Questions
Who is James Baldwin's audience?

Who is James Baldwin's audience?

In: Nursing

Nomenclatures undergo periodic evaluation and update. Investigate how the Diagnostic and Statistical Manual of Mental Disorders,...

Nomenclatures undergo periodic evaluation and update. Investigate how the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) impacted coding for hoarding in 2017. As part of your investigation, determine if the DSM-5 and the code set are fully aligned with this code and support your opinion.

In: Nursing

There are many factors that can influence such decision for cloud server and client server. security,...

There are many factors that can influence such decision for cloud server and client server. security, cost, training and more. which would you choose and why ?

there are many factors that influenced the decision on a cloud server or client server such as cost, security, training and more. which one would you choose, cost, security,training etc.

and why ?

cancel that answer

In: Nursing

ETHICAL PRINCIPLES APPLICATION Before making the final decision the doctor must consider the principles of health...

ETHICAL PRINCIPLES APPLICATION

Before making the final decision the doctor must consider the principles of health care ethics, which will help the physician make the choice that will have the best possible benefits for both the patient and society. Analyze the case scenario to be able to identify the 7 principles.

Mrs. De Leon, a patient who has an ovarian cyst, left untreated, will result in kidney failure. An operation to remove the cyst is the best treatment, but the patient is frightened of needles and is against the surgery that would require a needle to give her anesthesia. The doctor must work with the patient to respect the fact that she dislikes needles and doesn’t want the operation, and needs to find a solution that would prevent her from going into kidney failure, which is in her best interest. Although the surgery is the best choice, forcing the patient to accept the needle would be harmful to her . Finally, the doctor needs to consider the impact that the patient’s choices might have on others if she starts to go into preventable kidney failure, she’ll need dialysis, which affects other people who need the same treatment. The doctor also asked the patient that she will sign a consent form before the procedure and the nurse will ask her information, data, past and present medical history. The physician is committed to his roles and responsibilities as the attending physician of Mrs. De Leon.  

Write the statement from the given case that applied the ethical principles.  

Autonomy-

Confidentiality-

Veracity-

Fidelity-

Justice/ Fairness-

Beneficence-

Non- maleficence-

In: Nursing

Describe the most important deficits related to temporal lobe injury. Explain in detail and give examples.

Describe the most important deficits related to temporal lobe injury. Explain in detail and give examples.

In: Nursing

Your hospitalized patient is in ventricular fibrillation with no pulse and no respiratory effort. The code...

Your hospitalized patient is in ventricular fibrillation with no pulse and no respiratory effort. The code team has been called and a defibrillator is on the way. You should immediately:
Administer atropine
Administer epinephrine
Begin high-quality CPR
Administer vasopressin

Your patient is in cardiac arrest and you are doing CPR on him. The cardiac monitor shows he is in ventricular tachycardia. You have just delivered a shock without the desired rhythm conversion. Before you defibrillate again, do CPR for:
2 minutes
3 minutes
30 seconds
5 minutes

Your patient arrives to the ED with a pulse rate of 72 but no respiratory effort. You may do all of the following EXCEPT:
Give 1 rescue breath every 6 seconds
Initiate chest compressions
Insert an airway
Administer oxygen
What is the treatment for acute cardiac tamponade?
Pericardiocentesis
Thoracostomy with chest tube
Epinephrine
Surgical embolectomy

You are in an ambulance caring for a man with cardiac chest pain. Which of the following ECG findings would prompt you to activate the cardiac catheterization lab?
Third degree heart block
Supraventricular tachycardia
Elevation of the segment between the S and T waves
Asystole

Your patient in the emergency department is having a cardiopulmonary emergency and is unconscious. You should:
Perform the BLS Assessment first
Perform the ACLS Assessment first
Perform the assessments simultaneously

You do not need to perform either assessment
During CPR, correct compression depth for an adult is:
Between 2 and 2.4 inches
1 inch for females and 2 inches for males
1.5 inches
At least 2 inches

