Martha Moore is an 87-year-old woman with a history of osteoporosis and hypertension. She had an exploratory laparotomy for a small-bowel obstruction 2 days ago. Before assessing this patient you notice her hemoglobin level is 9 mg and her SaO₂ is 90%. You do her morning assessment and she reports her cough kept her awake last night. Currently her temperature is 101⁰ F, her BP is 150/78, her heart rate is 100, and her respiratory rate is 24 breaths/min. On auscultation you hear crackles in both lungs. The patient reports a sharp pain in her chest when she takes a deep breath. After the deep breath, she has a productive cough and you notice the sputum is green with rust-colored tinting. Mrs. Moore reports she tries not to cough because it causes abdominal pain at her incision site.

1. What risk factors do you identify for impaired gas exchange from Mrs. Moore?

2. What conclusions (nursing diagnoses) can you make after your assessment?

3. What is your care plan for Mrs. Moore?

4. How would you evaluate effectiveness of your plan?

Three patients in your ward are due to receive a single oral dose of the same drug. The first patient is getting a 60mg dose, the second patient is getting a 120mg dose, and the third patient is getting a 180mg dose.

Assuming that all else is equal in these patients and that there is no unusual pharmacokinetics going on:

Predict what will happen (increase/decrease/no change) to half-life, Cmax and Tmax with these increasing oral doses if all other factors remain constant.

the act of carrying out the planned interventions

Ruby lives in the community. She is very independent at 89. Ruby has had a hip replacement, and has difficulties walking long distances, but she prefers to walk when she can. She is about a ten minute walk from the shops and often walks into town for a coffee, or to buy her groceries.

Walking home one day, Ruby trips on a broken paver and falls. She cannot get up. A neighbour runs to help and calls an ambulance. Ruby spends four nights in the hospital. She wants to go home, but the health professionals want to make sure Ruby is stable and safe before any decisions are made

1.You are providing support services to Ruby and have identified with her that her goal is to continue living independently in the community. When planning service delivery, what types of resources would you look at in order to deliver identified services that will allow her to do this?

2.Explain three ways in which you would support Ruby to access and negotiate resources

3.What are two actions that should be taken if one of the services Ruby requires is no longer able to provide the level of support required?

4. How could you ensure that the action you take to minimise disruption to service delivery if a service is no longer able to provide the level of support Ruby requires? Identify two methods you would use.

5.Who could you consult when making decisions about Ruby’s new service delivery plan? approx 25 words

6.

Drugs A & B are used to treat a specific type of cancer. Clinicians sometimes prescribe both. They observe that patients on the 2-drug regimen survive, on average, one year longer than patients on either Drug A or Drug B.

What is the phenomenon they are observing?

In this scenario, is it a positive phenomenon, or a negative phenomenon?

If you were the analyst, what are the calculations you would perform?

Confounding is an important, but often confusing, concept. Choose one of these scenarios to state the confounder and briefly say why it is the confounder: 1) smoking and cancer, or 2) a causative gene allele and a nearby genetic marker

Answer the following questions Separately

Discuss how the rapid advancements of e-commerce and managed care placed new demands on the healthcare industry in the 1990s. How did this lead to the establishment of information infrastructures that facilitated timely, accurate, secure and interoperable patient information across the continuum of care?

• Complete your original post of 200 words

Why might it be important to link EHR to CPOE and/or CDSS? What about linking it to a physician’s smart phone or tablet? What challenges are organizations faced with when it comes to advancing technology while being mindful of HIPAA and patient confidentiality?

• Complete your original post of 200 words

Answer the following questions Separately

Part 1: discusses four major factors that influence the adoption of e-Health:

1. Perceived usefulness

2. Perceived ease of use

3. Individual attitudes towards e-Health application

4. Social normative pressures and perceived behavioral control

Choose one of these four factors and discuss why you feel it is most important.

• Complete your original post of 200 words

Part 2: We all understand that the future of healthcare delivery can only be improved with the use of technology and the amazing advancements in tele-health and E-Health delivery. Unfortunately, with these great advancements we must overcome the challenges associated with adopting E-Health.

