Surgery Assignment

A 25-year-old female client is being admitted to the postanaesthetic care unit (PACU) following a thyroidectomy for hyperthyroidism. The client had undergone three months of preoperative treatment with antithyroid medications and iodine preparations to establish euthyroid status prior to her surgery. At the client's bedside the nurse has set up a tracheostomy set, endotracheal tube, laryngoscope, and suction equipment. There are ampules of calcium gluconate on hand. The nurse places the client in a semi-Fowler's position and is supporting her head and neck with pillows and sandbags. The nurse frequently checks the client's vital signs and assesses her suture line for strain or bleeding. Once the immediate postoperative period has passed, the client will be transferred to the surgical ward where she will recuperate and learn about lifelong thyroid replacement therapy.

1. Why is it so important for the client to be euthyroid prior to thyroidectomy?
2. Why is it mandatory to have emergency equipment and ampoules of calcium gluconate on hand following thyroidectomy?
3. Why is it important to support the client's head and neck with sandbags and pillows?
4. Develop a plan of care for this patient two (2) actual and two (2) potential

In this case study, Ruth’s previous encounters with mothers of premature infants and her knowledge of the family experience inform her nursing actions. Experienced nurses incorporate much information simultaneously. Notice that Ruth determines that the baby’s physiologic condition is stable while she is beginning to interact with the mother. In this action, she is prioritizing patient safety. While she interacts with the mother, Ruth may interpret Cassandra’s behavior as a pattern sometimes displayed by mothers in the NICU. She understands how frightening it is to have a hospitalized newborn and knows from experience that fear can take on many faces. This may be evidence of Ruth’s intrapersonal characteristics that value empathy and consider the patient experience. Rather than focusing on Cassandra’s negative response to her, Ruth focuses on relationship building before moving on to teaching. This action opens the door to effective teaching. Notice that Ruth takes some time afterward to consider what went well in this challenging situation. This will inform future interactions with mothers of patients.

In what ways could reflection on the action be encouraged as part of nurses’ professional lives?

How do the interpretive and standards-based approaches to clinical judgment compare in relationship with the goal of patient-centered care?

Hello, I am doing psychomotor skill assigment. I would like to know about flu shot administration and step by step explanation and how to evaluate this technique. Thank you.

Part 1: For each of the following impulse control disorder.

1. Oppositional Defiant Disorder 2. Intermittent Explosive Disorder 3. Conduct Disorder A. Define the disorder. B. What factors may contribute to the development of your assigned disorder? C. What manifestations will an individual with then disorder present with? D. What are priority assessments for an individual who has this disorder? E. What are priority interventions? F. Is pharmacological intervention indicated with the disorder? If so, what medications are used?

Discuss why consumers are being encouraged to take a more active role in their health care.

axample of a fix trap question

1. What is a disaster?
2. What is the role of healthcare professionals in a disaster?
3. Describe the Incident Command System.
4. Discuss how a public health nurse could help his/her community to prepare for a disaster, including family preparation. What should be considered/included?
5. How can a public health nurse be involved in disaster preparation? Disaster care?
6. Describe communication challenges in a disaster. What are some solutions?
7. Why does care need to be coordinated in a disaster? What happens when it is not? (Give examples)

Part 2: For each of the following therapies.

1. Cognitive Behavioral Therapy 2. Psychodynamic Psychotherapy 3. Dialectical Behavioral Therapy 4.Parent-child Interaction Therapy 5. Parent Management Training 6. Multisystemic Therapy

A. Describe the therapy.

B. Discuss how the therapy may benefit someone with an impulse control disorder.

C. What type(s) of impulse control disorder(s) would be treated using this therapy?

Jaundice Case study

Situation: Anders is a 2 day/40 week infant. WT 7lb 11 oz HT 22 inches

     Admitted for treatment of hyperbilirubinemia (jaundice).  

Background: He lives with his parents and older brother who is 3 years old. MOB reports that the sibling was also treated for jaundice as an infant. MOB is breastfeeding exclusively with reports of the infant being difficult to wake for feeds. He is feeding about every 4 hours for 15 minutes.  

