Scenario 1: You are working as a waitress in a restaurant. You go to check on your table to see how their food is. As you are walking up to the table, one of the customers begins coughing. They suddenly stop coughing and start clutching their throat. Their lips begin to turn a bluish color and the family around the table begins to panic. You are first aid certified and want to help the victim. (1) What are the initial steps you would take in this situation? (2) Describe in detail how you would help the victim.

Scenario Continued: As you are giving care to the choking victim, they become unresponsive and you determine that they no longer have a pulse. (1) Describe in detail how you would now care for the individual with the new information.

Scenario 2: You are at a family get-together when your aunt starts screaming for help. You run over to your aunt to see her holding her 8-month old baby. She tells you that the baby is choking on a toy from one of the older children and she needs help. She hands you the conscious baby and you notice her lips are turning blue. (1) What are the initial steps you would take in this situation? (2) Explain in detail how you would care for the choking infant.

Scenario Continued: While you are caring for the infant, she becomes unconscious and she no longer has a pulse. (1) With this new information how would your care change? (2) Explain the new steps of care in detail.

do you think that case management for behavioral patients requires more of a team approach than for physically impaired individuals?

Use SPSS to conduct the necessary analysis to answer each of the questions based on the following scenario. If a statistical test is used, you should use .05 as the critical level of significance. You are a Nursing instructor at your institution. You teach Intro to Nursing. You want to know how your students’ final averages compare to institutional average for Intro to Nursing, which is 80. The final averages for your students are listed below. 90, 80, 77, 55, 67, 71, 82, 70, 99, 92, 93, 88, 66, 43, 91, 50, 75, 84, 94, 89, 62, 39, 68, 99, 86, 90.

1. What is the median average for your students?
2. What is the range of your final averages?
3. Was your class average higher or lower than the institutional average? What was the difference?

1. What is your position as a provider or Nurse practitioner of banning unvaccinated patients from visiting clinics and why?
2. What are the logical and reasonable responses to people who refuse being vaccinated?
3. What are the pros and cons of using a revised immunization schedule?

Patient Introduction

Location: Orthopedic unit 1555

SBAR report from day shift nurse:

Situation: Mrs. Jacobson is an 85-year-old white female who was admitted last evening after falling and fracturing her hip. X-rays have been taken and show left intertrochanteric hip fracture. Mrs. Jacobson is scheduled for surgery tomorrow.

Background: Mrs. Jacobson has a 10-year history of osteoporosis, and her daughter reports that recently Mrs. Jacobson has been having dizzy spells.

Assessment: Mrs. Jacobson's vital signs are stable. Her pain is under control with morphine every 4 hours, and I medicated her at 1400. Her pain level was 2 after the morphine. The skin is intact; color and sensation around the hip area are within normal limits. A Morse Fall Scale assessment was completed on admission, and her score was 45. Fall precautions were implemented.

Recommendation: You will need to reposition Mrs. Jacobson as she needs to be turned every 2 hours. You should perform a focused musculoskeletal assessment, reinforce safety, and provide patient education on fall risk. Assess her pain level and medicate for pain if needed.

Edith Jacobson
Documentation Assignments
Document your focused musculoskeletal assessment of Edith Jacobson.
Document your focused skin assessment of Edith Jacobson.
Document the patient teaching that Edith Jacobson would need related to fall risk and prevention during her hospitalization and upon discharge.
Document the essential elements of proper body alignment for Edith Jacobson and include the specific supplies that would be needed.

patient safety and falls in the hospital environment

A hip implant failed two weeks after surgery. It was removed and the contact angle was found to have a value of 120o. A new implant that was coated with fibronectin (with a contact angle of 40o) was found to get integrated within three days! Provide an explanation for these observations.  

Summarize your understanding in computational approaches on virology. Your summary must not be more than 3000 words and less than 1000 words.

Case Study 1:

Maria Cortez is a 32-year-old client who had surgery on her left knee 2 months ago. She is obese and has had difficulty ambulating since the surgery. She also has a history of pulmonary embolus (PE). She has been taking a low molecular weight heparin, enoxaparin, since the surgery because of her history of PE and risk for the development of deep vein thrombosis (DVT).

