You are working in the Emergency Department when EMS brings in a 3 year old struck by a drunk driver while riding his tricycle in the street. Despite all efforts by you and your trauma team, the child dies of his injuries. Discuss how you would speak with the family about the child's death - is there anyone you would involve - any type of referrals? This is the second child that has died in your department in 2 weeks. Discuss how you, as a nurse, would handle this additional stress.

Explain in your own words what you are to code when the first listed diagnosis is unconfirmed? Give an example coding scenario.

The Affordable Care Act (ACA) of 2010 has dramatically changed the U.S. health care system. Despite the beneficent intent of the reform, however, it has been suffering from many problems like the rise of insurance cost, etc. Discuss ethical challenges present in the ACA era from the market economic point of view

Do you believe that the ACA Reform is a move bringing our society one step closer to justice or fairness, or the opposite? Base your answers on the explanations you have provided in the questions above and expand.

Technology has certainly changed the way health care is practiced. Show some of the technological changes you have seen in the last five years, including both information and clinical technologies, and discuss what ethical issues the changes have created in a healthcare setting.

Mr. DM, a 79-year-old man who lives alone, is brought into A&E suffering from dehydration, which appears to be the result of prolonged (>24 hours) nausea and vomiting. He is shaking, confused, incoherent and unable to provide a lucid history. His basic laboratory values are: Na+ 152 mmol/L (137–145 mmol/L) K+ 3.1 mmol/L (3.6–5.0 mmol/L) Bicarbonate 29 mmol/L (22–30 mmol/L) Urea 7.3 mmol/L (2.5–7.5 mmol/L) Creatinine 115 micromol/L (62–133 micromol/L) White blood count 8.4 × 109 /L (4–11 × 109 /L) He has an intravenous cannula inserted and rehydration commenced with sodium chloride 0.9% w/v infusion. Mr. DM continues to retch and vomit. He is administered 10 mg metoclopramide by I.V. injection and promptly suffers an oculogyric crisis. This is reversed by the administration of I.V. Procyclidine. Twelve hours later Mr. DM is conscious and lucid but now has a pronounced tremor, characteristic of Parkinson’s disease. He reports he was initially diagnosed about a year ago by his GP. His GP has been prescribing Sinemet-110 (Co-careldopa) tablets, (the initial dose was titrated) but Mr. DM did not take any as the tremor did not really bother him until earlier this week. He decided to start taking the Sinemet but as the tremor was troublesome he started at the dose of 1 tablet T.D.S.

QUESTIONS:

1. Briefly outline the epidemiology, pathophysiology and clinical features of Parkinson’s disease.

2. Outline the pharmacological basis of the nausea and vomiting caused by the Sinemet.

3. Outline the pharmacological basis of the adverse effect, oculogyric crisis, Mr. DM suffered. '

4. Briefly discuss the alternative options that could have been considered for managing Mr. DM’s nausea and vomiting, with relative advantages and disadvantages.

5. Briefly outline the rationale for reducing the dosage interval rather than increasing the dosage.

6. The on/off syndrome and end-of-dose deterioration are both features of treated Parkinson’s disease. What are they, and are there any risk factors?

7. In addition to levodopa therapy, what other options are available to treat Parkinson’s disease and what is their place in therapy?

8. Mr. DM is concerned that he is likely to forget the five times daily dosage regimen and/or find it difficult to maintain a regular dosage interval. Is there anything you could do to help him?

What are two strategies you can use to monitor your own work to ensure the required standard of support is maintained?

In your discussion answer these questions: How do the changes in the body as we age affect nutritional needs – think about physical and physiological changes? How do you address these? What other related changes in dental health, gastrointestinal changes affect nutrition? How do you address these? What malnutrition or vitamin deficiencies can occur during aging? Why? How do you address these? Activity 2: Diet plans Using the meal plans you designed in the Task, come up with a three-day meal plan for one of the three categories: 1. senior with Type II Diabetes 2. senior with heart disease on a low sodium or low cholesterol diet; 3. a healthy senior who has a very active outdoor life. Remember to make the meals inviting, tasty, and nutritious. They need to meet the USDA food recommendations for seniors. Project Assignment: Transcript: "Good morning, I am Mr. Oliver over at the Senior Center. As you might know, we provide meals at lunchtime for the seniors who use our center. This includes healthy senior citizens as well as those who attend our adult daycare for memory-impaired seniors. Even some of our healthy seniors have diets that restrict things like salt. What we need is some help with planning diets that would be healthy and appropriate for all of our seniors. We serve lunch every day and also provide coffee, tea, and snacks throughout the day. I am sure you know all about diets for seniors and restrictions for those with memory impairment who have trouble swallowing. If you could plan two weeks' worth of menus for any of the following: 1 ) healthy seniors without restrictions or 2) low salt diets or 3) a special two-week diet for those memory impaired seniors who have difficulty swallowing, it will really help us provide a wider variety of good-tasting foods for our seniors that are healthy. Many of our seniors live alone and don’t cook for themselves. Of course, some of them get dinners from Meals on Wheels, but others rely on this lunch for their major meal of the day."

Complete three 3 different drugs used to treat a patient diagnosed with angina, each medication including their generic /brand name , category class, expected Pharmacological Action, Complications, Contraindications/Precautions, Interactions, Medication Administration, Evaluation of Medication Effectiveness, Therapeutic Use, Nursing Interventions, and Client Education.

Hello, Can someone review my personal statement for a Fellowship and make it better?

Things I am hoping to accomplish... Showcase that my past experience will help me grow into being a great health administrator To show that I am selfless (sorry I have been working really hard on this and just cannot get it right) At the same time to showcase that I have been able to learn and study autonomously to pass two state mortgage and realty exams.

One of the best experiences I had was working at Wells Fargo. As a mortgage loan officer, I worked in a department that helped retired clients refinance their homes. Through that experience, I learned some harsh realities regarding healthcare. Many of my clients were living on low fixed incomes. Simultaneously, their objectives were relatively the same in that they wanted to lower their mortgage payments. What found was that the little leftover money some of them had were going towards office visits, insurance, and copays. With that in mind, my inquiry in healthcare began with learning about foundations and grants that could assist my struggling clients with their copays. Through conversation with my clients, I would advise them of foundations and grants that I knew of to lower there out of pocket costs for medications. It felt great to help out and made days at work amazing. At the same time, I was also helping retirees save money on their mortgages. The exciting part of all this is that I had finished two semesters of my master's in Public Health prior to working as a mortgage loan officer. My driving force in life is to help people, especially when they are down. This is doesn't make me unique in any way because I believe that there is no better joy than making someone smile. Although I was thrilled with my mortgage sales career, my wife from Tennesee wanted to start her career as a pharmacist, and we made a move down from Ohio. We couldn't have been more excited in that she was accepted to the University of Tennesee pharmacy school. Prior to moving down, I studied for the Tennesee real estate certification and soon after was licensed in Tennessee. As a realtor, I learned quickly to facilitate contracts involving multiple stakeholders and vendors, like puzzles, putting the right pieces together while connecting the dots. In both careers, I had opportunities to contact people around the US. I also learned that I needed to quickly build relationships over the phone in the shortest time possible. Through that experience, I made some great friends in Ohio, Illinois, New York, and Florida. Making friends and building relationships is one of my most considerable abilities. If accepted for the fellowship program at University of Houston, my past career experience will show my ability to create bonds, deal with vendors and stakeholders, facilitate contracts, and that I can learn quickly whether on the job or when needing certifications.