1.What is ultrasound? How is it utilized in pregnancy (many reasons)? How often do low-risk women receive an ultrasound during pregnancy? Explain some reasons a woman may need to have more frequent ultrasounds.

2.What is a non-stress test? How is it performed; what equipment is needed? Why would this test be ordered for a pregnant client (numerous reasons)? What are the possible results and what do they mean?

3. What is a biophysical profile? How is it performed; what equipment is needed? What does it measure? Why would this test be ordered for a pregnant client (numerous reasons)? How are the various scores interpreted?

4. What are some referrals a prenatal care (OB) clinic may need to make to/for an antepartum (pregnant) client? Explain.

Objectives

1. Use effective communication techniques to delegate, supervise, and provide evaluative feedback to peers.
2. Maintain accurate and timely communication with clinical faculty and nursing staff on the unit.
3. Make and validate judgments about priorities of care.

As a nurse student in a clinical day your position would be leader in your group, what would be your ability to meet or struggles with meeting the above 3 objectives?

hi so im going to post a dicussion sooap note for a patient with chext pain and i would like you to respond to that discussion

i will also provide a sample answer use it as an example but please formulate your own thank you

here is the soap note discussion

HPI: Mr. C is a 56-year-old Asian male who presents to the clinic with chest pain x 2 days. He describes the chest pain as “a squeezing pressure” and states the pain has been intermittent. He notes the onset is gradual (over a few minutes) and it only occurs while he is performing strenuous activity such as sprinting but resolves within 5 minutes of resting. He has had a total of two episodes of chest pain since onset. The pain is localized to midsternal area and does not radiate. At its worse, he rates the pain as 7/10. Currently, he is not having any chest pain. He has taken ibuprofen with each episode of chest pain, minimal relief. He denies any diaphoresis, shortness of breath, nausea, vomiting, fatigue, palpitations, lightheadedness, or syncope. No previous history of similar chest pain. Denies any recent prolonged travel.

Past Medical/Surgical History: Hypertension (well-controlled) and type 2 diabetes. No history of coronary artery disease, cerebrovascular disease, DVT, PE, or GERD. No prior hospitalizations. History of appendectomy in 1984. No other surgeries.

Differential Diagnosis: acute coronary syndrome, myocardial infarction, acute pericarditis, acute thoracic aortic dissection, chest wall pain, costochondritis, acute congestive heart failure, cardiac tamponade, stress cardiomyopathy, pericarditis, pleuritis, pulmonary embolism, pneumonia, pneumothorax, esophageal perforation, peptic ulcer disease, GERD, pancreatitis, peptic ulcer disease, rib fracture, anxiety, herpes zoster, muscle strain (McConaghy, 2019).

Assessment (Diagnosis): Stable angina

Plan:

• Medication/Therapy:
  • Rx: Nitroglycerin 0.4 mg sublingual tablets, as needed for chest pain; take 1 tablet sublingually every 5 minutes, up to 3 times, at first sign of angina. Disp #24. (Medscape, n.d.).
    • Allow tablet to dissolve under tongue or in buccal pouch, do not rinse mouth or spit for 5 minutes after administration
    • If chest pain remains unrelieved following nitroglycerin, call 911
  • Diagnostic tests:
    • 12-lead EKG to rule out acute myocardial infarction.
    • Labs: complete blood count with differential, complete metabolic panel, lipid panel, PT/INR/PTT, TSH, and cardiac enzymes (troponin, creatine kinase (CK) or CK-MB).
    • Chest x-ray (A/P and lateral).
    • Consider referral for exercise stress test.
  • Patient education:
    • Patient provided detailed instructions on how to take medications along with side effects. Store nitroglycerin in a dark bottle protected from light.
    • Provide patient education regarding the causes and symptoms of stable angina versus unstable angina.
    • Provide patient education regarding 12-lead EKG purpose/results and potential need for exercise stress test.
  • Follow-up:
    • Refer to cardiologist for stress test and possible echocardiogram.
    • Return to clinic in 2 weeks or sooner if needed for follow-up, review of lab results, and evaluation of symptoms.
    • Seek emergency medical care or call 911 if you are experiencing chest pain that is unresolved with rest, chest pain that is new or severe, back pain concurrent with chest pain, difficulty breathing, lightheadedness, fainting, dizziness, palpitations, weakness, nausea, vomiting

sample answer as a response to that soap note discusiion(this is only an example just to show you)

You wrote an excellent SOAP note assessment for this patient. Your use of the numbers scale for this patient's pain assessment was well done. You used OLDCARTS for the HPI and your prescription was exceptionally done. Also, your succinct ROS brought all of the most pertinent positive and negative subjective information to the forefront, correlating to the chief complaint seamlessly.

