Accurate data in identify the patient

Case Study - Questions at the bottom

Dorothy Payne (D. P.) is a 76-year-old female who was admitted to the hospital 2 days earlier with complaints of right lower quadrant abdominal pain. Her medical history includes type 2 diabetes mellitus. She was evaluated in the emergency department and sent to the operating room for an appendectomy 8 hours after coming to the hospital.

D. P.'s vital signs are temperature 38.4° C (101.2° F), P 96 and regular, R 22 and unlabored, BP 130/72, and pulse oximetry of 96% on room air. She rates pain in her right lower abdomen as 3 of 10, but with movement, the pain level increases to 8 of 10. She reports sharp, stabbing pain in the abdominal area around her incision site. Pain medication and position change relieve the pain. The skin around the incision is warm and red, and the area is tender to the touch. Laboratory results are WBC 20,000 (cells/mm³), Hgb 16 g/dL, Hct 47%, BUN 25 mg/dL, creatinine 0.8 mg/dL, K 4.0 mEq/L, blood glucose 150 mg/dL, and Na 142 mEq/L.

Treatment orders are as follows:

• Vital signs q 4 h and as needed (PRN)

• Regular diet with supplements twice daily

• Intake and output (I&O)

• Activity: Up with assist of one

• Right abdominal dressing: Dry sterile dressing, cleanse incision with sterile saline solution, change q 8 h

• Turn, cough, and deep breathe q 4 h while awake

• Incentive spirometry q 2 h while awake

• Antiembolism stockings while out of bed

• Sequential compression devices (SCDs) while in bed

• Complete blood count (CBC) every morning

• Fall precautions

• Physical therapy (PT) for ambulation daily

Medication orders are as follows:

• Continuous intravenous 5% dextrose in 0.45% normal saline (D₅/0.45 NS) at 50 mL/h

• Enoxaparin 40 mg subcutaneously daily

• Metformin 500 mg PO twice daily

• Hydrocodone 5 mg and acetaminophen 500 mg PO q 4 h PRN for pain

• Cefuroxime 750 mg IV q 8 h

Please answer the following questions related to the Case Study.

Questions:

1. Identify at least four diversity considerations related to D. P. and infection control.

2. List the techniques necessary to assess D. P.'s possible infection.

3. Write a goal for the nursing diagnosis of Risk for Infection; Supporting Data: break in skin integrity, chronic disease: diabetes mellitus.

4. Identify at least three nursing interventions with rationales for the goal for D. P.: Patient's incision will remain infection-free during hospitalization.

How do the changes in client characteristics impact health care?

create a grid that identifies examples of data
capture and data entry and how it promotes data integrity.

1. Since every medical term should have a suffix, knowing the meaning of a suffix is a crucial part to understanding the meaning of a medical term. Choose three medical terms with different suffixes and explain their meanings.

2. The suffix -cyte means cell or blood cell. Write all the terms that have the suffix -cyte including the different types of blood cells. Explain what the terms mean and refer to the functions and different characteristics of all blood cells (Make sure you also explain the 5 types of White blood cells).

3. Prefixes add description to medical terms. They can indicate location, time, and amount. Provide three medical terms with prefixes that describe location, time and amount in a medical term. Divide them, label them and give their meaning.

4. Some suffixes and prefixes are opposites. Provide one set of suffixes or prefixes that are opposites.

HOW TO CODE AND SEQUENCE THE FOLLOWING:

1.ASSESSMENT: DKA, TYPE 1DM

Tip: ASSIGN A SECOND CODE FOR UNDERDOSING OF INSULIN FROM THE TABLE OF DRUGS AND CHEMICALS.

2. ASSESSMENT: TEST RESULTS SHOW ABNORMALLY LOW VITAMIN D LEVEL. PATIENT IS OBESE DUE TO EXCESS CALORIES AND HAS A (BMI) OF 30.5 KG/M2

TIP: Z CODE FOR ANNUAL CHECKUP IS NEEDED.

Determine the individuals who carry out contact investigations, or partner notification for STD’s at the local health department (by interview or web search). How do they contact a person who is less than 18 years of age? What strategies do they use to bring the contact in for treatment? How do they maintain confidentiality? References should be included at the end of the answer and in a reference page for complete credit

A 6 year old child is brought to the county public health department because of fever and diarrhea. During an interview with the 20-year-old mother the nurse discovers that the child has not had his “baby shots” or routine well-child checkups. After reviewing the 2019 CDC’s recommended immunization schedule:

a.) What immunizations should the child receive today?

b.) How would you go about assisting this family to secure immunizations and well-child checkups?

The United States’ health-related views and laws are shaped by social, political, and historical factors that are often part of the larger debate over individual rights versus the collective good. Based on this idea please discuss your thoughts on the 3 following public health topics.

• Should childhood immunizations be mandatory or optional?

• Should higher insurance rates or taxes be used to punish poor health choices (e.g., cigarettes, “junk” food)? Would this be unfair to individuals, or is this fair since all Americans pay a portion of the healthcare costs to care for people who make these choices?

• Should, in light of the current Covid-19 situation, should we be required to social distance, wear masks when we are in public, and be on lockdown when community numbers are higher?

