SITUATION A: You just gave an injection to a patient, and after withdrawing the needle, you notice that there is no sharps container in the room. Action: Recap the needle using a one-handed recapping technique. Why?

Situation B: You are getting ready to apply gloves and notice that you have a cut on your finger.

Situation C: You accidentally get some blood on your bare hands while removing your gloves.

Situation D: A part-time clinical medical assistant was just hired. She is not immunized against hepatitis B.

The following situations may occur in the medical office. For each situation, Discuss an appropriate action to take that complies with the OSHA Occupational Exposure to Bloodborne Pathogens Standard.

Situation: You just gave an injection to a patient, and after withdrawing the needle, you notice that there is no sharps container in the room. Action: Recap the needle using a one-handed recapping technique. Why?

Situation: You are getting ready to apply gloves and notice that you have a cut on your finger.

Situation: You accidentally get some blood on your bare hands while removing your gloves.

Situation: A part-time clinical medical assistant was just hired. She is not immunized against hepatitis B.

The following situations may occur in the medical office. For each situation, Discuss an appropriate action to take that complies with the OSHA Occupational Exposure to Bloodborne Pathogens Standard.

Situation: You just gave an injection to a patient, and after withdrawing the needle, you notice that there is no sharps container in the room. Action: Recap the needle using a one-handed recapping technique. Why?

Situation: You are getting ready to apply gloves and notice that you have a cut on your finger.

Situation: You accidentally get some blood on your bare hands while removing your gloves.

Situation: A part-time clinical medical assistant was just hired. She is not immunized against hepatitis B.

Consider a recent practice change that resulted from research efforts. What were some barriers to implementation? What are common barriers for translating research into practice?

Please provide references.

Patient C is a high school senior. During the opening drive in the Friday night football game, Patient C is hit from behind. When he falls, he sustains open, comminuted fractures of his left tibia and fibula. Because he is unable to stand, an ambulance is brought onto the field to transport the young player to the hospital for evaluation.

Upon arrival at the emergency department, Patient C's leg is examined, x-rayed, and evaluated by the orthopedic surgeon on call. It is determined that prompt stabilization and cleansing of the wound would be optimal for the best possible outcome; thus, Patient C is prepared for surgery. His parents, who were at the game, arrive in the emergency department just moments after the ambulance and are available to give permission for the operative procedure. As Patient C has been medicated for pain, a history is obtained from the parents. There are no notable problems; Patient C is a healthy young man in excellent physical condition. He has not had previous operations and no previous exposure to anesthesia.

Patient C is transferred to the operating room. The anesthesiologist gives the patient a number of preoperative medications, including those to prevent PONV. The anesthesia of choice is enflurane (Ethrane), a volatile gas. The patient first receives succinylcholine prior to intubation, followed by the anesthetic gas. Within minutes, the anesthesiologist notes that Patient C's carbon dioxide levels are beginning to rise. Just as the surgeon is to begin, the patient sustains a cardiac arrest.

The anesthesiologist immediately stops the insufflation of the gas and begins to administer 100% oxygen. A code response is initiated by the remaining members of the operating team. The rescuer performing chest compressions notes that the patient's skin is warm. While resuscitative efforts continue, blood for laboratory evaluation is obtained. The arterial blood gas results demonstrate a pH of 6.9, partial pressure of oxygen (PaO₂) of 110 mm Hg, and a partial pressure of carbon dioxide (PaCO₂) of 55 mm Hg. At this point, the anesthesiologist's suspicions are confirmed; the patient is experiencing an episode of malignant hyperthermia.

As soon as the diagnosis is confirmed, the staff is ordered to administer dantrolene at a dose of 2 mg/kg. The operating room personnel contact the PACU to ask for assistance in drawing up and preparing the dantrolene. Only one nurse is available to leave the PACU, and she assists with mixing and administering the dantrolene as soon as it is prepared. Additionally, the patient requires repeat doses of sodium bicarbonate to combat the falling serum pH.