The rate for compressions for an adult is:
60-80 compressions per minute (normal adult heart rate)
80-100 compressions per minute
At least 100 compressions per minute
Between 100 and 120 compressions per minute

Before beginning CPR, check for a pulse for:
No longer than 10 seconds
At least 20 seconds
30 seconds
Take as much time as needed to definitively feel a pulse

The patient in bradycardia begins to have chest pain and her blood pressure is 90/50. The correct drug and dosage for this patient is:
Atropine 0.5 mg IV push
Atropine 1 mg IV push
Epinephrine 2 mcg/min drip
Epinephrine 2 mg/min drip

Your patient has a heart rate of 50 with strong pulses and no other symptoms. The correct intervention is:
Monitor and observe
Atropine at 0.5 mg IV bolus
Transcutaneous pacing
Dopamine infusion at 2-10 mcg/kg/minute

Your patient is bradycardic with a systolic blood pressure of 80 mm Hg. You gave one dose of atropine (0.5 mg IV push) that was not effective. The patient is still unstable, but conscious. The next treatment is to:
Try a second dose of atropine
Begin an epinephrine infusion at 10-20 mcg/min
Provide transcutaneous pacing (TCP)
Monitor and observe

Which of the following rhythms is most likely to convert to cardiac arrest?
Atrial fibrillation
1st degree heart block
2nd degree heart block
3rd degree heart block3rd degree heart block

Your patient is unresponsive with no pulse and a flat line on the monitor. As the team leader you know that you should continue doing high-quality CPR and:
Defibrillate the patient as soon as possible
Perform synchronized cardioversion
Administer atropine 1.0 mg IV
Review the H's and T's to determine if there is a reversible cause for the asystole

You are doing CPR on a patient with pulseless ventricular tachycardia. You should check for a pulse:
Never
After each cycle of CPR
After 2 minutes of CPR
After 10 minutes of CPR

Which of the following should NOT be treated with a fibrinolytic (i.e. tPA)?
Ischemic stroke
Hemorrhagic stroke
ST-segment elevation myocardial infarction
Pulmonary embolism

Therapeutic hypothermia may be recommended for:
Hypothermia is never recommended following resuscitation
Only patients with head injury and successful CPR
All patients after resuscitation

Comatose patients with return of spontaneous circulation (ROSC) after cardiac arrest
You are taking care of a hemodynamically stable patient with a narrow QRS complex supraventricular tachycardia. Which of the following interventions should you provide first?
Amiodarone
Adenosine
Atropine
Synchronized cardioversion

Your patient has tachycardia with a heart rate of 200 beats per minute with pulses; his systolic blood pressure is 80 mm Hg; he is lethargic. Of the options provided, which is the best first step?
Perform immediate unsynchronized cardioversion
Give adenosine 6 mg IV rapid push
Give amiodarone 150 mg IV
Obtain an ECG to determine the specific rhythm

A patient began to have cardiac chest pain at 6am on Friday. She came to the emergency department at 8am on Saturday because she still wasn’t feeling well. Her 12-lead EKG is consistent with an ST elevation myocardial infarction but she is stable. How should this patient be managed?
STEMI Algorithm: Emergent PCI.
Unstable Angina Algorithm: Admit to hospital and monitor. Give statins and control blood pressure.
Non-STEMI Algorithm: Admit to hospital and monitor. Give anti-platelets and anticoagulants.
Stable Angina: Discharge from ED with follow-up with primary care doctor.

The immediate general assessment of a possible stroke victim by the stroke team or physician should be done:
Within 1 minute of arrival to the ED
Within 10 minutes of arrival to the ED
Within 30 minutes of arrival to the ED
Within 60 minutes of arrival to the ED

Which if the following drugs can be used to rapidly reverse the effects of opioids?
Epinephrine
Caffeine
Naloxone
Methadone

As of 2015, what agents are no longer recommended for routine post-cardiac arrest care?
Lidocaine
Beta-blockers
Atropine
Both lidocaine and beta-blockers

In: Nursing

pharmacological implications of Lysosomal degradative enzymes

pharmacological implications of Lysosomal degradative enzymes

In: Nursing

Allisson Russo is a 15 year old girl admitted to the Emergency Room with Right ,...

