The ethical DNA of healthcare organizations is to provide health care for those who need. In the U.S., EMTALA, the federal regulation enacted in 1986 is a legal way of ensuring the beneficent commitment of the healthcare institutions. Under EMTALA, the staff at hospital emergency departments are required to screen every patient who seeks emergency care and to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability to pay. However, fully abiding by the law sometimes places the hospital in financial risks. Imagine that you are the CEO of a not-for-profit-hospital. How would you satisfy the ethical demand of EMPTALA? Note that your ethical decision must be financially sustainable; however, the question is asking about your ethical direction in terms of resource allocation, not the financial and management details.   

1. Describe the Pharmacovigilance system.

2. Who are the key stakeholders in pharmacovigilance system?

3.Give the responsibility and function of stakeholders.

4. Enumerate the guidelines of good pharmacovigilance practice.

5. What is the correlation between pharmacovigilance and antimicrobial stewardship program?

2. List at least three questions that Ms. Williams should ask the office nurse during the appointment prior to receive or not receive the experimental gel Injection?

Some hospitals concurrently review records for deficiencies; others review retrospectively. Which is the best practice, and why? What are your thoughts about the process of peer review?

1. Steven, a 4-year-old boy, is seen in the pediatric office for a well-child exam. He is a healthy, active boy who attends extended-day preschool as his mother works long hours. His mother states she has some questions about Steven. She says she is concerned about Steven’s growth, his language skills, and disciplining him. Steven’s mother tells you that “he seems heavier than my other children did at his age.” Upon measuring Steven you note his height to be 38.5 inches (98 cm) and his weight to be 46 pounds (20.9 kg). His calculated BMI of 21.76 plots well above the 95^th percentile for age. After further discussion with Steven’s mother, you determine that he has an excessive daily intake of fruit juice and whole milk, and eats numerous fast-food meals weekly.

1. Describe teaching about diet and activity that you will do with Steven’s mother.

Steven’s mother asks if there is something wrong with Steven because he stutters and says “um” a lot.

2. What type of education or support will you give Steven’s mother?
3. When questioned about the type of discipline used in the home, Steven’s mother states that she feels bad when she spanks him, because he becomes so withdrawn afterwards and that it doesn’t really seem to work anyway. She states she just doesn’t know what else to do. What kind of anticipatory guidance can you provide?

A Chinese woman in her mid-twenties had just given birth. The staff became concerned when she would not eat the hospital food and did not bathe. She would only eat foods that her family brought to her. The patient later explained her custom prevented her from bathing for seven days after childbirth and permitted her to eat only certain foods.

Research Chinese cultural beliefs:

What is a lying-in period?

What are the effects of giving birth on this women’s yang?

What accommodations or interventions could a nurse make?

List 3 Stereotypic myths regarding the Chinese that caregivers must recognize and “unknow”:

Name 3 changes or additions to an EHR that could help patients feel more respected and educate healthcare staff -

How should “sexting” among teenagers be treated by school authorities?

Should we be concerned about people forming emotional attachments to robots?

Mr. T. was admitted to the critical care unit after being diagnosed with an MI, which severely injured the left anterior ventricle.  Mr. T. is 80 yrs. old, has a history of diabetes type 2, and hypertension.  He states he was “active” prior to his recent MI and liked to walk at the mall for exercise.  He is alert and oriented, has never smoked, and lives with wife and son.  

Mr. T. was placed on hemodynamic monitoring due to his low blood pressure and urine output.  Mr. T’s pulmonary artery wedge pressure (or pulmonary artery occlusion pressure, PAOP) is 22. Mr. T. has distended neck veins, dyspnea and audible crackles bilaterally.  

Questions:

1. Discuss the risk factors for the development of cardiogenic shock in Mr. T.

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2. Describe how the afterload affects the cardiac output in Mr. T.

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3. Discuss the goals of management in cases of cardiogenic shock.

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4. What is the nurse’s role in the goals of management? Describe specific nursing actions necessary to care for Mr. T.

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5. Review Sodium Nitroprusside (Nipride) in the Abrams Clinical Pharmacology book (p. 519). Describe the pharmacological action of Nitroprusside and why it is ordered for Mr. T. at this time. What should the nurse do to safely administer this drug?  

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6. What is the mortality rate for patients in cardiogenic shock following an MI?

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Case study 4 Alana’s husband and sons are now in her room. They are speaking very loudly and crying. They insist that Mai ‘do something’ quickly. They direct their anger towards her. Mai listens patiently and speaks calmly. The doctor arrives accompanied by an interpreter. He suggests that Alana take a dose of morphine orally at regular intervals to help settle her pain and make her last hours comfortable Alana’s family are worried that increasing the dose of morphine will hasten Alana’s death. Shortly after, Alana’s breathing becomes irregular and Alana is not able to be roused. Alana’s husband notices that Alana’s legs are mottled and her finger feel cool to the touch. He requests that Alana be given more blankets. Although the family members know Alana is dying, it is still a shock when it happens. They are pleased that Alana’s wishes were respected. Alana’s family starts to wail, a traditional Italian expression of open grief. Mai had developed a caring relationship with Alana during her time caring for her. She is sad, as she thought Alana would have lived a little longer; however, she has often thought about death and dying and is comforted by her own beliefs. She follows the organisation’s protocols for maintaining Alana’s dignity after death and comforts Alana’s family members and makes sure her sadness doesn’t affect anyone else. The team leader is impressed by how Mai handles her grief, especially as she is a new worker. He asks Mai to prepare five helpful hints about handling personal grief, which the organisation can provide to new workers in the future.

1. With whom should Mai raise any concerns or ethical issues?

in response to the comment that all there is for the question? maybe thats why it got me confused dont know how to answer it, give it a shot will take anything as i am blank

Develop 5 interview questions you feel you will be asked during an interview for a professional role or a role within a hospital.

Write what your response would be to each of the 5 questions you identified.

Post your questions and responses to discuss with the class. Answer the following questions in your response:

• What did you learn from your classmates? What strategies will you use to prepare for an interview?

Why is it important for health care leaders to have a strong and positive mentor? Provide specific examples. Do you have a mentor? If so, share your experiences. If not, how might you find one?

select two of the following theorists to research.

Piaget Erikson Vygotsky Bronfrenbrenner Freud Skinner

Once you have selected your theorists respond to the following questions/statements:

What are the names of your theorists?

Provide background information about the theorists (i.e. place of birth, age, family information, place of residence, photo, etc.).

What was each person’s theoretical perspective?

Compare and contrast the theories. Explain what the theory asserts and how they are alike and different.

What do you think about each theory? Specifically state what you agree/disagree with and/or like/dislike.

Pete Zaria has a history of HIV and has developed esophageal candidiasis.  The hospitalist prescribes fluconazole 400mg IV once daily.

1. BRIEFLY describe the MOA of the “azole” antifungals.

2. What laboratory values must be frequently monitored in patients receiving fluconazole?

After being hospitalized and receiving treatment for 5 days, Pete’s condition deteriorates, and blood cultures reveal systemic fungal infection.  Amphotericin B is ordered.

1. How is this medication administered? (include information re:  route, setting, rate, dose, etc…)

2. What are the major adverse effects of amphotericin B?  How should the nurse monitor for these adverse effects?

Hematology

1. Describe the composition of blood and their function

2. Identify 3 conditions related to any of above components.