Within 15 minutes of administering the dantrolene, the patient begins to demonstrate a perfusing rhythm, although this is punctuated by frequent runs of premature ventricular contractions. Antiarrhythmics are administered to control the cardiac complications.

Simultaneously, the patient is cooled with external cold packs applied to the groin and axilla areas. The leg wound is dressed to prevent further contamination during the resuscitative efforts. Repeat blood is obtained for laboratory analysis. The patient's potassium is elevated, and the patient is started on a glucose-insulin drip.

After the patient's cardiac condition is stabilized, the operating room staff request transfer of the patient to the PACU for further management. The patient is moved, and the PACU staff becomes responsible for managing the patient. The antiarrhythmics, the glucose-insulin drip, and the cooling measures are continued. During the first 30 minutes in the PACU, the patient's urine is noted to be deep red color, indicative of developing rhabdomyolysis and potential renal failure. The patient is given 100 mg furosemide, and fluids are increased to 150 mL/hour. Within 20 minutes, the urine lightens in color, although it retains a reddish tinge.

Approximately three hours after the first cardiac arrest, the patient suffers a second arrest with the development of ventricular fibrillation. A second code response is called, and the patient is again resuscitated with dantrolene, antiarrhythmics, and sodium bicarbonate. Once again, the patient responds to treatment and regains a perfusing cardiac rhythm.

The patient is ordered to receive dantrolene every 4 hours for the following 48 hours to ensure that another episode of malignant hyperthermia does not develop. The patient is subsequently stabilized and transferred to the ICU, where he remains for 72 hours.

1. What went well? Could anything have been improved?

2. Why do you suspect the patient developed MH?

3. Do you think that the patient's fracture was stabilized and repaired? What will need to happen during subsequent surgical procedures for this patient?

A CCMA is caring for a patient who has active tuberculosis.

Which PPEs must be used during the patient’s care and why?

Metabolic syndrome is defined as a cluster of some of the following risk factors. Select each of these risk factors. Group of answer choices Low serum LDL cholesterol levels Excess abdominal fat Hyperglycemia (high blood glucose) Hypertension (high blood pressure) Low serum HDL cholesterol levels Hypertriglyceridemia (high blood triglycerides) Hyperkalemia (high blood calcium)

A patient scheduled for abdominal assessment complains of pain in the right iliac fossa. How would you carry out his abdominal assessment?   

Can you please share more information about how ACTH deficiency could affect a child with Diabetes insipidus in a child with a pituitary tumor?

Consider the Global Goals from the perspective of a community healthcare worker. Sustainable Development Goals (SDGs) Millennium Development Goals (MDGs) Answer the following questions:

1. What can you do in the community health setting to support the achievement of the Global Goals?
2. How would you educate your community about the Global Goals, especially those that focus on health and well-being?

Social issue/problem and historical background of the health care organization policy OR Hospital policy. 200 words.

A. Differentiate between focused and complete physical assessment. B. John Bosco a very good swimmer accidentally hits his head to the floor of a swimming pool during a swimming competition after diving from a 30 feet height. He was picked with a head injury in a state of unconsciousness. Describe the scale that you will used in assessing his level of unconsciousness. (7 MARKS

Four (4) technological developments made during the last twenty 25 years that influenced the workplace culture/medical field of today

As a nurse, ensuring proper identification of your clients is a top priority safety issue. QSEN and the National Patient Safety goals put client identification high on the list of safety precautions. Using appropriate strategies, such as evidence-based tools and checklists, can add to the value of measurement of certain client conditions that will lead to quality care. Nurses play a role as a change agent when necessary, to improve nursing outcomes and increase job satisfaction.

Post an example of RN experience(s) with safety issues, using checklists, and being a change agent. This can either be from a healthcare perspective, or in everyday life.

• What areas are RNs strong in knowledge and/or experience and what areas do RN’s have the weakest knowledge and/or experience?