Allisson Russo is a 15 year old girl admitted to the Emergency Room with Right , lower quadrant pain. She is eventually diagnosed with appendicitis and scheduled for an appendectomy. After visiting Allison in the Er, the surgeon Alerts the Operating Room nurse, Ms. Wendy Harnes that the surgery will take place in an hour. Allison is HIV positive from emergency medical acre and blood transfusions that she received six years ago, following an auto accident. Allison does not know that she is positive, at the request of her parents, who are born high-powered attorneys. Allison tells Ms. Harnes that she used to to be involved in sports but has dropped these activities in school because of feeling more tired than usual. She thinks that her academic studies are simply requiring more of her attention , but her mother has suggested that perhaps she would be seeing a new doctor soon. Allison asks the nurse “ Do you think being tired at my age is a serious concern? I thought all teenagers feel like this. I feel that I have a serious health problem.” How should Ms. Hayes respond to Allison?

In: Nursing

3 possible diagnoses for patients with hyperactive bowel sound, lower lew quadrant pain with slight fever?

3 possible diagnoses for patients with hyperactive bowel sound, lower lew quadrant pain with slight fever?

In: Nursing

The U.S. Department of Health and Human Services Agency for Healthcare Research and Quality has identified...

  1. The U.S. Department of Health and Human Services Agency for Healthcare Research and Quality has identified seven Portfolios of Research. The full list can be viewed at http://www.ahrq.gov/cpi/portfolios/index.html

2. Two of the Portfolios of Research that are of key importance to this week's learning are

(1) Health Information Technology and (2) Patient Safety.

Describe how these two Portfolios of Research relate to the ONC's Health Information Technology Patient Safety Action and Surveillance Plan: June 2013 (Washington, DC: Office of the National Coordinator for Health Information Technology, 2013).

please include references

In: Nursing

What edits would you make to the General Hospital’s disclosure policy, if any, to improve the...

  1. What edits would you make to the General Hospital’s disclosure policy, if any, to improve the clarity of the requirements to both the patient and hospital staff?
  2. If General Hospital implemented a new online patient portal that allowed patients to request disclosure of their medical information online, what changes would need to be made to their release of information policy?
  3. In the scenario in question 8 above, could General Hospital mandate all release of information requests be submitted through the online patient portal to help streamline the process internally and mitigate access and disclosure risks? Why or why not?

TITLE:

AUTHORIZATION TO RELEASE PATIENT INFORMATION – USE AND DISCLOSURE OF MEDICAL INFORMATION

POLICY:

All information contained within a patient’s medical record will be maintained in a confidential manner to protect the patient’s right to confidentiality and comply with City, State and Federal Regulations including HIPAA.

PURPOSE:

This policy includes the procedures to follow when a patient requests to disclose their medical information to another physician, hospital, or medical facility, an attorney, an insurance company, to the patient or any other party as authorized by the patient.

Protected Health Information (PHI) may only be accessed/used or disclosed, as follows:

  • to those directly involved in the treatment of the patient;
  • to comply with public health regulations;
  • for the payment of services provided to a patient;
  • to researchers as authorized by the patient or an IRB approval;
  • as required by law; or
  • as authorized by the patient or other legally authorized individual/or entity.

Protected Health Information may be disclosed with a written authorization from the patient if all the following are met:

  • The authorization is in writing, is dated, and is signed or otherwise authenticated (scanned or electronically signed). The exception is immunization records, which may be disclosed to a school with the verbal permission of the parent or the patient.
  • The authorization specifies the information to be disclosed.
  • The authorization specifies the entity or location to disclose the information.
  • The authorization specifies the person or persons to receive the information.

