HIT 120

Evaluate the following E&M codes assignments for accuracy. Defend your answers and provide corrections if necessary.

1. The new patient was seen in the physician’s office and the physician documented an expanded problem focused history, detailed examination and medical decision making was of low complexity.

E&M code assigned: 99203

2. The established patient was seen in the physician’s office and the physician documented a detailed history and examination with medical decision of low complexity.

E&M code assigned: 99214

3. The new patient was seen in the outpatient clinic and the physician documented a detailed history, comprehensive examination and medical decision making of moderate complexity.

E&M code assigned: 99204

4. The physician visits an established patient in an assisted living facility and documents a detailed interval history and detailed examination with medical decision making of low complexity.

E&M code assigned: 99336

Depression, or major depressive disorder is the leading cause of disability in patients 15-44. It negatively affects the way you think, the way you feel and the way you act towards society. Some symptoms of depression includes feeling sad, trouble sleeping, changes in appetite, feeling worthless and suicidal thoughts. As nurses, its important understand how depression affects the mind and it's reason for onset. " Distinguishing between grief and depression is important and can assist people in getting the help, support or treatment they need." (Torres, 2020). Although, I've never personally treated someone with depression I understand that there are many ways treatment for these patients can go array. Psychotherapy combined with medication suits most depressed patients best, this allows them to decipher their problems and come up with ways to mediate them. Just providing medication without therapy can be one reason a treatment plan is unsuccessful. Some nursing interventions that could be helpful are encouraging the client to express their feelings, this allows the nurse to further understand their patient and allows the client to deal with overwhelming emotions. Antidepressant are prescribed to patients to help modify brain chemistry, they include SSRI's, TCA's and MAOI's. Overall, I believe that patients who only receive medication without some sort of therapy are not safe, they are a great risk for harming themselves because the medication may promote energy before affecting the mood. Referring patients to a psychiatrist will be in the best interest for the patient.

Respond to the above post and explain in 5 sentence if you agree or disagree with how they would handle a client who was having those symptoms. If you do not agree with the post, please provide how they could have approached the client differently.

Identify two classes of diuretics with regard to mechanism of action, indications, dosage, routes of administration, adverse effects, toxicity, cautions, contraindications, and drug interactions. Using a minimum of two scholarly article to support it, describe how these diuretics work in the kidney and how they lower blood pressure in individuals as well as why they are the drug of choice out of many diuretic medications (pathophysiological correlation).

Pt is a 52 yr old male. He was admitted for Right Total Hip Arthroplasty and had surgery for hip replacement. He's on telemetry. He has hx of hyperlipedemia, sleep apnea, HTN, PTSD, osteoarthritis, chronic back pain, narcotic dependence. He's allergic to Gabapentin and bee sting (anaphylaxis reaction). Past surgical hx are appendectomy, arthroscopy of left knee, left knee surgery, and tonsillectomy. His vital signs were stable yesterday, afebrile. No bowel movement since his surgery 10/26/20. Dressing to his right hip tegaderm and gauze CDI, no breakthrough drainage. Pt reported continuous 8/10 "burning, tightness, throbbing, radiating" pain to his incision site, lower back, right knee, and groin. Medicated hydromorphone dilaudid 2x and oxycodone 2x as needed. His pain didn't decrease at the end of my shift. Physical therapy came in to ambulate him and transfer him to reclining chair with an abduction pillow. Lidocaine patch to his right leg, using ice pack for comfort. He was not able to take a nap due to the pain. Getting discharge today.

MEDICATIONS:

Mag-Tab Sr tablet 84 mg PO daily

Morphine Sulf ER tablet 15 mg PO BID

Tylenol Tab 975 mg PO TID

Norvasc tab 5 mg PO daily

Protonix tab 40 mg PO daily

Senna 8.6/50mg tab PO daily

Lovenox Inj. 40 mg SQ 0.4mL

Miralax packet 17gm PO daily

Oxycodone 5mg PO Q4HP PRN

Hydromorphone HCL 1mg IVP Q2HP PRN

LAB TEST:

RBC 3.65L

Hgb 11.4L

Hct 35.6L

Neutrophils 76.8H

Lympocytes 12.9L

Creatinine 0.76L

Glucose 162H

- What is the most important nursing diagnosis for this patient?

- What is one biggest problem or biggest concern for this patient? Include "related to" and "as evidenced by".