1. Ms. Cortez calls the medical clinic and asks to speak to the nurse. She states that she has just learned that she is pregnant and is concerned that the enoxaparin will harm the baby. How should the nurse respond?
2. Ms. Cortez has a successful delivery of a baby girl. Ten months later, she is hospitalized for additional surgery on her knee. Her recovery is complicated by the development of a DVT, and she is started on warfarin. Discuss the teaching that the nurse should provide Ms. Cortez before discharging her on warfarin.

Case Study 2:

A client is being treated for a deep vein thrombosis in the left lower leg.

1. The client is being treated with heparin. Discuss potential assessments for this client.
2. The client is started on warfarin along with the heparin infusion. The client asks, “Why am I on two anticoagulants?” Discuss your possible responses and client teaching.

Case Study 3:

Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of heparin administration.

1. Describe the occurrence of HIT in clients and how it is detected.
2. What are the risk factors for this disorder?
3. What are the potential interventions to control the outcome of HIT?

Case Study 4:

Andrew Oliver is a 45-year-old man who works as a mental health counselor. He presents to a small community emergency department with an acute anterior ST elevation myocardial infarction. Within 20 minutes of arrival, he receives alteplase by continuous intravenous (IV) infusion over 3 hours. He also simultaneously receives an IV bolus of heparin and is started on a heparin drip. You are the nurse assigned to his care.

1. To regulate the amount of heparin Mr. Oliver receives, his aPTT is measured. What is the therapeutic value for aPTT?
2. Oliver’s prescriber adds warfarin to his treatment regimen. The order is for Warfarin 5 mg PO daily and for evaluation of baseline Pt and INR. The nurse administers the warfarin and order the blood work for the next morning. What therapeutic INR value indicates that the warfarin dosage is appropriate?

Case study 5:

A 57-year-old man with a history of hypertension and unstable angina is admitted to the emergency room with severe, crushing chest pain. He was working in the yard when he began to have pain in his left arm with diaphoresis and nausea. He took three sublingual nitroglycerin tablets before asking his wife to call EMS.

1. Why is nitroglycerin indicated for the relief of chest pain caused by myocardial ischemia?
2. What instructions should be given to patients prescribed sublingual nitroglycerin?
3. The following medications are ordered. What is the purpose of these drugs, and what assessment should the nurse perform related to the administration of these drugs?

• Aspirin 81 mg chewable tablets, give 4 tablets STAT
• Intravenous morphine sulfate 2 to 4 mg every 10 minutes as needed to control pain
• Atenolol 5 mg IV
• Nitroglycerin IV drip at 10 mcg/minute

The patient undergoes a successful placement of a stent in the right coronary artery. The patient has aspirin 324 mg orally every day and metoprolol 100 mg orally twice a day prescribed.

The following medications are ordered. What is the purpose of each of these drugs and patient teaching required?

• Nifedipine 20 mg PO twice a day
• Clopidogrel 75 mg PO daily

Case Study 6:

Richard Gerald, a 72-year-old man, has a history of hypertension and coronary artery disease. He stopped smoking and began a regular exercise program after having a non-ST-segment elevation myocardial infarction 2 months ago. He was discharged on nitroglycerin- in a sublingual form and as transdermal patch (1 inch) every 4 hours while awake (off at night) – and on atenolol 50 mg orally daily.

1. Why dose Richard have to remove the nitroglycerin transdermal patch at night time?

Mr. Gerald returns to the clinic for a follow-up. His blood pressure is 130/86 mm Hg. And his heart rate is 86 beats per minute. He reports that he has been pain free since discharge. He is taking his atenolol as prescribed but reports that he is using the nitroglycerin patch four times a day around the clock because it is easier for his schedule. Given his vital signs, his provider increased the atenolol to 100 mg daily.

1. Gerald asks the nurse why he needs to take atenolol at all, when he has no pain, and why the dose has been increased. How should the nurse respond? What patient teaching needs to be reinforced?

While reviewing his medication instructions with Mr. Gerald, the nurse learns that he has a history of erectile dysfunction and has some sildenafil.

1. Which was prescribed for him before his MI. what actions should the nurse take?