Described two of A geopolitical place consists of community boundaries, transportation infrastructure, geographic features, climate, vegetation, animals, and human-made homes and facilities?

M10 Discussion Question:

The Terri Schiavo case involved a 15 year battle between Terri Schiavo’s parents and Terri’s husband after Mrs. Schiavo suffered a medical crisis at age 26.  Go to www.terrisfight.org and read some of the articles regarding the right to die and Terri's case. Click on Terri's Story" and read "Terri's Case: Frequently Asked Questions." (You can watch videos by clicking on the window at the bottom of the Home page labeled “Open Your Eyes” if you wish.)

PART 1: POST BEFORE THE MODULE CLOSES (WORTH A POSSIBLE 35 POINTS):

• In the "Terri's Case: Frequently Asked Questions", was Terri's case an end of life issue or issues on persistent vegetative state?  What is the difference?
• Do you think an Advanced Directive would have changed the case? Why or why not?
• Taking into consideration what you originally thought about this case, did this information change your opinion? If so, how? If not, why not?

with Traditional Chinese medicine, what is flow of qi among the two paired meridians? describe the element associated with them.

Should the country adopt a plan similar to Massachusetts’ plan, the Oregon plan, or some other states’ plan?

Should the U.S. undergo a transformation of its health care policies? Should it be in the form of quality drivers, disease-specific initiatives, restraining physicians’ autonomy in cost reduction, improved consumerism of health care, or some combination of approaches? Is there an alternative approach you believe should be tried?

1) Mr. Johnson, 68-year-old, has been vomiting and has had diarrhea for 2 days. He complains of being dizzy. The nurse assesses his physiologic status and notes that his muscles are weak, his abdomen is distended, and bowel sounds are absent.

a. Develop one care plan for this case study.. It should contain a NANDA nursing diagnosis, one goal, and at least four nursing interventions. Nursing interventions are not doctor’s orders

Discuss qi flow between the meridians and how it affects the body. How does excess or stagnant qi imbalance in these organs/meridians?

what treatments are available for qi imbalance in these organs/meridians.

Headaches - disorder template

respiratory management use therapeutic procedures.

