what reimbursement model do you see in current work environment. What are the limitations and benefits associated with that model.
In: Nursing
Case Study:
Mr S. is a 45-year-old man who has just been admitted to the ICU postoperative cardiac surgery. He has had an uneventful coronary artery bypass graft with no complications in the operating room. He is intubated and placed on complete mechanical ventilation. His vital signs are: blood pressure (BP) 150/90 mm Hg, heart rate 86 beats per minute, respiratory rate 12 breaths per minute, and temperature 35.3°C
The target systolic BP for Mr S. is less than 130 mm Hg and the surgeon’s postoperative orders include BP medications and intravenous morphine sulfate for pain. In addition, the surgeon prescribes an nonsteroidal anti-inflammatory drug, ketorolac, to be administered to the patient once it has been determined that they are not bleeding excessively and have acceptable renal function.
The ICU where Mr S. is admitted has a respiratory therapist (RT) on staff. This RT is aware that mechanical ventilation is very uncomfortable for patients. There is a standing order in the ICU that heart surgery patients may be weaned from the ventilator as tolerated and extubated when stable.
When Mr S. is beginning to arouse from the anesthesia, he is grimacing and his BP is rising above the target level. The nurse administers morphine sulfate as ordered. In addition, Mr S. is given a warming blanket to increase his body temperature.
The next morning, Mr S. is seen by the ICU physiotherapist. When assessing Mr S.’s comfort needs, the physiotherapist recognizes that he is anxious about moving and exercising so soon after surgery. With this in mind, the physiotherapist carefully explains her plan of care to Mr S. in a calm and unhurried manner. This allows Mr S. to relax. He becomes willing and able to work with the physiotherapist in his postoperative exercise routine.
The healthcare team worked collaboratively to enhance the patient’s comfort during the immediate postoperative period. This, in turn, led to Mr S. having a successful recovery period with no significant complication.
1. What will be the best action of the nurse together with other members of the health team in the dance of caring process?
2. How would you promote to the maximum level of health of Mr. S considering his present condition . How could you increase his self efficacy in performing activities when he is discharge from the hospital?
In: Nursing
George is a 75 year-old patient with urosepsis being treated in the Intensive care unit (ICU). The nurse assesses George and finds that he has blood in his urine and stool, and is oozing blood from his central line site and his gums.
Fred, a 43 year-old construction worker, has a history of hypertension. He smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. His current concern is calf pain during minimal exercise, which decrease with rest.
Georgia, a 30 year-old woman, is diagnosed as having secondary hypertension when serial blood pressure recordings 170/100 mm Hg. Her hypertension is the result of renal dysfunction.
In: Nursing
Describe your role(s) as a healthcare leader as it applies to the practice of advocating for cost effective care for vulnerable populations.
Need at least 500 unique words
In: Nursing
Briefly define the qualifications for Medicare and Medicaid
benefits. How can qualifications be modified to serve more people
who are considered a vulnerable population?
In: Nursing
This week reflect upon the Medicare and Medicaid programs to
address the following:
Describe the Quality Improvement Organization (QIO) and explain how
the QIO improves policies and healthcare for Medicare
beneficiaries.
Briefly define the qualifications for Medicare and Medicaid
benefits. How can qualifications be modified to serve more people
who are considered a vulnerable population?
Discuss the impact (including at least two positive and two
negative aspects) that the ACA has had on benefits and coverage for
Medicare and Medicaid recipients.
Describe your role(s) as a healthcare leader as it applies to the
practice of advocating for cost effective care for vulnerable
populations.
In: Nursing
Rewrite the following notes using the appropriate language for nursing documentation. Please Correct only where necessary.
a. D.K. is a 56 y/o African American male with a h/o HTN, high cholesterol, and arthritis; D.K is 5'10" and 300 pounds; pt. denies CP, SOB; pt. does not care about the risks of heart disease - he eats whatever he wants including fatty and salty foods; pt. told that he has to eat a low sodium low cholesterol diet if he doesn't want to die; pt. states that he has arthritic knee pain bilaterally - rates pain at 8/10; pt. looks like he is not in that much pain - given Tylenol for mild pain instead of 2 Percocet ordered for severe pain; patient told that obesity is causing knee pain.
b. J.B. is 40 y/o Caucasian male admitted for CP, r/o MI; pt. denies smoking but clothes and breath smelled like cigarette smoke so patient was obviously being dishonest; pt. also denies drug use but patient was lying about that too b/c he has signs of drug abuse - marks from heroin injections along both arms.; MD ordered morphine prn for chest pain due to low BP; pt. c/o CP at 0400 but not given prn morphine due to patient just seeking drugs; MD notified of patient lying about being in pain.
c. R.M. is a 95y/o admitted with pneumonia; h/o CVA - pt. is non-verbal; lives with granddaughter and her boyfriend; pt. has been physically abused - multiple bruises that definitely look like finger marks found on patient's arms bilaterally; RN asked granddaughter if her boyfriend is physically abusing pt. - she lied and said the patient fell and banged his arms on the kitchen table; RN notified social services that this is a clear case of elder abuse.
d. Mr. W. is a 76 y/o male admitted with COPD exacerbation; h/o anxiety and depression; pt. complaining that RN not answering call-light fast enough; pt. is being very unreasonable and impatient; pt. states that he is extremely anxious and needed his prn anti-anxiety med and says he is mad that the RN ignored the call light; pt. does not appear anxious - he is just complaining b/c he doesn't like to be alone for too long in his room; notified nurse manager that patient will likely write up a poor evaluation of the unit.
In: Nursing
explain the importance of biostatistics and epidemiology in public health. (essay form)
In: Nursing
Describe your role(s) as a healthcare leader as it applies to the practice of advocating for cost effective care for vulnerable populations.
In: Nursing
You are working as travel health nurse in one of the
clinic, a patient has approached you to have an
evaluation of his health before travel
- Specify why you are going to use that tool.
In: Nursing
What is religious and spiritual beliefs?
(Word limit 170)
In: Nursing
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.
1. Assessment - 2 subjective & 2 objective
2. Nursing diagnosis (1) using related to as evidence by
3. Goals - 2 long term & 2 short terms
4. Interventions - interventions w rationales (4)
5. Evaluation - 4 evaluations of interventions
In: Nursing
1 List the 5 stages of stress and describe each stage. Provide an example of the behavior that may be demonstrated in each stage.
2 The textbook and PowerPoint list several tips for reducing stress. Which tips do you feel are most important? List 5 and explain why you feel they are most important.
Match the following types of stress, in order, leading to burnout. (Brownout Phase, Phoenix Phase, Awakening Phase, Honeymoon Phase, Full-Scale Burnout Phase)
In: Nursing
What are specific names of benzodiazepines?
Which medication has the safest side effect profile as a sleeping pill for the elderly?
What is important patient teaching for a patient receiving Dilantin?
What are toxic effects of Dilantin?
Therapeutic range for Dilantin?
Anxiolytics...who are they? how do they act in the body? special implications?
How do SSRI antidepressants work?
Important assessments re. tricyclic antidepressants?
Characteristics of atypical antipsychotics?
What effects do antipsychotic medications exert on vital signs?
Anticholinergic side effects? What drugs cause these?
Extrapyramidal symptoms...what are they? who causes them? treatment?
In: Nursing