PROCEDURES:

The following information must be reviewed, and documented that it was reviewed, before protected health information is disclosed:

  • A patient or other designated/authorized individual requesting disclosure of the medical information has completed a Release of Information form. The Release of Information form must be completed or updated by the patient or other designated/authorized individual.
  • The Release of Information should be reviewed to verify the signature (scanned or electronically signed) of the patient or legally authorized representative. Verbal or telephone authorization are not accepted.
  • The date on the authorization must be no more than three-years-old or must not have expired.
  • A healthcare provider can verbally disclose or fax medical information to a physician, hospital, or medical facility upon receipt of the required authorization or a statement in the record documenting that the patient is unable to authorize release of their information in an emergency.
  • Medical information may be released and/or disclosed with another healthcare provider/healthcare organization without a signed authorization if the healthcare providers have a known patient in common or for continuity of care.

In: Nursing

Which of the following is/are true about Medicaid? Group of answer choices States cover the same...

Which of the following is/are true about Medicaid?

Group of answer choices

States cover the same categories of people

States are not required to provide Medicaid

Institutional providers contract with the federal government

Authorized by Title I of the Boren Amendment

All of the above are true

None of the above is true

In: Nursing

The right of a provider to receive payment from public insurers generally is determined by regulation...

The right of a provider to receive payment from public insurers generally is determined by regulation or statute, rather than contract.

Group of answer choices

True

False

In: Nursing

what are the roles and responsibilities involved in system implementation?

what are the roles and responsibilities involved in system implementation?

In: Nursing

Sepsis and MODS Patient Profile W.A. is a 70-year-old female who presented to the emergency department...

Sepsis and MODS

Patient Profile

W.A. is a 70-year-old female who presented to the emergency department with fever, severe nausea, vomiting, and diarrhea. She is admitted to the intensive care unit (ICU) with a diagnosis of kidney failure and septicemia. Her previous medical history includes glaucoma, chronic kidney failure, hypertension, and insulin-dependent diabetes. She had a left above-the-knee amputation 1 year ago.

Subjective Data

  • W.A.’s daughter states she was able to do her daily chores at home independently, but for the last few days it was getting difficult for her to get around and that she needed to take frequent breaks because of shortness of breath and no energy. Her daughter also reports that W.A. had been having headaches with nausea and dizziness for the past few days.
  • Goes to hemodialysis 3 days a week

Objective Data

Physical Examination

  • Blood pressure 172/92, pulse 110, temperature 101.5°F, respirations 28
  • Oxygen saturation 86% on 15 LPM via mask
  • Oriented to name only
  • Crackles in bilateral lower lobes
  • 2+ edema bilateral lower extremities and hands
  • Abdomen is distended with hypoactive bowel sounds x4 quadrants

Diagnostic Studies

  • CBC: Hemoglobin 7 g/dL, hematocrit 23.8%, RBC 2.57 million/mm3, WBC 14.8 mm3
  • Chemistry Panel: Serum sodium 132 mEq/L, serum potassium 6.0 mEq/L, calcium 9.3 mg/dL, phosphorus 6.0 mg/dL, glucose 197 mg/dL, albumin 2.4 U/L, serum blood urea nitrogen 77 mg/dL, serum creatinine 7.30 mg/dL, eGFR African American 10, BNP 182 pg/mL
  • Urinalysis: Dark yellow and cloudy, protein 28 mg/dL, positive for casts, positive for red blood cells and white blood cells, positive for glucose and ketones
  • Blood cultures pending

Discussion Questions

  1. What is multiple organ dysfunction syndrome (MODS)? After reviewing W.A.’s presentation, what organ systems do you suspect are involved and why?

  1. What do you think is the origin of W.A.’s septicemia?
  1. What additional tests would you anticipate for W.A.?

  1. What are the interprofessional care goals for W.A.?

In: Nursing