You had an excellent assessment, plan, education, and medication section to this SOAP note. Perhaps it would be important to include how his blood sugars have been. Indapamide combined with metformin may cause hyperglycemia (Epocrates, 2020). It was a good idea to include the CMP in your diagnostics. What are your thoughts on adding a routine BG test in the clinic given his recent change in condition?

Thank you so much for your thoughtful and informative post.

If you were a member of the NLRB, would you rule that HCR violated section 8(a)(1) of the NLRB by discharging the three nurses (assuming that they were covered by the NLRA)? Why or why not?

C.R. is a 42-year-old white male who fell from a 60-foot scaffold while working on the construction of a new building. He is admitted to the emergency department (ED) by ambulance and is strapped to a rigid backboard with cervical immobilization. At the site of the accident, C.R.'s co-workers immobilized his body until the ambulance arrived. His supervisor called his wife.

Question #1: Using the principles of prioritization that you have learned in this course, answer the question: what prioritization category does cervical immobilization fall under?

C.R.'s wife arrives at the emergency department (ED) at the same time the ambulance arrives. She is very agitated and crying. He sees her as he is wheeled into the ED, reassures her that he is okay, and tells her he fell at work. You take her to a waiting room, explaining that she can see her husband as soon as he is stabilized.

Question #2: Comment on your feelings about the wife being taken to the waiting room and told she will need to wait until the patient is stabilized.

Question #3: Using therapeutic communication, write what you could say to the patient at this point in the care of the patient/family.

Chapter 16 End Case Study
from Surgical Technology for the Surgical Technologist: A Positive Care Approach, 5th ed.

A 73-year-old male patient complains of progressive darkening and clouding across his entire left field of vision. The patient reports no pain or trauma, and the progression has taken place very gradually. He is diagnosed with a cataract in the left eye.

1. What surgical procedure will be performed in this case?
2. 
   
3. Describe how the microscope will be draped.
4. 
   
5. Why is it extremely important that all personnel in this procedure wear powder-free gloves?
6. 
   
7. What is the likely postoperative treatment plan for the patient?

How can hospitals use big data to improve on their policy and procedures

Body Pain:

Issue/Opportunity: Back pain caused by long durations of time bent on a computer.

Idea: Posture Corrector Write a power point presentation on Posture Corrector. Include its mission statement, opportunity, planning, give examples etc.

PLEASE TYPE THE ANSWERS and BE MORE SPECIFIC.

Read about the country context (Eastern Europe and Central Asia) and write about the laws/policies, stigma/discrimination, violence, expenditure, prevention of HIV/AIDS

1. Which of the following should be included when teaching a client newly diagnosed with diabetes about dietary management?

- Food intake should be decreased prior to exercise -

Consistency between food intake and exercise is important -

Carbohydrate are strictly limited before activity -

Sugar intake should be increased to prevent hypoglycemia

2. Significant risk factors for development of venous thrombosis include. Select all that apply?

- Altered blood coagulation

- Stasis of blood -

Vessel wall injury -

Arterial insufficiency

Good Samaritan laws, which protect the responder from financial liability, were developed to encourage people to help others in emergency situations. They assume a responder will do his or her best to save a life or prevent further injury. Good Samaritan laws require the responder to use common sense and a reasonable level of skill and to give only the type of emergency care for which he or she is trained. Good Samaritan laws usually protect responders who act the way a “reasonable and prudent person” would act if that person were in the same situation. For example, a reasonable and prudent person would:

■ Move a person only if the person’s life were in danger.

■ Ask a responsive person (or the parent or guardian of a minor) for permission to help (consent) before giving care.

■ Check the person for life-threatening conditions before giving further care.

■ Call 9-1-1 or the designated emergency number.

■ Continue to give care until more highly trained personnel take over. If a lay responder’s actions were grossly negligent or reckless, or if the responder abandoned the person after starting care, Good Samaritan laws may not protect the responder. For more information about your state’s Good Samaritan laws, conduct an Internet search or contact a legal professional.

Answer the following questions in your own words.

QUESTION:

1. What is the Good Samaritan Law?

Cleaning and Disinfecting Surfaces and Equipment Reusable

equipment and surfaces that have been contaminated by blood or other potentially infectious materials need to be properly cleaned and disinfected before the equipment is put back into service or the area is reopened. Clean and disinfect surfaces and equipment as soon as possible after the incident occurs. Remember to wear appropriate PPE. If blood or other potentially infectious materials have spilled on the floor or another surface, prevent others from accessing the area. If the spill contains a sharp object (e.g., shards of broken glass), do not pick the object up with your hands. Instead, use tongs, a disposable scoop and scraper, or two pieces of cardboard to remove and dispose of the object. Wipe up or absorb the spill using absorbent towels or a solidifier (a fluid-absorbing powder). After wiping up the spill, flood the area with a freshly mixed disinfectant solution of approximately 1½ cups of bleach to 1 gallon of water (1 part bleach to 9 parts water, or about a 10 percent solution). When using a bleach solution, always ensure good ventilation and wear gloves and eye protection. Let the bleach solution stand on the surface for at least 10 minutes. Then use clean absorbent materials (such as paper towels) to wipe up the disinfectant solution and dry the area. Dispose of all materials used to clean up the blood spill in a labeled biohazard container. If a biohazard container is not available, place the soiled materials in a sealable plastic bag or a plastic container with a lid, seal the container and dispose of it properly.