Review the case of Paradise Hills Medical Center, below. The CEO has asked you for a recommendation. What will you tell him? PARADISE HILLS Medical Center is a 500-bed teaching hospital in a major metropolitan area of the South. It is known throughout a tri-state area for its comprehensive oncology program and serves as a regional referral center for thousands of patients suffering from various forms of malignant disease. Paradise Hills is affiliated with a major university and has residency programs in internal medicine, surgery, pediatrics, obstetrics/gynecology, psychiatry, radiology, and pathology, all fully accredited by the Accrediting Commission for Graduate Medical Education. In addition, Paradise Hills also has an oncology an oncology fellowship program, a university-affiliated nursing program, as well as training programs for radiology technicians and medical technologists. All of these teaching programs are highly regarded and attract students from across the nation. Paradise Hills enjoys an enviable reputation throughout the area. It is known for its high-quality care, its state-of-the-art technology, and its competent, caring staff. While Paradise Hills is located within a highly competitive healthcare community, it boasts a strong market share for its service area. Indeed, its oncology program enjoys a 75 percent market share and its patients provide significant referrals to the surgery, pediatrics, and radiology programs as well. Paradise Hills is a financially strong institution with equally strong leadership. Its past successes, in large part, can be attributed to its aggressive, visionary CEO and his exceptionally competent management staff. But all is not as well as it seems to be at Paradise Hills. While the oncology program still enjoys a healthy market share, it has been slowly but steadily declining from its peak of 82 percent two years ago. In addition, the program's medical staff are aging and some of its highest admitting physicians are contemplating retirement. The oncology fellowship program was established a few years ago in anticipation of this, but unfortunately, thus far the graduates of this program have not elected to stay in the community. Of most concern to the CEO and his staff is the fact that the hospital's major competitor has recently recruited a highly credentialed oncology medical group practice from the Northeast and has committed enormous resources to strengthening its own struggling oncology program. Last week the board of trustees for Paradise Hills had its monthly meeting with a fairly routine agenda. However, during review of a standard quality assurance report, one of the trustees asked for clarification of a portion of the report indicating that 22 oncology patients had received radiation therapy dosages in excess of what had been prescribed for them. The board was informed that the errors had occurred due to a flaw in the calibration of the equipment. The board was also informed that the medical physicist responsible for the errors had been asked to resign his position. The question was then asked if the patients who were recipients of the excessive radiation had been told of the error. The CEO responded that it was the responsibility of the medical staff to address this issue and it was their decision that the patients not be informed of the errors. The board did not concur that the responsibility for informing the patients of the errors rested solely with the medical staff and requested that the administrative staff review the hospital's ethical responsibility to these patients, as well as its liability related to this incident, and report back to the board within two weeks. The CEO and his management staff responsible for the radiology department and the oncology program met with the medical staff department chairmen for internal medicine and radiology, the program medical directors for oncology and radiation therapy, and the attending oncologists. The CEO reported on the board discussion related to the incident and the board's request for a review of the actions taken, specifically the decision to not inform the affected patients. The physicians as a whole agreed that the adverse effects of the accidental radiation overdose on the patients were unknown. Therefore, they argued the patients should not be told of the incident. These are cancer patients and they don't want or need any more bad news, the oncologists argued. “Let's face it, these patients are terminal.” “Informing the patients of this error will only confuse them and destroy their faith and trust in their physicians and in the hospital,” they added. Furthermore, they claimed, informing the patients of the errors may unnecessarily frighten them to the extent that they may refuse further treatment and that would be even more detrimental to them. Besides, argued the physicians, advising the patients of potential ill effects just might induce these symptoms through suggestion or excessive worry. Every procedure has its risks, insisted the chairman for radiology, and these patients signed an informed consent. Physicians know what is best for their patients, the attending oncologists maintained, and they will monitor these patients for any ill effects. The department chairman for internal medicine volunteered that, in his opinion, this incident is clearly a patient-physician relationship responsibility and not the business of the hospital. Besides, added the chairman of radiology, informing the patients would “just be asking for malpractice litigation.” The medical director for the oncology program then suggested that the board of trustees and the management staff “think long and hard” about the public relations effect of this incident on the oncology program. “Do you really think patients will want to come to Paradise Hills if they think we're incompetent?”, he asked. The CEO conceded that he supported the position of the medical staff in this matter and he, too, was especially concerned about preserving the image of the oncology program, but “his hands were tied” since the board clearly considered this an ethical issue and one that would be referred to the hospital's ethics committee for its opinion. The physicians noted that if indeed it was the subsequent recommendation of the ethics committee that these patients be informed, then realistically, that responsibility would rest with the patient's primary care physician and not with any of them. Reference: Perry, F. (2002). The Tracks We Leave, Chicago, IL: Health Administration Press, pp. 1-3

System Disorder
Topic: Multiple sclerosis
Alteration in Health (Diagnosis)

Client Problem Related to Alteration in Health

Pathophysiology Related to Client Problem

Assessment

Past Medical History=

Risk Factors=

Objective and Subjective Data=

Medications=

Laboratory Data=

Diagnostic Procedures/Surgical Interventions=

Nursing Interventions (Evidence-Based)=

Client Education=

Outcomes/Evaluations=

Teamwork and Collaboration

Discharge Planning

Interprofessional Care

Coordination of Client Care

System Disorder
Topic: Parkinson disease
Alteration in Health (Diagnosis)

Client Problem Related to Alteration in Health

Pathophysiology Related to Client Problem

Assessment

Past Medical History=

Risk Factors=

Objective and Subjective Data=

Medications=

Laboratory Data=

Diagnostic Procedures/Surgical Interventions=

Nursing Interventions (Evidence-Based)=

Client Education=

Outcomes/Evaluations=

Teamwork and Collaboration

Discharge Planning

Interprofessional Care

Coordination of Client Care