An adult male patient has a Carboxyhemoglobin level of 26% and is exhibiting intermittent confusion and disorientation. You, as the respiratory therapist are recommending HBO therapy. The physician, being unfamiliar with the treatment, asks what your rationale is for recommending HBO. How would you explain it to her?

please read the soap note below and write a presentation for it thank you (case presentation)

Joanne Bennett, 29 yr old Caucasian woman

CC: “I have a cough that won’t go away.”

S) HPI: c/o cough for one month. It began suddenly. Noticed that it started around the beginning of spring as weather became warmer. Becomes worse when goes outside, especially at night. Symptoms worse at night and often wakes with coughing. On two occasions coughing fits have caused her to throw up. Denies sputum with the cough. Concerned because during her coughing attacks she sometimes feels that she cannot catch her breath, which is “extremely frightening.” Sometimes sounds wheezy. Taking Robitussin every 4-6 hours, but this is not alleviating her cough. Sleeps w/ 1pillow. Sleeps with windows closed.

PMH: Last Physical Ex was more than 2 years ago. Was told to lose wt. No h/o of asthma or bronchitis. Surgery: none. No hospitalizations.

Meds: birth control pills (Lo-Ovral for the past 2 years). OTC Claritin 10mg for seasonal allergies taken occasionally.

Allergies: NKDA; no food allergies. Seasonal allergies to pollen. Sleep: 8 hours/night when not coughing.   TB skin test neg 6 months ago. Flu shot last winter.

SH: works full time as a receptionist in a corporate office building x 2yrs. Sedentary lifestyle. Her only exercise is walking 3 blocks from BART station to work each day. Non-smoker. Denies drug use. ETOH occasionally. 3 cups of coffee daily. Lives alone in apt; in no current relationship. Has no pets.

FH:           Father: 56, smoker, asthma, COPD, HTN                           PGF: asthma; died age 56 in MVA

                  Mother: 55, smoker, DM type 2, HTN                                 PGM: 78, alive with Alzheimer

                  MGF: died age 68 from CVA                                                    Brother: 25, asthma, obesity

                  MGM: died age 70 from CVA, DM type 2                         

ROS:   General: Denies recent weight changes, fevers, or chills.

Derm: Denies rash

HEENT: Voice hoarse; no throat pain. No nasal d/c. Denies sinus pain or pressure.

Resp: See HPI

CV: Denies chest pain or SOB with exertion.

Endocrine: Denies excessive hunger, thirst or excessive urination.

MS: Chest muscles tight from coughing. Has mild knee pain sometimes esp with going up stairs.

Psych: Denies depression, thoughts of harm to self or others.

O) Vitals: Temp: 98.5, BP: 124/85, RR: 16, HR: 70, O2 sat: 98%,   Height: 5’2”, wt: 168 lbs BMI: 31

General: obese. Wheezing with inspiration.

Skin: pale. No excessive dryness.

HEENT: Canals clear. TMs visible, translucent, gray, cone of light and landmarks visible. Nasal mucosa pink, clear d/c, septum midline. Oral mucosa pink and moist, no pharyngeal erythema, no exudates, tonsils 2+. No frontal/maxillary sinus tenderness. Neck supple, trachea mid-line. No LAD. Thyroid without enlargement or nodules.

Heart: normal S1, S2, No MRG

Lungs: Diffuse expiratory wheezes throughout. Resonant to percussion, thoracic expansion equal. No increased AP/lateral diameter. No egophany. Tactile fremitus equal.

Extremities: No edema, pulses equal 2+ bilaterally in all 4 extremities.

A) Asthma, triggered by seasonal allergies.

P) #1. Rx: Albuterol HFA MDI 2 puff q 4-6 hours prn wheezing/cough. Flovent MDI 40 mcg 2 puffs BID. Claritin 10mg q am.

                  Dx: none                

                  Pt. Ed: Teach use of peak flow meter; begin learning to self-monitor asthma. Rinse mouth after use of steroid inhaler,

                  F/U: RTC in 2 weeks; bring log of symptoms and use of rescue inhaler.

10. Identify possible nursing diagnoses for Addison’s.

11. Who would benefit from Sodium Polystyrene? Possible side effects and patient teaching?

CPR

Now that you have taken the time to evaluate your lifestyle by completing the Healthy Lifestyles Awareness Inventory, you may be able to identify behaviors that could lead to injury or illness, now or in the future. Identifying these behaviors is the first step to leading a healthier life. By using this contract as a tool, it will help you focus on working towards a specific goal to make your lifestyle healthier.

Behavior Modification Contract

Now that you have taken the time to evaluate your lifestyle by completing the Healthy Lifestyles Awareness Inventory, you may be able to identify behaviors that could lead to injury or illness, now or in the future. Identifying these behaviors is the first step to leading a healthier life. By using this contract as a tool, it will help you focus on working toward one specific goal to make your lifestyle healthier.

Goal:

Complete the sentence below. Be as specific as you can.