There are 11 barriers to E-Health adoption discussed in our text. Four of these major barriers include financial, technological, social/cultural, and physicians/clinical providers. Choose two barriers and discuss why you believe these are the most important. Thinking outside the box, come up with at least two methods that could be used to overcome these barriers.

• Complete your original post of 200 words

Case study: Mrs X is 35 and is in need of dialysis. She is refusing treatment because she is scared of the treatment which she believes is invasive. She has been counseled about the nature of the treatment - there are no alternatives that would be of practical benefit. She is competent to make treatment decisions. She understands that if she refuses dialysis she will die. She has a daughter of 15 years who lives at home. The clinician feels very strongly that she should receive dialysis but despite numerous attempts to persuade her she refuses.

1. Identify the major ethical principles.

2. Propose an ethical decision making process that best represents the patient’s wishes.

• Choose an intervention that you could use for the adolescent obesity community (other than the one you have selected for your Final Project).
• Describe the issue and the intervention you would implement in response to it.
• Discuss why that would be an appropriate intervention for that issue.
• Include the level of prevention, steps required to complete the intervention, and how you would evaluate it.

Is “retrospective” a type of study design? Why or why not?

Identify at least 4-6 indicators that show why the Veterans Population is vulnerable to the condition (Suicide in Veterans)

Provide at least three citations.

In your understanding, give your critics on the evolution of viruses, based on 1 example of virus of your choice (eg: Ebola virus,

A 35-year-old woman with type I diabetes was admitted to the hospital with severe anemia, vomiting, and fever. She had not felt well for the past several months. She had lost more than 25 lb without dieting.Physical examination revealed a pale and slightly obese female with a distended abdomen. She was the mother of two young children, ages 3 and 5. Her menstrual periods were regular. A CBC, blood glucose, urinalysis, and pregnancy test were ordered.

■ Laboratory Data Hemoglobin 11.40 g/dL RBC 4.06 ́ 1012/L Hematocrit 35.5% MCV 87 fL MCH 28.1 MCHC 32 g/dL RDW 16% WBC 22.1 ́ 109/L Her peripheral blood smear showed abnormal erythro-cyte morphology, anisocytosis, poikilocytosis, and some teardrop (dacryocytes) cells. Her serum blood glucose was elevated. Her urinalysis was normal, except for an elevated blood glucose. The result of her pregnancy test was negative. A follow-up ultrasound of the abdomen revealed a 20-cm extrauterine mass. Subsequent surgical excision of the mass revealed a malignant epithelial tumor of the left ovary with metastases to the pelvic lymph nodes, opposite ovary, and right lung. ■ Questions 1. Does this patient have AOI? 2. Which hematopoietic cells are involved in an inflammatory response? 3. What are the characteristic iron and iron storage results in anemia of chronic inflammation?

Duncan coordinates the support of older people in community care. He is preparing feedback forms for service providers to complete when they provide service to people in their care. Service providers include day programs for older people, personal care support, delivered meals, home maintenance, respite services, transport, allied health and nursing. People that the organisation supports, need any combination of these services. The purpose of the feedback forms is to make sure the service being delivered meets the person’s needs. It is also to check that the individualised care plans are effective in their delivery.

1.What are two questions Duncan could include in his feedback form to obtain information about the effectiveness of the individualised plan? (Approx. 15 words

2.How could Duncan explain the mechanisms for providing feedback on the individualised plan to other service providers? What are two explanations that he must provide? (Approx. 20 words

3. What is a service agreement and how could Duncan use it to explain the mechanisms of providing feedback to all providers? (Approx. 80 words)

4. Why should Duncan seek feedback about the effectiveness of the individualised plan from one of the older people he supports or their advocate? (Approx. 50 words).

5. Explain two ways that Duncan can seek feedback about the effectiveness of the individualised plan from one of the older people he supports. (Approx. 40 words).

6) One of the people Duncan supports is having trouble reading. They still drive, and Duncan is worried that their eyesight may affect their driving ability. How could Duncan report to the supervising health professional about this issue? (Approx. 40 words).