What do the different presentations of GI Bleed mean? Eg. Hematochezia vs coffee ground emesis vs melena vs bright red vomit

Location: Skilled Nursing Home Care Facility 0800

Report from charge nurse:

Situation: Mrs. Morrow is an obese, 80-year-old white female who developed a venous stasis ulcer on her right medial malleolus while still living at home. She moved into our skilled nursing home care facility 3 days ago. The current plan of care is focused on promoting wound healing, improving venous return, and preventing skin breakdown.

Background: Mrs. Morrow has a past medical history of chronic obstructive pulmonary disease (COPD), chronic venous insufficiency, and deep vein thrombosis (DVT). Peripheral arterial disease is ruled out by duplex ultrasound. Her daughter had her admitted to this skilled nursing home care facility due to concern for her safety with impaired mobility, an unhealthy diet, and inability to adequately care for herself at home.

Assessment: Mrs. Morrow is alert and oriented, but sometimes forgetful of recent events. Vital signs have been within normal limits and are performed weekly. Results from yesterday's labs are in the chart. She is on a regular diet with nutritional supplement and has been eating the majority of her meals since admission. She requires assistance with positioning in bed and assistance times 1 to get out of bed to the chair or ambulate. Her gait is unsteady, and she is easily fatigued. Her Braden Scale score is 16, and her skin is intact except for the venous stasis ulcer on the right medial malleolus. She has brown hyperpigmentation on both lower legs with +2 edema. The venous stasis ulcer is covered with a hydrocolloid dressing, which is due to be changed. In preparation for her dressing change, she was medicated for pain half an hour ago.

Recommendation: You should complete a basic assessment, review the labs, perform a wound assessment and dressing change, and then reposition the patient to optimize venous return. Please provide patient education on improving venous return to prevent further stasis ulcers, and continue compression therapy with the use of elastic bandage and an antiembolism stocking.

Josephine Morrow

Documentation Assignments

1. Document the findings of a focused skin assessment of Ms. Morrow, including any findings that identify the presence of chronic venous insufficiency.
2. Document any abnormal laboratory results that are associated with the presence or status of Ms. Morrow's stasis ulcer.
3. Record the results of Ms. Morrow's Braden Scale assessment.
4. Document the characteristics of Ms. Morrow's venous stasis ulcer.
5. Document the dressing change and irrigation of Ms. Morrow’s wound.
6. Record patient education on ways to promote venous return.
7. Prepare 3 Nursing Diagnosis and their defining characteristics for Ms. Morrow's diagnosis.

What is the “heart” of qualitative research?

. A toddler may react to stress in the family unit by returning to earlier behavior patterns. This is called

a) Progression      

b) Regression

c) Suppression

d) Denial

8. Prejudice is defined as the unfair treatment of people based on their group membership:      

a) True

b) False

Which type of qualitative research is the most flexible and widely used for applied research?

16. An epidemiologic study of breast cancer among elderly women followed 1,000 women, 65-79 years of age, without evidence of breast cancer over several years. Every two years the investigators examined the women for breast cancer. The results were as follows: 12 new cases at the first evaluation, 11 new cases at the second evaluation, 23 new cases at the third evaluation, and 28 new cases at the fourth (and final) evaluation. The investigators also noted that 40 women had withdrawn from the study at the third evaluation. Based on this information, calculate the person-time incidence rate (in person-years) of breast cancer in this group. Show all of your work.

Define and use clear health care facility finance examples A to H each term have to write at least 150~ 200 words. -Important This is the essay question. Dont use exactly same as coursehero. APA format and dont do Plagiarism! 1. Define and use clear health care facility finance examples (You must include numbers as well as words) A. The difference between facility charges, payment and costs B. Payment to cost ratio C. Payer mix D. Global Managed Care E. Shifting Financial Risk F. The Forms of Shifted Financial Risk G. Benchmarks H. Operational Performance Indicators (mention at least 4)

NEED THESE ANSWERED IMMEDIATELY PLEASE!

There are several possible ways of intervening to prevent overweight in adolescents, including clinical intervention and public health intervention. What is the difference between clinical intervention and public health intervention? What are the potential difficulties associated with each approach?

Below is a piece of an article which discusses one of thee many disputes which can come about when patients seek organ donation. it deals with a little girl named Sarah who desperately needed a double lung transplant but due to certain policies almost lost the opportunity to obtain it.

"Sarah’s family and the family of another cystic fibrosis patient at the same hospital challenged transplant policy that made children under 12 wait for pediatric lungs to become available or be offered lungs donated by adults only after adolescents and adults on the waiting list had been considered. They said pediatric lungs are rarely donated. The family challenged this policy and had Sarah placed on the adult donor list. Sarah’s aunt, Sharon Ruddock, said the donor lungs came in through normal channels as a result of being on the adult donor list. It was a direct result of the ruling that allowed her to be put on the adult list,” Ruddock said. “It was not pediatric lungs, she would have never gotten these lungs otherwise.” Before the ruling, Ruddock said, Sarah was “very close to the end. Maybe a week. Maybe two.”

You may read the full article at: http://www.nj.com/south/index.ssf/2013/06/philadelphia_girl_at_center_of.html

Students what do you think of policies such as the one above being in place which make children wait on another list separate from adults and adolescents giving them preference to organ donations?

Critical thinking 1) Sacha’s mother has brought him to the doctor's office because he has been misbehaving at home and at school and never seems to listen to anything the adults say to him. His mother noticed that he does not respond when she calls his name, and he often seems to live in his own world. Now that he has entered kindergarten, his teacher also reports that Sacha does not seem to respond quickly and has limited vocabulary. How should the medical assistant respond?

2) Alicia, who is 62 years old, comes to the office for a routine eye examination. When you ask her when her last eye exam was, she tells you that she hasn’t had her vision checked in about 7 years, because the exams make her nervous. What should you tell Alicia to help her feel more comfortable and to help her understand the importance of her eye examination?

3) Tom brings his 6-year-old daughter Jane to the office. The physician diagnoses her with conjunctivitis and prescribes eye drops. How should you advise Tom to help Jane avoid spreading the disease to her siblings and classmates?

For this second class discussion, I want you to identify one vulnerable population that is at a high risk for being a victim of medication errors and answer the following questions:

1. What policies and procedures have been developed by hospitals and healthcare systems to help prevent medication errors for the vulnerable population you have chosen?

2. What steps can be taken by the healthcare team to ensure safe and proper medication administration for your chosen vulnerable population?

3. What forms of communication have you personally witnessed at work, school, TV, movies, etc. to successfully communicate with any kind of vulnerable population?

{Answer each question with a paragraph of at least 4 sentences.

Write three questions you want to know about modelling and role modelling theory?

How do you think this theory is applicable in clinical settings?

Think of a health issue that interests you. Then, go to the following government websites and explore each website to find information about the health topic you have chosen.
(You may need to adjust your topic if you do not get results—that’s okay.) Explore each website.

• The Centers for Disease Control and Prevention
• The National Institutes of Health
• The World Health Organization

In your initial post, fully compare and contrast your search results.

• What kind of information did each website have?
• How was the information similar? How was it different?
• What are you able to infer about the purpose or mission of each of these organizations?
• What did you learn about the topic you did not previously know?
• What surprised you or seemed unexpected?

Please be sure to validate your opinions and ideas with citations and references in APA format.

Based on Charles' weight, what is the total dose for the rtPA infusion?