write a summary on the evolution of nursing: the history of nursing and nursing education, changes in nursing during the 20th century,significant changes,development of practical and vocational,factors that influenced practical and vocational nursing,licensure for practical and vocational,health care delivery systems,delivery of patient care,nursing care models and roles and responsibilities of vocational nursing education

Surgical Instruments: insert an image and use of each of the following types of surgical instruments. Identify any of the following parts present on each instrument by labeling the instrument: box lock, spring handle, ratchets, serrations, cutting edge, and teeth.

Needle holder:

Splinter forceps:

Standard hemostatic forceps:  

Suture scissors:

Operating scissors:

Thumb forceps:

Scalpel:

Bandage scissors:

Sponge forceps: Used to hold sponges.

Tissue forceps:

Mosquito hemostatic forceps

4.) Nutrition has been shown to play a minor role in which two diseases:

a. some cancers and osteoporosis

b. iron-deficiency anemia and obesity

c. pellagra and heart disease

d. obesity and scurvy

32.) Total energy expenditure is the energy our bodies expend to maintain basic functions.

a. True

b. False

36.) The macronutrient composition of the diet influences the storage of body fat.

a. True

b. False

37.) What are some risks associated with being underweight?

a. increased risk of infections and illness

b. impairs the body's ability to recover

c. lack of appetite

d. a and b

What client assessments are imperative for an individual taking corticotropin therapy who is also taking digitalis and an oral Glucophage?

Would you consider these hospitals' work to use alternative medicine a result of a QI intervention? Why or why not? Explain your answer.

A 29-year-old G4P2 Hispanic woman, with a history of gestational diabetes mellitus (GDM), presents to her OB/GYN office for a routine prenatal visit at 24 weeks’ gestation. Her physical examination is unremarkable, and her fetal well-being is reassuring. Because of her previous history of GDM, she is at high risk of developing GDM during this pregnancy and the doctor recommends a glucose challenge test, which is the most common method of screening for GDM. Test results reveal that her 1-hour glucose loading test (GLT) is 179 mg/dL (normal value <140 mg/dL). Because her GLT value is high, she then undergoes a 3-hour glucose tolerance test (GTT), which is used for a definitive diagnosis of GDM. The patient is positive for GDM when all of her plasma glucose values are elevated. Treatment recommenda- tions include beginning a diabetic diet, participating in moderate exercise sessions three times a week, daily home glucose monitoring, and weekly antepartum visits to monitor glycemic control. The doctor explained to the mother that GDM poses little risk to her at this time; however, it is associated with an increase in infant birth trauma and perinatal morbidity and mortality with the risk to her fetus directly related to its size. The goal of antepartum treatment of GDM is to prevent fetal macrosomia, which is defined as an estimated fetal weight of ⩾ 4500 grams, and its resultant complications by maintaining desirable maternal blood glucose levels throughout gestation. It was explained that if diet alone did not maintain blood glucose at desirable levels, then hypoglycemic therapy with insulin injections given several times a day may be required.

1. Why was this patient considered to be at high risk for GDM and tested at 24 weeks’ gestation?

A 29-year-old G4P2 Hispanic woman, with a history of gestational diabetes mellitus (GDM), presents to her OB/GYN office for a routine prenatal visit at 24 weeks’ gestation. Her physical examination is unremarkable, and her fetal well-being is reassuring. Because of her previous history of GDM, she is at high risk of developing GDM during this pregnancy and the doctor recommends a glucose challenge test, which is the most common method of screening for GDM. Test results reveal that her 1-hour glucose loading test (GLT) is 179 mg/dL (normal value <140 mg/dL). Because her GLT value is high, she then undergoes a 3-hour glucose tolerance test (GTT), which is used for a definitive diagnosis of GDM. The patient is positive for GDM when all of her plasma glucose values are elevated. Treatment recommenda- tions include beginning a diabetic diet, participating in moderate exercise sessions three times a week, daily home glucose monitoring, and weekly antepartum visits to monitor glycemic control. The doctor explained to the mother that GDM poses little risk to her at this time; however, it is associated with an increase in infant birth trauma and perinatal morbidity and mortality with the risk to her fetus directly related to its size. The goal of antepartum treatment of GDM is to prevent fetal macrosomia, which is defined as an estimated fetal weight of ⩾ 4500 grams, and its resultant complications by maintaining desirable maternal blood glucose levels throughout gestation. It was explained that if diet alone did not maintain blood glucose at desirable levels, then hypoglycemic therapy with insulin injections given several times a day may be required.

