History:

Margaret Spezia is a married, 49-year-old Italian American with eight children whose ages range from 3 to 18 years. For the past 2 months, Mrs. Spezia has had frequent morning headaches, and occasional dizziness and blurred vision. At her annual physical Assessment 1 month ago, her blood pressure was 168/104 and 156/94. She was instructed to reduce her fat and cholesterol intake, to avoid using salt at the table, and to start walking for 30 to 45 minutes daily. Mrs. Spezia returns to the clinic for follow-up.

ASSESSMENT

While escorting Mrs. Spezia to the Assessment room and obtaining her weight, blood pressure, and history, Lisa Christo RN, notices that Mrs. Spezia seems restless and upset. Ms.Christos says, “You look upset about something. Is everything OK?” Mrs. Spezia responds, “Well, my head is throbbing, and I’m sort of dizzy. I think I’m just overdoing it and not getting enough rest. You know, raising eight children is a lot of work and expense. I just started working part time so we wouldn’t get behind in our bills. I thought the extra money might relieve some of my stress, but I’m not so sure that’s really happening. I’m not getting any better and I’m worried that I’ll lose my job or become disabled and that my husband won’t be able to manage the children by himself. I really need to go home, but first, I want to get rid of this awful headache. Would you please get me a couple of aspirin or something?” Mrs. Spezia’s history shows a steady weight gain over the past 18 years. She has no known family history of hypertension.

Physical findings include:

• height 63 inches (160 cm)
• weight 225 lb (102 kg)
• T 99° F (37.2° C)
• P 100 regular
• R 16
• BP 180/115 (lying)
• 170/110 (sitting)
• 165/105 (standing)
• Skin cool and dry
• capillary refill 3 seconds right hand, 3 seconds left hand.

Mrs. Spezia’s total serum cholesterol is 245 mg/dL (normal< 200 mg/dL). All other blood and urine studies are within normal limits. Based on analysis of the data, Mrs. Spezia is started on captopril 12.5mg twice daily and hydrochlorothiazide 12.5 mg and placed on a low-fat low-cholesterol, no-added 2gm sodium diet.

Highlight the data in the history and the assessment that needs to be addressed. Read the brief history and identify: concerning

1) subjective/objective data,

2) potential/actual problems,

3) what interventions,

4) Education

5) follow-up would be suggested.

6). Explain the prioritization of problems.

How would you prioritize these problems? Which two would you address first?   Why

Write n essay Based on data from the U.S. Department of Education and the National Institute of Literacy (2015), what other verbal and non-verbal competencies should health care providers be cognizant of in treating patients?

By establishing a provider network, it will help contract cost for care or services, the quality of it (that is being provided), and it also creates drug formulary (pharmaceutical) or tiering cost of the drug for the patients. This network of provider sort of acts as a bundle where all services that are being given or requested falls under this group. Manage Care Organizations (MCOs) also contract with health plan insurance to create some type of program where they can help manage the patient's medication, a service where they have someone reviewing and answering any question the patient may have about their medication and making sure that they are using it correctly and effectively. Prior to any treatment or services that are about to receive, the patient can request a second opinion, to see if that treatment or services is appropriate, before going forward with it. It is about managing cost for the patient and provider, the patient will be receiving adequate care at a reduced cost, and the provider is generating profit from it because the client base is assured

NURSING ABBREVIATIONS

Bariatric sugery Obesity  patient

why this  is important for the patient

How do you educate them

What complications can occur after this surgery?

What client education topics are important to reinforce for this client?

Pick the option that is the most natural way through which to get oxygen.

RA

CPAP

Nasal Cannula

BiPAP

Who is the person primarily responsible for helping the patient in the room and dispensing medications to the patient?

Nurse

Scribe

Biller/coder

Transcriptionist

Your patient has Chest Pain. Which diagnosis is NOT on your differential?

Rib fracture

Heart Attack

Toe contusion

Angina

A 62 year old male reports a history of gallstones, which ultimately required a gallbladder removal. What procedure would you document in his PSHx?

Adenoidectomy

Cholecystectomy

Tracheostomy

Appendectomy

A patient with hypertension is commonly asymptomatic. What is often the first concern for HTN?

High fever

Strong urine odor

Low blood sugar

High blood pressure

You are caring for a 58-year-old electrician admitted to your emergency room for purulent drainage from his incision site. He is a one-week post-CABG. His cardiologist reports positive blood cultures. Hospital admission reports no health insurance, and the patient shares he has been having difficulties paying for his medications. His wife is at the bedside.

Case Study Analysis Assignment Outline:

Introduction Brief overview of the pathophysiology of the disease.

Include: What lab abnormalities would you look for? What diagnostics would you expect to see? Give a rationale.

