenhydramine

B.         Spironolactone

C.         Metoclopramide

D.         Desmopressin

58.       A nurse is completing an assessment of an older adult client and notes reddened areas over the bony prominences, but the client's skin is intact. Which of the following interventions should the nurse include in the plan of care?

A.         Apply an occlusive dressing,

B.         Turn and reposition the client every 4 hr.

C.         Support bony prominences with pillows.

D.         Massage the reddened areas three times daily.

47. A nurse is teaching a client how to use a quad cane for ambulation following a right-hemispheric stroke. Which of the following client actions indicates an understanding of the teaching?

1. Client moves the cane 2 feet ahead
2. Client takes a step before advancing the cane
3. Client holds the cane with the left hand
4. Client advances the weaker leg forward first

49. A nurse is planning care for a client who has a central venous access device for intermittent infusions. Which of the following actions should the nurse include in the plan of care?

A.         Change the dressing every 24 hr.

B.         Cleanse the site with povidone-iodine.

C.         Use clean technique when changing the dressing.

D.         Flush the catheter using a 10-ml. syringe.

62.       A nurse is planning care for a client following a cardiac catheterization. Which of the following actions should the nurse take?

A.         Keep the client on bed rest for 24 hr.

B.         Maintain the client's affected extremity in extension.

C.         Limit the client's fluid intake to 1 L per day.

53.       A nurse is caring for a client who has cervical cancer and is receiving brachytherapy. Which of the following actions should the nurse take?

A.         Discard the radioactive device in the client's trash can.

B.         Instruct visitors to remain 3 feet from the client.

C.         Limit time for visitors to 2 hr per day.

D.         Keep so led bed linens in the client's room.