Labs from ED:

Serum Bilirubin level: 14 mg/dl

Coomb’s- negative

CBC-Hg 213, Ptl 176, WBC 9.8- no left shift

Assessment:

Infant is visibly jaundiced at torso and head. Responsive to touch but sleepy. Reflexes WNL Anterior fontanel is soft and flat. Milia visible on face. Skin is warm and dry.

HR 148, no murmur

RR 50, CTA bilaterally

Temp 36.8

BP on admit 76/54, Capillary refill less than 3 sec

BT are +

Admit Orders:

Diet BF ALD

Strict I & O

VS per routine

Phototherapy- double- blanket and lights

Redraw bilirubin level in 12 hours

1. Do you have any additional HX questions you would like to ask the family?

2. What are your initial nursing priorities?

3. What other healthcare team member may you need to consult with?

4. What interventions do you anticipate regarding initiation and monitoring of phototherapy?

5. What concerns do you anticipate needing to address for the family?

Discuss the pathogenesis and progression of ebola. What safety concerns were addressed during the 2014 outbreak?

Chapter 46 Acute Kidney Injury Disease

Acute Kidney Injury

Patient Profile

A.S. is a 70-year-old white woman who presented to the emergency department because of a 4-day history of increased shortness of breath and generalized weakness. A.S. stated that she has been able to do her daily chores at home independently, but for the past few days, it was getting difficult for her to get around and that she needed to take frequent breaks because she was short of breath and had no energy. She has a long history of heart failure, type 2 diabetes, and hypertension. She is admitted with a tentative diagnosis of acute kidney injury (AKI).

Subjective Data

• Has been having headaches on and off, with nausea and dizziness
• Reported that she had not been taking her medications regularly at home because of “forgetfulness”
• Has not been urinating a lot
• Feels “puffy” in her legs and hands

Objective Data

Physical Examination

• Blood pressure 178/96, pulse 110, temperature 98.9°F, respirations 24, and an oxygenation of 93% on room air
• Alert and oriented to person, place, and time
• Mild jugular venous distention
• Fine crackles in bilateral lower lobes
• Heart rate regular, no murmurs
• Bowel sounds normoactive and present in all four quadrants
• 2+ edema bilateral lower extremities and hands

Diagnostic Studies

• Echocardiogram shows decreased left ventricular function
• Urinalysis: Urine dark yellow and cloudy, protein 28 mg/dL, negative for glucose and ketones, positive for casts, red blood cells and white blood cells
• 24-hour urine output = 380 mL
• Laboratory Tests:

Case Study Questions

• 1. A.S. has to have a 24-hour urine collection performed, as she is not urinating a lot. Describe in steps the collection procedure by the nurse.
• 2. What is your interpretation of A.S.'s BUN, Cr, and BNP?

BUN (10 -20 mg/dL)

Cr (<1.2 mg/dL for women <1.4 mg/dL for men)

BNP (<100 pg/mL):

3. Should you be concerned about A.S..'s potassium level of 5.2 meq/L? (Yes/No)

List two treatment types that the health care provider might prescribe if deciding to treat A. S. hyperkalemia.

1.

2.

• 4. Based on A.S.’s presentation, what nursing assessments, interventions, and monitoring skills need to be performed by you the registered nurse? Student must list at least six:
• 5. What orders do you as the nurse, anticipate the physician will order? Student must list at least six (frequencies not necessary to list; only what you think the physician will order):

6. Explain what might have contributed to A.S.’s present condition as described above? What are two evidence-based preventive health care provisions/programs that if put in place early might have prevented this from occurring?

Explain what might have contributed to A.S.’s present condition:

Evidence-based Preventive Health Care Provisions/Programs:

1.

2.

7. What is the significance of A.S.’s Hemoglobin, Hematocrit, and RBC levels being significantly decreased?

8. You are planning discharge for A.S. What would you include in your discharge instructions/teachings and what other interdisciplinaries/health professionals would you include? Student must list at least five each:

Nursing Teaching/Instructions                    Other Health Professionals

1.                                                                 1.
2.                                                                 2.
3.                                                                 3.
4.                                                                 4.
5.                                                                 5.

Reference: (Lewis, S. M., Bucher, L., Heitkemper, M. M. L., Harding, M., Kwong, J., & Roberts, D. (2017). Medical-Surgical Nursing: Assessment and Management of Clinical Problems. St. Louis: Elsevier