Answer the following questions in your own words

QUESTION:

How do you clean or disinfect a surface or equipment used in an emergency?

hio so im going to post a soap note that i want you to write a response to in regard of theses questions

formulate a substantive response to a minimum of two different students. Is objective and subjective data included in the right format? Please be specific to information related to the SOAP note format.

1. Does HPI have relevant information related to CC?
2. Medication listed with right timing, dosing, and number of tablets specified?
3. PMH, FH, and SH has all the appropriate information?
4. Does information in ROS correlate to CC?
5. Is there any information lacking in physical documentation of CC (Students often get confused between ROS and objective findings)?
6. Includes assessment, plan, follow up information, and patient education?

here is the soap note that i would like you to response to (its a discussion question )

Subjective)

CC: “I have pain in my chest for two days”

HPI: Mr. Tom Nguyen is a 56-year-old Asian male who presents to the clinic with a primary complaint of chest pain that started two days ago after lifting a heavy object at work. Pain is to left lateral chest, radiates to left side of neck, jaw, and mid back. He describes the pain as “Off and on” sharp tight 9/10 pain and is worse with activity. He took a nitroglycerine tab once yesterday evening that he thinks helped but made him dizzy, so he did not use it again. Shortly after the pain improved but returned this morning so he took another Nitro tab, but it did not help. He states similar chest pain has occurred once before. Three months ago, and he went to the Emergency Department and was kept overnight as observation. At discharge, he was prescribed Nitroglycerine but has not had to use until the current episode. He was also prescribed Plavix, Lipitor, and Metoprolol. He admits he does not take the medications regularly and only takes if he remembers. He does not check his blood pressure daily and never followed up with the cardiologist due to his busy work schedule. He works in San Jose for an electrical company and is a reliable historian.

Allergies: Aspirin (body rash)

PMH: high cholesterol, hypertension, angina

Surgical: No known surgery                          

Medications: Plavix 75 mg Daily, Lipitor 40 mg Daily, Metoprolol 25 mg BID.

immz: Flu Vaccine current, all other Vaccines up to date

screening tests: TB skin test negative within 6 months

FH:      Father died of stroke at age 63; Mother Alive DM age 73; Brother Alive age 52 DM

SH:      Graduated High School, immigrated from Vietnam at age 5. Married 30 years with 4

adult children who live on their own. Mother lives with him and wife.

            Exercise: Goes for walks in the evening with wife when weather permits.

            Diet: Eats a regular diet. Mostly traditional Vietnamese cooking that his mother and wife

make.

Tobacco: Prior ½ ppd smoker quit 20 years ago       

Alcohol/drugs: Family functions drinks up to 12 beers. Last time was 4 months ago at a    

friend’s wedding.

ROS:

General: Reports sweating this morning when chest pain restarted while he was laying in bed.

Denies recent weight changes, fevers, or chills

Derm: Denies rash or skin changes

HEENT: Denies vision changes, sinus pain, pressure, or discharge

Neck: reports pain to the left side of the neck but denies stiffness

Respiratory: Feels SOB with chest pain

C-V: See HPI current chest pain 8/10

GI: Denies n/v of abnormal bowel pattern

Peripheral Vascular: Denies swelling to extremities or changes in skin color.

Musculoskeletal: Pain to left ribs, denies pain to joints

Neurologic: Denies numbness tingling

Endocrine: Denies excessive thirst, hunger, or hx of diabetes

Psychiatric: Denies anxiety, depression or other mental health histories

Objective)

VS: BP 170/90 ; T 99.0 ; P 87 ; R: 22 O2 Sat 95% RA

            General: Mild distress and anxiety, cooperative                                           

            Skin: diaphoretic, pallor

            Neck: Good ROM, trachea midline

            Thorax & lungs: Struggling to breathe deeply, otherwise, lungs sound clear in all fields

            Heart/pulses: S1, S2 no murmur bruit or thrills. Radial,Ped/Tibial pulses +2

            Abdomen: Soft non-distended, no pain to palpation, bowel sounds x4

            Lower extremities: No edema noted, cool to touch

            Musculoskeletal: Pain to left ribs does not worsen with palpation, remains constant.

