Case Scenario: Your patient, a 70-year-old male recently admitted to the hospital, has a pCO₂ of 64, pO₂ of 69, and pH of 7.4. He is short of breath and has rattles in the bases of both lungs.

1. Question: Give an admitting diagnosis based on blood gases. Defend your answer using specific facts, data, and other information drawn from the textbook and at least one other supplemental source.

Describe the steps of preparing a sterile field and applying sterile gloves. While preparing a sterile field, you noticed that one of the necessary equipment is touching the drape 0.5 inches from the border of the drape. What would you do next and why?

Discuss ways that nursing informatics could be applied to all areas of professional nursing practice, including clinical practice, administration, education, and research. Provide examples of each. What do you see as the biggest significance of nursing informatics, and why?

Nursing Research for Evidence-Based Practice

chapter - 1 Connection Between Research and Evidence-Based Practice

1. What is the difference between EBP vs EBR?
2. What are some influential factors on EBP?
3. Define research.
4. How do these play a role in EBP: nursing confirmation, nursing expertise, decision-making process, and holistic patient care.
5. Describe quantitative and qualitative research.
6. What is the significance of generating evidence, provide some examples where EBR has impacted nursing practice.
7. What are some possible obstacles that are found in nursing research, please explain?

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

85-year-old female diagnosed with ovarian cancer 5 years ago. She was treated with surgery and chemotherapy. Surgical treatment included bilateral salpingo-oophorectomy and total abdominal hysterectomy. At that time, the clientwas found to be BRCA1 positive. She declined any prophylactic surgery or treatment. She was subsequently diagnosed with breast cancer 18 months ago and underwent a lumpectomy of the right breast, followed by chemotherapy and radiation. Two months ago, she was diagnosed with Stage IV metastatic disease in her bones, brain, and liver. Question 1. What is the priority in caring for Amira Quintona? What are two nursing interventions you can utilize when caring for her, please provide the rationale. Question 2? You hear a nurse talking about “Death Rattle.” What is this, and what is the significance of it in a patient who is in hospice care? 3. Describe the ethical and legal issues of advanced directives including the role and responsibilities of the healthcare surrogate decision-maker. 4. Discuss the nursing management of the client-family unit at end-of-life. 5. Based on what you’ve learned about the nursing process, describe one applicable nursing diagnosis, treatments and nursing considerations for this diagnosis

Discussion Topic

Maya Korrapati was diagnosed with T1DM when she was 7 years old, and her appetite suddenly soared.
“She was a skinny little thing,” her mother says, “even though she kept eating and eating and eating. She had six hot dogs one day at a neighbor’s backyard barbecue, and I was so embarrassed. I asked my neighbor, ‘Why didn’t you stop her?’ but they all thought it was cute. It was then that I noticed she was constantly running into the kitchen all day for a drink. I just thought at first it was because—hey, you know—it was summer, after all, and Maya was a very, very active little girl. It was my sister who finally said, ‘Maybe you should just get that checked out. You know why.’ I guess up until then, I was in a kind of denial. So I took her, and, of course, she was diagnosed with T1DM.”

When Maya was first diagnosed, her mother was given instructions on how to administer conventional insulin therapy. Now, however, Maya is starting her freshman year of high school, and she is requesting a switch to an intensive insulin therapy regimen.

“I’ll be in school all day and going to after-school activities. I’m on the girls’ soccer team and I am determined to make varsity by my sophomore year. So, my eating is going to be kind of weird.”

Her mother clicks her tongue in frustration at this, and the two exchange unhappy looks.

After a pause, her mother says, “I think Maya’s anorexic.”

“What? No! Stop it, Mom. You’re embarrassing me.”

“I’m concerned,” Mrs. Korrapati says.

1. Now that Maya is gaining a little more independence and is spending a little more time away from home, she wants to switch her insulin regimen. What might be her rationale for this? Do you think switching her regimen is a good idea?

2. Mrs. Korrapati suspects that Maya may have an eating disorder. What kinds of signs might the nurse look for to determine whether this is the case?

3. Mrs. Korrapati reports that she and Maya frequently argue about Maya’s involvement in team sports.
“I’d feel better if she’d switch to art or playing a musical instrument. Of all the extracurricular activities you could have chosen,” she says to Maya, “why go with sports when you know you have diabetes?”
Maya becomes resistant when her mother talks like this.

She responds now, “It’s not a death knell, Mom, and I’m good. I want to make varsity and then work for a scholarship. Don’t you always talk about wanting me to get a good scholarship?”

“Not if it makes you sick,” her mother says.

Her mother has to admit that Maya has always been pretty healthy, despite her T1DM; and as far as anyone can tell, she has been responsible about diet, maintaining good blood glucose levels, and managing self-administration. Based on these facts, how should the nurse advise Maya and her mother?

Question: How can data collection for diseases be improved? What tools do we need? What are medical intelligence and syndromic surveillance, and how are they used or how could they be used?

Informatics History, Theory, Concepts & Competencies

Definitions:

• Informatics history, theory, and concepts

• Need for Healthcare Data Management

• Computer literacy vs. information literacy

• Informatics competencies and continuous education

• Knowledge management and transformation

• Informatics and nursing workflow

You are the Vice President for Network Operations of Regnat Populus Health System, comprised of three hospitals and two clinics. The system is located in “the Delta,” the most rural parts of Arkansas. You want to inform the In-House Counsel (Attorney) and the Chief Medical Officer (CMO) about the value of telehealth.   Prepare a short slide presentation, not to exceed 10 slides including the title slide and references slide.

Focus on the Medicare and Medicaid populations served by the hospitals and clinics. (Find some data that reflect populations in rural Arkansas). Explain how they will benefit from telehealth. Now, find the laws in the state of Arkansas that pertain to telehealth. How will the laws help you to leverage your vision of instituting telehealth across the hospital system and clinics? What are the common legal barriers to instituting telehealth? How can they be overcome?

ou are a health systems analyst with MegaHealth. After seeing a news report on the aging of American, the board chair has expressed an interest in opening long-term care facilities in Oregon, Wisconsin, and Minnesota. The vice president for planning has asked you for background information on Certificate of Need (CON) requirements in these states. Prepare a brief passage that defines a CON and explores the pros and cons of the law. Then, create a table that compares the legal requirements for CONs in those three states. Finally, summarize your findings. Which state law is the least onerous? Why? Which one is the most difficult of the three? Why? Are they controversial? If so, in what way?

Who certifies providers’ compliance with CoPs? Explain “Deemed Status.” Is The Joint Commission a regulatory agency?

Consider the settlement in U.S. v. Halifax and the Corporate Integrity Agreement entered into by Halifax Hospital Medical Center, which addresses methods for preventing Anti-Kickback violations. What measures required by the Corporate Integrity Agreement do you believe will be most effective in preventing future violations? Which, if any, do you think will be least effective or ineffective in preventing future Anti-kickback violations? Explain your reasoning.

The refugee population faces many challenges and issues, obvious many of the immigrants want to become citizens. And, it is difficult to become citizens with paperwork and lawyer fees. How can a Community Health nurses assist in the health of this population?