1. Who is at greatest risk when the mother has GDM?

Case Study 1

A 29-year-old G4P2 Hispanic woman, with a history of gestational diabetes mellitus (GDM), presents to her OB/GYN office for a routine prenatal visit at 24 weeks’ gestation. Her physical examination is unremarkable, and her fetal well-being is reassuring. Because of her previous history of GDM, she is at high risk of developing GDM during this pregnancy and the doctor recommends a glucose challenge test, which is the most common method of screening for GDM. Test results reveal that her 1-hour glucose loading test (GLT) is 179 mg/dL (normal value <140 mg/dL). Because her GLT value is high, she then undergoes a 3-hour glucose tolerance test (GTT), which is used for a definitive diagnosis of GDM. The patient is positive for GDM when all of her plasma glucose values are elevated. Treatment recommenda- tions include beginning a diabetic diet, participating in moderate exercise sessions three times a week, daily home glucose monitoring, and weekly antepartum visits to monitor glycemic control. The doctor explained to the mother that GDM poses little risk to her at this time; however, it is associated with an increase in infant birth trauma and perinatal morbidity and mortality with the risk to her fetus directly related to its size. The goal of antepartum treatment of GDM is to prevent fetal macrosomia, which is defined as an estimated fetal weight of ⩾ 4500 grams, and its resultant complications by maintaining desirable maternal blood glucose levels throughout gestation. It was explained that if diet alone did not maintain blood glucose at desirable levels, then hypoglycemic therapy with insulin injections given several times a day may be required.

1. What are two testing methods for GDM?

Case Study 1

A 29-year-old G4P2 Hispanic woman, with a history of gestational diabetes mellitus (GDM), presents to her OB/GYN office for a routine prenatal visit at 24 weeks’ gestation. Her physical examination is unremarkable, and her fetal well-being is reassuring. Because of her previous history of GDM, she is at high risk of developing GDM during this pregnancy and the doctor recommends a glucose challenge test, which is the most common method of screening for GDM. Test results reveal that her 1-hour glucose loading test (GLT) is 179 mg/dL (normal value <140 mg/dL). Because her GLT value is high, she then undergoes a 3-hour glucose tolerance test (GTT), which is used for a definitive diagnosis of GDM. The patient is positive for GDM when all of her plasma glucose values are elevated. Treatment recommenda- tions include beginning a diabetic diet, participating in moderate exercise sessions three times a week, daily home glucose monitoring, and weekly antepartum visits to monitor glycemic control. The doctor explained to the mother that GDM poses little risk to her at this time; however, it is associated with an increase in infant birth trauma and perinatal morbidity and mortality with the risk to her fetus directly related to its size. The goal of antepartum treatment of GDM is to prevent fetal macrosomia, which is defined as an estimated fetal weight of ⩾ 4500 grams, and its resultant complications by maintaining desirable maternal blood glucose levels throughout gestation. It was explained that if diet alone did not maintain blood glucose at desirable levels, then hypoglycemic therapy with insulin injections given several times a day may be required.

1. What is the primary treatment for GDM?

A 35-year-old woman presented to the prenatal clinic after missing her last two menstrual cycles. Her home pregnancy test was positive and an ultrasound confirmed the pregnancy. Gestational age was calculated to be at 10 weeks. An initial assessment of the woman’s medical and obstetric history included the following: She smoked tobacco for 15 years and currently smokes one pack per day; she had recently used cocaine but stated it is not frequent; she denied alcohol use. Her obstetric/gynecologic history included an uncomplicated spontaneous vaginal delivery at 35 weeks’ gestation 4 years ago and 2 years later a cesarean section at 36 weeks’ gestation for nonre- assuring fetal heart tones. Her medical history included chronic hypertension and a history of asthma, for which she had never been intubated or hospitalized. Her vital signs were as follows: temperature 36.7°C, respiratory rate of 20 breaths per minute, heart rate of 86 beats per minute, BP 142/79 mm Hg. Lab results: hemoglobin 13.0 g/dL, hematocrit 37%, white blood cell count 8000, blood type A–, Rh antibody screen positive. She was negative for gonorrhea, chlamydia, and HIV.

1. What fetal complications are associated with this patient’s presentation?

A 35-year-old woman presented to the prenatal clinic after missing her last two menstrual cycles. Her home pregnancy test was positive and an ultrasound confirmed the pregnancy. Gestational age was calculated to be at 10 weeks. An initial assessment of the woman’s medical and obstetric history included the following: She smoked tobacco for 15 years and currently smokes one pack per day; she had recently used cocaine but stated it is not frequent; she denied alcohol use. Her obstetric/gynecologic history included an uncomplicated spontaneous vaginal delivery at 35 weeks’ gestation 4 years ago and 2 years later a cesarean section at 36 weeks’ gestation for nonre- assuring fetal heart tones. Her medical history included chronic hypertension and a history of asthma, for which she had never been intubated or hospitalized. Her vital signs were as follows: temperature 36.7°C, respiratory rate of 20 breaths per minute, heart rate of 86 beats per minute, BP 142/79 mm Hg. Lab results: hemoglobin 13.0 g/dL, hematocrit 37%, white blood cell count 8000, blood type A–, Rh antibody screen positive. She was negative for gonorrhea, chlamydia, and HIV.

1. At this time, what recommendations would you give this patient to improve her health?

DISCUSS NDNQI , WHAT IT IS AND WHY ITIS IMPORTANT