Linda Stevens, LPN, works on a medical floor at the local hospital. One of the patients she has been assigned to take care of is Frank Gibbons, a 72-year-old newly diagnosed with diabetes (a condition in which the body does not produce enough insulin to control blood sugar levels). Part of Linda’s process of preparing to care for her patients is to review the patients’ charts for any new physician orders. She notes that Dr. Romero was in the previous evening and ordered the patient’s blood sugar to be checked at 8 a.m. According to the results, insulin is to be given. (The higher the level of blood sugar, the greater the amount of insulin that is given, based on a formula defined by the physician.) Linda is a “thinking nurse” and starts to question if this is an appropriate order. She realizes that breakfast trays arrive at 7:30 a.m. on her floor and that Mr. Gibbons will already have eaten when she checks his insulin level at 8 a.m. She knows that after eating, a person’s blood sugar normally increases for a few hours. This is why blood sugar tests are usually ordered when the patient has not eaten for a number of hours. Linda reasons that if she calculates the amount of insulin based on the temporarily elevated blood sugar levels, Mr. Gibbons will receive too much insulin and may have a negative reaction. Linda calls Dr. Romero to clarify the order. Dr. Romero states that he believed the breakfast trays did not arrive until 8:30 a.m. He thanks Linda for catching the error and changes the order.

• What might have happened if Linda had simply performed the blood sugar test exactly as ordered?

• Do you think Linda should have been considered responsible for the error if she had followed the orders exactly?

• Review the five Ws and How questions in relation to this situation. Give examples of questions that Linda may have asked herself.

A family, of Cuban heritage, is gathered in the waiting room waiting to visit their ill family member in the hospital. The family member‘s voices are loud and they are gesturing in a very animated nature. A healthcare provider enters the space and asks to speak to the patient’s spouse. The healthcare provider asks the spouse “Is everything okay? I notice you all seem upset or angry?” What assumption is being made by the healthcare provider? How might you have handled this situation differently?

1. What is the importance of the skull?
2. What lightens the skull and warm and moisten the air as it passes into the respiratory system?
3. How many divisions are there for the vertebrae?
4. What are the divisions of the vertebrae?
5. What is another name for coccyx?
6. How many total bones are there in all 5 regions?
7. The sternum belongs to which skeletal region?
8. The ilium belongs to which skeletal region?
9. What is another name for patella?
10. Which is the largest bone in the body?
11. What is the flexible, connective tissue called?
12. Ethmoid, frontal, occipital, parietal, sphenoid, and temporal are all part of what?
13. This plate exists at the ends of long bones where lengthwise growth takes in the immature skeleton.
14. What is the soft spot between the skull bones of an infant?
15. Opening of the occipital bone through which the spinal cord passes is called?
16. What is the upper portion of the sternum called?
17. What is the round projection on the temporal bone behind the ear called?
18. What is the flared portion of a long bone, between the diaphysis and the epiphyseal plate?
19. What is the name of a medical doctor who specializes in bone, joint, and muscle conditions?
20. What is the process of bone formation?
21. Name the bone cells that helps form bony tissue.
22. Name the medical doctor who specializes in rehabilitation?
23. Name the twelve pairs of curved bones that form the chest wall.
24. What is the pole-like process extending from the temporal bone on each side of the skull?
25. What is the immovable joint between bones?
26. Name the Lower, narrow portion of sternum.
27. What is the knuckle-like process at the end of a bone near the joint.
28. Name the upper arm bone.
29. What is the lower jaw bone called?
30. What is the upper jaw bone called?
31. What are free, movable joints such as ball and socket or hinge type of joints called?
32. What is a crescent-shaped fibrocartilaginous structure that partly divides a join cavity?
33. Closed sacks of synovial fluid with a synovial membrane located near, but not within a joint.
34. What is loss of articular cartilage and formation of bone spurs at articular surfaces?
35. The disease that causes inflammation due to excessive uric acid in body.
36. What is the compression of median nerve as it passes between transverse ligament and bones and tendons of the wrist?
37. What is a fluid-filled cyst arising from the joint capsule or a tendon in the wrist?
38. What disease is often marked by a “bull’s eye” rash at the site of the tick bite?
39. What chronic inflammatory disease involves joints, skin, kidneys, nervous system, heart and lungs affecting collagen in tendons, ligaments, bones, and cartilage all over the body?
40. Name 3 types of muscles.
41. What type of muscles are under voluntary control?
42. Which type of muscle is not consciously controlled and found exclusively in the heart?
43. Which type of movement is away from the midline of the body?
44. Which type of movement is toward the midline of the body?
45. Which type of movement is circular movement around a central point?
46. Name a group of inherited diseases with progressive muscle weakness and degeneration?
47. What is a uric acid test used to diagnose?
48. What is the acronym for nonsteroidal anti-inflammatory drug?
49. For what conditions might an ESR be requested?
50. Which type of movement is bending the sole of the foot downward toward the

Why is it important for you to properly chart a patient's findings? What can happen if you do not chart these findings correctly? What advise do you have for classmates on how to improve their learning of proper charting techniques?