1) Describe a Bowel Obstruction.

2) Name 3 potential causes of a Bowel Obstruction?

3) Identify 5 signs and symptoms indicative of a Bowel Obstruction?

4) What are 3 complications of a Bowel Obstruction and/or its signs/symptoms?

5) Name 5 nursing interventions for a bowel obstruction and/or the signs and symptoms associated with a Bowel Obstruction.

6) How is pain treated in a patient with a Bowel Obstruction?

7) What are nursing considerations related to controlling pain in a patient with a Bowel Obstruction?

What are some similarities in challenges that the various countries face with their health systems? What are some differences?

Public health is an essential function of the government on a par with, and for reasons similar to, national defense and law enforcement. Specific public health needs, such as sanitation systems and clean water, cannot be met by individuals acting alone. The government is required to organize community efforts as well as compel cooperation when necessary; otherwise, individuals would be free to benefit from, but not contribute to, the resulting public good.

Considering the above, respond to the following:

• What are the key roles for government in serving the public’s health? Why?

• Give examples and reasons in support of your responses.

• Write your initial response in 300–500 words.

MN, a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by bolus, was given. Following the IV bolus, heparin 5000 units given subcutaneously every 6 hours was prescribed. An aPTT was ordered.

Use the drug cards you created and your textbook to respond to the following questions:

• Was MN's heparin within the safe daily dosage range? ( answer please)
• Why was an aPTT ordered( answer please)

• After 5 days, MN was prescribed warfarin 5 mg daily. An INR test was ordered.

• • What is the pharmacologic action of warfarin? ( answer please)
  • What serious adverse reactions could result with prolonged use or large doses of warfarin? ( answer please)
  • What nursing diagnosis would you generate for this client? ( answer please)
  • What patient teaching interventions should the nurse include? ( answer please)

Give three examples of how the Semi-interactive console will be tested ARDMS test

what kind of knolwedge will be needed to answer semi-interactive console questions at ARDMS

After reading scenario answer the questions:

1.identify the history type:comprehensive, problem focused, detailed or comprehensivie?

2. identify the subcategory of the E/M level?(new patient or established patient)

3. what code should be reported?(99202,99221,99204,99201)

4. identify the medical decision making?(straight forward, low complexity, moderate complexity, high complexity)

5. identify the elements of PFSH( past history, family history, social history, all of them)

6. identify the level of PFSH( complete, problem pertinent)

7. what e/m category this would fall under?(inapatient services,, office or other outpatient services)

8. identify the chief complaint(Borderline glucose level, hypertension, CHF, Astha)

9. identify the problem pertinent body system reviewed( endocrine system, cardiovascular system, respiratory system, urinary system)

10. identify the HPI level (brief, extended)

Mr Kim is a 35 year old welder by trade who was found to have borderline glucose levels during a hospital stay 1 month ago.The levels were higher after meals but never exceeded 200mg/dL.The patient thinks he might have experienced some frequent urination, but that could be from increased fluid intake.Since his hospital stay, the patient has been concerned about his blood sugar and has started walking 20 minutes at least 5 days/week, and reducing fis caloric intake.

Mr .Kim reports no recent weight changes or changes in appetite .His vision has returned to normal since his corneal transplant .He has not noticed any recent cuts or bruises that are slow to heal.No extremity tingling or numbness.No oral infections.No skin infections .No bladder infections .Normal bowel movements .No shortness of breath,no chest pains.

Patient reports his knees hurt from time to time from remote history of athletics , but pain is controlled with ibuprofen.No depression,slight anxiety concerning healing eye trauma.No other current endocrine symptoms or disease.Patient is immunosuppressed due to the corneal transplant and reports his medication is preventing rejection.

No other medications.Patient reports paternal grandfather developed type II diabetes over 60.No other diabetic history.Patient is a welder and has recently started an exercise routine.

Exam:

Head:normocephalic,atraumatic

Neck:supple,trachea midline,no lymphadenopsathy

Eyes:grossly normal

ENMT:mucous membranes pink

Cardiovascular:RRR

Respiratory:clear breath sounds bilateral

GI:Positive bowel sounds,no organomegaly

GU:external genitalia normal, no hernias palpated

Extremities:full ROM in all four extremities; positive reflexes and strength x4; no skin changes noted

Neuro:cranial nerves II-XII normal; patient is oriented X3

Data reviewed:

Patient had a fasting blood sugar 3 days ago 90 mg/DL, which is high normal.

Cholesterol also elevated but WNL

Other labs were normal.

Assessment and plan:

Mr.Kim had recent elevated blood sugars, but latest test shows high normal.At this time I would not consider him diabetic or prediabetic, given his absence of symptoms and transient blood sugar levels.Mr.Kim should continue new diet and exercise habits.I gave him a pamphlet today on healthy eating.Mr.Kim should see me every 6 months to monitor his progress and hopefully avoid any disease process.Should his blood sugars start to increase , we will revisit his diagnosis and treatment.I considered multiple treatment options and reviewed a moderate amount of data.At this point ,I think Mr.Kim has a moderate risk of developing type II diabetes at some point in the future,   

Since Pennsylvania has little specific statutory law on AID (artificial insemination by donor}, what protections do you recommend for parents and donors?

Do you think the ethnographic method/ethnography is the best method to use when collecting observational research data related to healthcare and health informatics?

A. Terrible method

B. Not too bad

C. Good method

D. Best method

What is your reasoning for selecting the previous question's answer?

Consider the following situations. What is the appropriate response for each and what would you do to calm the sitatuion?