Implications for Self-Care How does this disease process impact the patient’s and/or their care provider’s ability to care for themselves?

Consider Maslow’s hierarchy of needs Application of Orem’s Theory of Self-Care. Patient Education Strategy Consider educational strategies and a plan of care for your patient based on the implications for the self-care section. Support with rationale.

Interdisciplinary Collaboration What interdisciplinary team members need to be included. Include rationale.

Consider nutrition, discharge, transition, and financial implications Conclusion

Explain how authority gradients influence teamwork and patient safety?

A patient with hyperlipidema is commonly asymptomatic. what is often the first concern for HLD?

Higher fever

High LDL level

Low blood sugar

High BP

When the atria of the heart contract out of sync with the ventricles, the blood in the upper chambers can pool. this is why ______are more common with AFib.

Headaches

Leg cramps

Toothaches

Blood clots

This finding can be appreciated by palpation.

Leg swelling

heart sounds

overall discomfort

redness to the eyes

select the condition that is concerning when the patients has Right Lower Quadrant Abdominal Tenderness.

MI

AFib

Asthma

Appendicitis

An acute blockage of the coronary vessel would likely cause chest pain. What diagnosis is most concerning at this time?

MI

CVA

HA

DVT

The doctor can't decide the diagnosis from the exam. Why do they need to order testing?

To check many boxes as possible

To hope another doctor can help

To charge the patient more money

To further rule out diagnoses

The patient developed shortness of breath after taking sulfa medication, belongs in the_____

Dx

FHx

PE

Allergies

1) compare and contrast the countries systems with the health care system of England, and Switzerland this should be two page long

2) How the system is designed (What type of system is it?) in other words who runs it, is it tax based etc.

3) advantage and disadvantage of the system

4) How expensive it (how much is spent year on health care?

5) How does that compare with the USA?

6) What insurance looks like in that country (describe in detail how the system works)

7) What the system covers (broadly)

8) The significant differences between this country and the USA system.

make sure everything has to be in compare not in a separate form with USA, incluse that as part of the other countries.

9) which choice as to which health care system you would prefer and why, please make sure you give the the cite where the video or article is from.

You are a healthcare professional who provides care directly to patients (pick which kind you want to be based on your readings from this module). You feel very confident that the medical care you provide is extremely important to your patients and to the U.S. healthcare system but you also know that there are many kinds of care and care providers. You like to think of yourself as open-minded about other providers of care, particularly because there are many kinds of patients and different people need different kinds of care and treatment. You read a back issue of O Magazine (August 2004, to be precise), and come across the following quote from Oprah: “Getting my lifelong weight struggle under control has come from a process of treating myself as well as I treat others in every way.” How does this fit with your own philosophy of medicine and, if many other people were to take Oprah’s perspective, would that be a good thing or a bad thing for our healthcare system?

Hi, this is Miss Wheeler over at Meals on Wheels. Here in New Town, we have a very diverse group of people for whom we provide meals every day. They represent 1) Jewish, 2) Muslim, 3) Ethiopian, 4)Chinese, 5)Native Americans, 6) Indian, and 7) Iranian cultural groups as well as our American and African American clients. We really need some help in figuring out how to plan meals for so many different cultural groups. Could you help us? Since we depend heavily on the food pantry for supplies that our volunteers prepare, we need to figure out how to use many of our common supplies but still meet the diverse needs. If we need to supplement that supply please let us know exactly what is important so we can ask for donations or for funds to purchase the items. If you could come up with ONE WEEK EVENING MEAL ONLY that meets the needs of our different cultural groups (may need to be multiple menus), it would be really great.

Catherine Cooper is a 68-year-old woman scheduled for a right total knee replacement in 6 weeks. She has a history of previous injury from years of playing tennis and basketball. She states that she is concerned about the possibility of receiving a blood transfusion. She has read stories of people contracting diseases and viruses, and her friends have told her about someone who became very ill from a transfusion.

1. You are conducting Ms. Cooper's preoperative planning. How should you respond to her concerns?

2. Ms. Cooper decided to donate a unit of blood before her operation in the event that she needed transfusion therapy after surgery. She comments to you that she is so glad that she doesn't have to worry about any problems since she is receiving her own blood. What can you tell her about what to expect about her blood donation?

3. Following a type and cross, it is determined that Mrs. Cooper has AB+ blood. Which type of blood can she receive? Which type of antigens does she carry on her red blood cells?

4. Describe your responsibilities associated with initiating and monitoring the transfusion.

5. The health care provider orders another transfusion of red blood cells. Because Ms. Cooper had only 1 unit of autologous blood, she consents to a unit of allogenic blood. Within 15 minutes of the bloo