- What are the goals presented for priority problems listed with measurable outcomes?

- What are the interventions (at least one education intervention) Relationships apparent between interventions and each goal/outcome and problem. Be concise and clear, achievable, relates to the stated diagnosis and client outcome.

- Evaluation: States how client outcome was met, what might have helped or hinder attainment of the outcome, analyzes the care given. If needed, revisions in the care plan done; interventions, assessment, state if should have done something differently in retrospect.

- Labs: (discussed how the labs relates to the patient’s specific condition).

Read about the different adult education philosophies. Identify an adult education programme in your community or online and answer the following questions.
1.Mention the type of adult education philosophy used in the programme. Motivate your answer as to why you chose the philosophy. (10)
2.Explain the role of the adult learner in relation to the activities of the adult education programme. You must relate how the role of the adult learner is consistent with the applicable philosophy. (10)
3.Define the role of the adult educator. Describe whether the practice of the adult educator is compatible with the applicable philosophy. (10)
4.Discuss whether the educational content is relatable with the philosophy you chose. (10)
5.Mention the education methodologies which are applied and write explanatory notes on its effectiveness in terms of the educational philosophy.

Nursing SBAR for patient with alzheimer's

What should the nurse monitor. Match the ff.

Digoxin____ A. Sleep pattern

Acetaminophen____ B. Respiratory Rate

Glipizide____ C. INR

Morphine____ D. Delayed wound healing

Prednisone____ E. Potassium

Warfarin____ F. Blood glucose

Zolpidem____ G. Temperature

Olanzapine____ H. Culture and Sensitivity

Levofloxacin___ I. Mood

Which Medication Might Be Given. Match the ff.

____Prevent heart disease A. Atorvastatin

_____ Prevent an MI B. Oxybutynin

____Slow the progression of arthritis C. Clopidogrel

____ Prevent urinary incontinence D. Duloxetine

______Prevent rubella E. Esomeprazole

______ Lower blood pressure F. Etanercept

_____Treat neuropathy G. Montelukast

_____Treat GERD H. Pregabalin

_____Treat bipolar disorder I. Quetiapine

_____ Treat COPD J. Tiotropium

_____ Treat depression K. Valacyclovir

____Decrease symptoms of Herpes Zoster L. Valsartan

_____ Prevent bronchospasm M. MMR Vaccine

How might the nurse adapt care for Erikson's Stages of Development?

Years Stages Health Promotion

0-1

1-3

3-6

6-12

12-20

20-35

35-65

65

Implementing an Electronic Health Record (EHR) system in a hospital is a process that requires many stages. Explain the different stages that need to be followed for successful implementation of the EHR.

Answer: 500 Words.

Considering the pandemic/CDC guidelines/the public and political response in the United States in which masks have become a political statement, do you think paternalistic interventions [by the state or other authorities] … can be ethically justified if they infringe general moral considerations such as respect for autonomy, including liberty of action?

Nursing Care of Women's Health

Maternity Teaching Plan Assignment

I. Choose a topic that is relevant to your newborn and its mother. Appropriate topics can include, but are not limited to: breastfeeding (ex. latch, positions, engorgement, mastitis, etc.), formula preparation, pumping, manual expression of breast milk, breast- milk storage, infant sleep safety, infant reflexes, car seat safety, bathing baby, circumcision care, hepatitis B vaccine, taking a baby's temperature, infant massage, baby blues and shaken baby syndrome, etc.

II. Organize your teaching plan: Decide the four major points that you wish to teach about the topic, list sub-topics beneath the four major points.

III. The outline should include key words or phrases that would help guide your presentation with the mother.

Example Topic: "Making Breastfeeding Successful"

           I. Things that help support milk production

A.   Early skin-to skin

B.    Baby suckling at the breast

C.    Maternal Fluid Intake

D.    Adequate Maternal Sleep

           II. Creating the right atmosphere for breastfeeding

                       A. Privacy

                       B. Good timing with feeding cues                 

C. Being in surroundings you enjoy.

Etc. with III and IV

The teaching outline should be due no later than one week before the clinical ends. The grade is based on organization of material, and clarity of the points you are trying to make. You will teach the patient during clinical. You can also teach the other students in post-conference.

Your OUTLINE should be no longer than one page and will be turned in to your clinical instructor & uploaded in the appropriate assignment on blackboard week #7

.

Patient's take-in only short amounts of information at a time so keep