1. The patient’s chest tube comes out

2. The amount of drainage from the chest tube has suddenly decreased

3. While performing the chest tube dressing change, the nurse notes a crackling sensation on palpation.

4. The nurse notices fluctuation in the connection tubing with inhalation and exhalation.

Jenny, a twenty-two year old college graduate, has recently decided to spend two years as a missionary in a coastal African village. As part of her duties, she will work in the missionary clinic that has recently been established in the village. This clinic will provide routine medical care and a travelling physician and nurse will visit once each week. Jenny feels fortunate to have the opportunity to use the information that was presented to her in various classes she completed while in college. After completing a 4-month intensive training period (language classes, medical preparation for work in the clinic, and cultural enrichment), she departed for Africa. Upon her arrival, Jenny found that she would be spending most of her time in the clinic since the village had been without routine medical care for the past 2 years. The previous clinic was closed due to flooding and insufficient funds to rebuild. Initially, Jenny found that she was very dependent upon the physician’s weekly visits since her training was limited. Gradually, she found that she was beginning to call upon her training (both clinical and classroom) and she felt comfortable diagnosing and treating some of the more routine cases. One morning, a mother came in with her five-year-old child. The mother reported that the child had been unable to eat or drink anything for the past day because of vomiting. In addition, her child was experiencing severe diarrhea. Jenny asked the mother if any other family members were exhibiting similar symptoms, to which the mother replied that a few other members of the family had similar symptoms, however, not as severe. Jenny’s first thought was that the symptoms were very similar to those she had exhibited following a bout of food poisoning while in college. Since the villagers had no refrigeration and poor sanitation, Jenny gave the mother an electrolyte solution containing glucose similar to Gatorade® and told the mother to have the affected children consume this solution and nothing else for the next 24 hours. After that time, if the children were no longer vomiting, she could start feeding them tea and broth. Jenny also cautioned the mother that if the children did not seem to be getting better after 24 hours to bring the children back to the clinic. The next morning Jenny opened the clinic to find the mother, and not just the child she had seen the previous day, but three more of the woman’s children. All of the children were exhibiting similar symptoms that now included muscle cramping and excessive thirst in addition to diarrhea and vomiting. When checking the vital signs of the children, Jenny noticed increases in both the pulse and respiratory rates accompanied by decreased blood pressures. Uncertain as to the appropriate course of action, Jenny contacted the physician by radio. Upon conveying the histories and information to the physician, Jenny received instructions to keep the children at the clinic, start intravenous (IV) infusion with lactated Ringer’s solution, and allow the children to drink as much of the electrolyte solution with glucose as they would like. The physician also gave Jenny a list of laboratory tests to run on the blood, urine and stool samples that she should collect. Jenny started the IV infusions and gave each child some of the electrolyte solution. After this, she obtained stool, blood and urine samples from each child and asked the mother to leave the children with her for care and observation. The mother agreed and said she would return later that night to help with the children. The results of the tests run indicated severe metabolic acidosis, an increased hematocrit, hypokalemia, and the presence of Vibrio cholerae bacteria in the stool samples. Based on the results of these tests, the physician and Jenny diagnosed the children with cholera and obtained a more detailed history in an attempt to determine whether these individuals were the only ones exposed or whether these cases were the first of a possible epidemic. Jenny and the physician found that the family had recently visited relatives in a distant village where similar symptoms had been present in a number of families that had all celebrated a recent shellfish harvest. The physician prescribed continued IV infusions with lactated Ringer’s solution and electrolyte fluid replacement by mouth. The children were not allowed to consume other foods or drinks, especially coffee or any other beverages containing caffeine. The children were also told that once the vomiting stopped they could start consuming solid foods. The children were all treated with antibiotics and stool samples were taken from other family members to determine whether or not they were infected with Vibrio cholerae. Infected, asymptomatic individuals were treated with antibiotics. The physician later explained to Jenny that caffeine was prohibited because the toxin produced by the bacteria (termed choleragen) binds to the surface of the epithelial cells of the small intestine and activates adenylate cyclase. In addition, the toxin interferes with the active transport of sodium ions in the intestinal lumen. Using the medical terms you learned this week answer the following questions about this case

Why did Jenny initially suspect that the child and other family members were experiencing food poisoning? Upon further evaluation on the second day why would the child present an increased pulse and respiratory rate but decreased blood pressure?

Managnment Principles for HIM

Reflecting on job titles: Using the Internet, research a current job opening which you might be interested in after graduation and the job description or summary that is provided within the advertisement of the job. Include the following components within your initial post or discussion: Is the job title reflective of what is described within the job summary? I

f it is not reflective of the tasks, create a new title that would be more interesting and more closely related to the job tasks. If it is reflective of the tasks, describe what makes the title unique for this position. Explain whether or not you would be interested in applying for this job based on the job title and job summary provided. Provide a working link to the job advertisement

Public health measures have often led to conflict and controversy in past. One current example of a controversial public health measure involves requirements for wearing masks in public to minimize the spread of COVID-19. Part of the controversy has been attributed to politics, as well as the public’s trust in health agencies. Think about what you learned from the podcast “There’s Something About Mary” and about the current COVID-19 pandemic. 1)What do you think contributed to Mary Mallon’s reluctance to follow public health measures/recommendations? 2)As the pandemic goes on, do you think that we are likely to see similar tensions between individual decisions and the public good? Why or why not? • What can public health officials do to gain the public’s trust in health information . write 250 words

The Affordable Care Act allow states to expand Medicaid services by raising the income eligibility guidelines. The federal government will pay for 90% of the costs of the program expansion and the state is required to pay the remaining 10%. Many states (including Oklahoma) have opted not to particiapte in the program expansion. Do you feel that our state should or should not participate in Medicaid expansion and why?