1. What do CHW's do and where are they employed?

2. What does Title VI of the Civil Rights Act of 1964 require?

3.What are some issues that can arise with the use of ad hoc interpreters?

Your patient is an active 80-year-old woman with heart failure and chronic atrial fibrillation. You are taking an angiotensin-converting enzyme inhibitor, a beta-blocker, a diuretic, and digoxin. During her evaluation, she tells him that she felt very dizzy this morning.

How would you approach your evaluation and why?

Identify some of the key evaluation factors.

What nursing interventions are necessary?

How would you change your evaluation and interventions if your patient also had chronic obstructive pulmonary disease and kidney failure?

Read the following case study, then answer the questions that follow.

Akot is an aged care coordinator. He conducts an assessment of Mrs. Brown using a falls assessment tool. Mrs. Brown tells him she is extremely confident she will not fall when carrying out all activities of daily living, circling 10 in response to all of the questions on the scale.

Later, Akot observes Mrs. Brown and notes she moves quite slowly and maintains contact with the handrail while walking down the corridor. A worker, Frank, tells Akot that Mrs. Brown has experienced episodes of incontinence as she waits until the last minute to go to the toilet.

Akot discusses his concerns with his supervisor to seek direction on what should happen next.

Question

1. What indications are there that Mrs. Brown is at risk?
2. What may have prevented Mrs. Brown from answering the falls assessment questions honestly?
3. Describe the actions Akot should take in relation to his duty of care.

You are working on a medical/surgical floor with a client with adrenal dysfunction. The client is a 61-year-old male who presented to the ED in a markedly unwell state. He complains of progressive development of symptoms that include feeling generally not well, weakness, and fatigue. He is dizzy most of the time, and it gets worse upon standing. During your admission assessment he comments on unintentional weight loss and a darkening of his skin, "like a suntan.” His vital signs on admission are: P = 110, RR = 20, BP = 95/55, & T = 97.6 (F). He is diagnosed with primary adrenal insufficiency or Addison’s disease.

Answer the following questions:

1. Explain the pathophysiology of your clients' disease processes.

2. Explain the fluid volume, electrolyte, hemodynamic, and metabolic imbalances your clients are experiencing.

3. What other lab value abnormalities would you anticipate?

4. What symptoms, other than the ones listed, might your clients manifest?

5. What tests would confirm the diagnoses?

6. What medical interventions do you anticipate?

7. What medications do you expect to be ordered, and what are the nursing implications of those meds?

8. What are your priorities in planning care for these clients?

9. What nursing interventions will you implement?

10. What discharge teaching will you provide?

how does atherosclerosis cause vasospasm?

A number of drugs with different properties are shown below. Which of these drugs are most likely to cross the blood-brain barrier? (select all that apply)

- High molecular weight drug

- Low molecular weight drug

- Water-soluble drug

- Fat-soluble drug

- Nonpolar drug

- Small drug

- Polar drug

Lab Assignment

• Create a table and identify ranges of acceptable vital sign values (temperature, pulse rate, respiration rate, blood pressure and oxygen saturation) for an infant, a child, and an adult.

• J.P. is a 15-year-old African American adolescent who was diagnosed with sickle cell disease 3 years ago. J.P. presents to the emergency department with pain related to sickle cell crisis.

Subjective Data
Pain level is an 8/10 location = bilateral legs, described as deep muscle pain
Student in 10th grade, honor roll student
On the track team
Lives with mother and father

Objective Data
Vital signs: T 37 P 80 R 18 BP 140/68
Weight: 140
HT: 5 feet, 6 inches

Questions

1. What other assessments should be included for this patient? Explain your answers.
2. Discuss the various types of pain that a patient can experience. Explain your answers.
3. What type of pain does this patient describe? Explain your answers.
4. What standards of assessing pain will be applied to this patient’s plan of care? Explain your answers.
5. Discuss three (3) patient education/teachings that should the nurse consider from the problems list. Explain your answer.
6. Provide four (4) interventions that should be included in the plan of care for this patient. Explain your answers.

J.P. is a 45-year-old man who presents to the outpatient clinic with two swollen toes on his right foot. He does not recall injuring his foot.

Subjective Data

Pain level is a 6/10 location = right foot, throbbing
Works as a truck driver

Objective Data

Vital signs: T 37 P 80 R 14 BP 120/68
+2 edema great toe and second toe, right foot, warm to touch
+ pulses
+2 capillary refill

Questions

1. What other assessments should be included for this patient?
2. From the readings, what is the most probable cause of the edema?
3. What are two (2) nursing diagnoses related to the patient's situation?
4. What would be included in the nursing care plan? Explain your answer.
5. Discuss three (3) interventions that might be included in the plan of care for this patient. Explain your answer.

C.M. is an 89-year-old female who presents with her daughter to the provider’s office. The daughter is concerned because her mother has not been eating well.

Subjective Data

PMH: HTN, Hypothyroid
24-hour diet recall reveals approximately 1,100-calorie intake
Lives alone, daughter nearby
Does not drive
Daughter shops
Patient cooks light meals

Objective Data

Vital signs: T 37 P 72 R 12 BP 104/64
Weight: 105 lb
Weight last visit, 3 months ago: 115 lb
HT: 5 feet, 1 inch
Medications: Metoprolol 12.5 mg per day, Synthroid 0.75 mg per day
Oral mucosa dry, gums bleeding, dentures loose
Poor skin turgor

Questions

1. Develop a problems list. Differentiate from the objective and subjective data.
2. What two (2) nursing diagnoses can be derived from the problems list?
3. What should be included in the plan of care?
4. Calculate the patient’s body mass index.
5. How many calories a day does this patient need to maintain her current weight? Explain your answer.
6. Discuss three (3) laboratory studies that would help determine the patient’s nutritional status. Explain your answer.