Active ROM all extremities

            Neurologic: Mental status: A/O x4, sensation and coordination intact

Differential Diagnosis:      

1. ACS
2. Unstable Angina

Assessment: Acute MI

Plan:

Dx: EKG, Nitro 0.4 mg SL, and call EMS to get him to ED for evaluation and need for percutaneous coronary intervention (PCI)

IF CHEST PAIN WERE STABLE:

Diagnostics and Labs

• Chest x-ray to r/o rib fracture or acute pulmonary issue. Can also get a good idea of cardiac size.
• CBC w/diff, Lipid panel, cardiac markers Troponin, CK, HA1C, D-dimer
• stress test
• Echo
• CT angiogram of chest.

MEDICATIONS:

• Nitro 0.4 mg SL Q5 min for chest pain, do not exceed 3 doses.
• Plavix 75 mg Daily
• Lipitor 40 mg Daily
• Metoprolol 25 mg BID

PATIENT EDUCATION:

            Medication compliance, side effects, when to hold medications.

            It is important to monitor blood pressure prior to taking BP medication and keep a log

            S&S to monitor for: Chest Pain that does not go away with rest, n/v, diaphoresis.

            If pain persists after 3 Nitros and resting call EMS.

            Must keep all appointments made. Attend cardiologist appointment. F/U with Clinic x1

week for lab review.

You have been asked, as a digital health professional, to attend a team meeting at your hospital to discuss discharge plans for Mildred Mason. She is a 68 year old widow, hospitalized for a fractured wrist and ankle and a head injury resulting from a fall at home.   She is almost ready for discharge from acute care, but the team is concerned that she will need care in the short term. Because of some problems that may have led to the fall and may cause more difficulties in the future, the team also foresees she will have increasing needs in the future. While a short term admission to a senior care facility until she can function independently has been suggested, Mildred is adamant that she will not go to a long term care facility, even on a short term basis. She fears she will be “warehoused” and never go home again. The team hopes they can integrate digital devices into her care to help her to stay at home safely.

Mildred is a retired school teacher. Her husband died 4 years ago of a heart attack. She lives alone in a 2 bedroom condominium apartment with laundry facilities in the unit. Sandra, who lives down the street, has been a good friend to Ms. Mason for many years and visits daily. Ms. Mason is very active in the community, helping raise money for United Way, organizing her church’s Christmas craft sale, belonging to a book club, and going to exercise classes twice a week. At the exercise class, she had complained to the instructor that she found she was having increasing problems with balance. She has a pension that allows her to live comfortably and take a trip each summer to visit her two sons and their children in BC and the Yukon. She uses weekly Skype calls to keep in touch between visits.

She has had Type 1 diabetes since she was 10 years old. Her diabetes has been well controlled until recently, but the diabetes educator at the hospital clinic she visits regularly is concerned that she sometimes seems to be forgetting to monitor her blood sugar or to refill her insulin pump completely.   Last week, Ms. Mason slipped in the bathroom, fracturing her right wrist and left ankle, and sustaining a head injury that caused her to lose consciousness for a few minutes. She had her cell phone with her and was able to call 911 when she regained consciousness. She now has a cast on her right wrist that will be on for 6 weeks. She had surgery to insert pins in her left ankle and will not be able to weight-bear for several weeks. She still complains of pains in her head from the concussion. She has been going to Rehabilitation in the hospital for physiotherapy, but her mobility is hampered by the cast and weight bearing restrictions.

Her neighbour Sandra has told staff she would be willing to help with things like groceries, but since she has two small children at home and a full-time job, she can only make brief visits. Sandra also expressed concern that Mildred has seemed “vague” lately, forgetting things and not taking as good care of the apartment as she used to. Mildred has also had many visits from friends who have reported they are planning to provide meals and regular visits when she goes home. The Home Care liaison in the hospital has been involved, but has indicated that only 3 hours a week of support for bathing, laundry and other tasks are likely to be approved. The nurses report that Mildred is adamant that she wants to return home. Because of concerns about how Ms. Mason can manage after discharge from the hospital, a team meeting has been called to plan for the future. As the team discusses options, they turn to you to find out if there are digital solutions to help Mildred return home on discharge and stay there as long as possible.

Questions to be answered in the assignment:

1. What do you see as the main problem(s) faced by the patient & significant others, and the interprofessional team in this situation?
2. Which professionals should be involved in planning the discharge of this patient? Why?
3. Which health care providers should be involved in the on-going care of this patient? What should their roles be?
4. What other resources might be needed for discharge plans to be successful?
5. What role can a digital health professional play in this scenario?
6. What digital resources would you recommend?
7. How would you explain your role and recommendations to the team and to the patient?