In the _____ weeks of this course, my goal is to—.......

Objectives Make a list of the lifestyle changes that are necessary to accomplish your goal. For instance, if your goal is to lose 10 pounds, you might want to make these changes in lifestyle: lower the fat intake in your diet, exercise at least three times a week and start eating a nutritious breakfast daily.

1.

2.

3.

4.

5.

Potential Roadblocks Try to anticipate any roadblocks or difficulties you may face in meeting your goal. Then think about how you will overcome these roadblocks to meet your goal.

1.

2.

3.

Evaluation To realize your goals, it is important to measure your progress at regular intervals. Make a list of the ways in which you will track your progress.

1.

2.

3.

4.

5.

Reward Rewarding positive changes in behavior is important. When I meet my goal, I will reward myself by .......

I agree to do my best to accomplish the goal of this contract during the time allotted.

name:

witness:

date:

Write a introduction and methods section of a scientific research paper on coffee and average number of cups of coffee consumed per day in association with heart disease.

With regard to using this data for your own individual investigation, you will have to decide: how and when the 105 participants were selected and enrolled in the study; if any inclusion/exclusion criteria were applied when selecting the participants; whether or not the participants belong to a specific population that the study was limited to; when the physical assessment was done, which measurements (i.e., variables) were made during the assessment, and exactly how each measurement was obtained; and which measurements (i.e., variables) refer to a past history vs a prevalent state vs an incident event, how having/not having each history/state/event is defined, and exactly how each measurement was obtained.

46) Identify the developmental stages of adulthood, two (2) major activities related to each stage and 1 example of variation in health needs and ADLs. Developmental stage of adulthood:

46.1) Early adult period (20 to 40 years)

46.2) Middle adulthood (40 to 65 years)

46.3) Older adult (older than 65 years of age)

Please very super breifly, aproximately 30-50 words, explain below elements in regards to the above senarios seperately for each one of them on each one of the senarios:

Major activities?

Variation in health needs and ADLs?

48) Briefly, in a very short possible way, discuss the technique of assessing each of the following clinical measurements using the methods mentioned below (in 30-40 words).

48.1) List down various methods used to measure or evaluate vision and hearing.

48.2) List at least 2 aids and equipment used for assisting clients with vision and/ or hearing impairment.

Research the Josie King case, and address ethical as well as legal issues you identified. Who do you feel was most responsible? Would an EHR have helped in this situation? How?

1. How will the nurse care of the patient following a adrenalectomy?
2. What factors can lead to the development of a goiter?
3. What is the purpose of the parathyroids? What would alert the nurse of parathyroid gland compromise?

Write a reflection about the introduction to NURSING RESEARCH.

Your reflections should include (1) your opinion, (2) personal experience, and (3) evidence to back up your thoughts and/or opinion (APA citation).

Cost management is a significant part of managing a clinical unit. As a nursing student, propose two strategies where cost can be contained on a unit that is consistently over their allowed budget. Basic patient care supplies such as linen, wound care supplies, and overtime cost are ongoing discussions at the staff meetings.

D.V., a 32-year-old man, is being admitted to the medical floor from the neurology clinic for evaluation of his symptoms. D.V. has experienced increasing urinary frequency and urgency over the past 2 months. Because his female partner was treated for a sexually transmitted infection, D.V. underwent treatment, but the symptoms did not resolve. D.V. has also recently had two brief episodes of eye “fuzziness” associated with diplopia and flashes of brightness. He has noticed ascending numbness and weakness of the right arm with the inability to hold objects over the past few days. Now he reports rapidly progressing weakness in his legs along with blurred, patchy vision. D.V denies any allergies to medications, as well as any significant past medical history. However, he does report the occasional cold during the winter months.

Determine what possible diagnosis D.V.will have from the evaluation of his symptoms and what do each of the symptoms mean and how do they relate to his diagnosis?

You work for a 575 bed Acute Center level 1 Research Trauma Center. The hospital is also a teaching hospital connected to a university. The medical center brings in many millions of dollars in grants each year. The facilities maternity ward delivers the most babies in the city. They have an active heart surgery center. There are six months of data in the new EHR. There are two years worth of paper on the shelf. The two years of records includes the contents of the EHR, since the administration does not trust that EHR administration yet. All older records are maintained on microfilm. You have just ran out of storage space. Because of this you have been asked to evaluate the current retention policy, which is to retain records forever.

1. Identify the factors that the minimum retention policy should be based on.

2. Determine the statute of limitations for your state.

3. Recommend the length of time that the health records should be kept. Justify your recommendation.

4. Specify the method of destruction that you recommend for the paper and electronic data.

5. Recommend whether you would perform the destruction in-house or outsource it. Justify your recommendation.

6.Explain Certificate of Destruction.

Application or removal of a cast or splint can be billed separately in some situations but not in others. In which situations is separate billing appropriate? Why do some situations dictate separate billing but others treat cast application as an included procedure? Must be at least 250 words