Read the following scenario and answer the questions.

Dr. Henry Duck was working his regular shift as the only doctor working in a small town Emergency Room at around 5:00 pm one day in May when a large tornado struck Dr. Duck’s county directly, causing catastrophic damage and multiple life threatening injuries. Dr. Duck knew that it would make for a long, busy evening treating patients in the Emergency Room, and was ready for the challenge, but did not fully appreciate the Ethical and Moral decisions he would have to make during the evening.

Almost immediately after the tornado passed, the small town’s emergency responders were overwhelmed and neighboring counties’ ambulance and first responder teams helped transport victims of the tornado to Dr. Duck’s emergency room. People were coming in at a rate never seen by Dr. Duck before, with all sorts of varying injuries caused by the tornado. The tornado patients who were coming in were all from different socioeconomic backgrounds, had ages varying from infant to 89 years of age, and included two pregnant women. Dr. Duck was unable to keep up with the heavy flow of incoming patients, which seemed to be never-ending, and began to have to make difficult decisions about who should receive priority in treatment for equally devastating injuries.

At around midnight, Dr. Duck finally felt he was getting the overcrowded emergency room in order and stabilized most of his patients, when the doors of the emergency room flung open. A gunshot victim with life threatening injuries, who was the suspect of a bank robbery in the affluent part of town was being hurried in by police. Almost simultaneously, a woman who underwent complications during a scheduled home delivery of baby twins was rushed through the doors by her concerned and frantic husband who was screaming, “we need help, my wife is going to die! My babies are going to die! Help! Please!” At the same time, Dr. Duck’s beloved 16 year old niece, Daphne, arrived by ambulance with significant, but non- life threatening injuries sustained as a result of a motor vehicle crash.

During the hectic time at the Emergency Room that occurred as a result of the tornado, how would ethical theories and moral judgments impact Dr. Duck’s decisions regarding who to treat first? Would Dr. Duck’s personal values play a role in his decisions?

When the three patients are hurried into the ER at around midnight, who should Dr. Duck treat first and why? What ethical theories apply to this scenario? Does situational ethics, justice and/or bias come into play with the three injured patients who enter the ER around midnight?

1. Explain how digested fats are absorbed and transported in the body including the health effects of the different types of lipoproteins. Include the following terms in your explanation: lipoproteins, chylomicrons, HDL, LDL.

2. Explain how fat is digested including the 3 enzymes that assist in digestion, the function of bile, and which part(s) of the GI tract fat digestion takes place.

SUBJECT: GERONTOLOGICAL NURSING

STUDY QUESTIONS

TOPIC: PAIN

1. Enumerate types of care to the cancer patient. What is the Nurse Role for this patient?

2. Types of medication given to Patient with acute pain and with chronic pain.

3. List down the Nurse Role in giving medication.

STUDY QUESTION:

TOPIC: SENSORY

1. What are the effects of aging on sensory function?

2. What can be done to prevent vision and hearing losses with aging?

3. What are the 5 sensory systems?

STUDY QUESTIONS:

TOPIC: CARDIO

1. Identify non-modifiable and modifiable risk factors for hypertension.

2. What are the major sign and symptoms of congestive heart failure? Give nursing interventions for each sign and symptoms.

3. How will you decrease the workload of the heart of the patient with heart disease?

4. Make a drug study of common medication use for heart disease.

Professional groups enhance the practice of members through:

Training

Networking

Publications

Regulations

Healthcare associations work with government agencies and health organizations to regulate standards of risk management and to ensure the quality of services and patient safety.

• Discuss 2 different ways the American Society for Healthcare Risk Management (ASHRM) supports risk management efforts in healthcare organizations.

How do external regulatory institutions support healthcare organizations to establish standards for managing risks, and what is the role of internal governance in fostering such relationships?

The advantages and disadvantages of different types of wound care products used for pressure injuries including: hydrocolloid, Hydrogel, Alginate, Hydrofiber, Antimicrobial, Transparent films, Foams, Collagens, Negative pressure, Composites, and Contact Layers.

Tony is a newly hired RN whose first assignment after graduation is the recovery room of a hospital that specializes in cardiovascular procedures. He has learned the recovery room procedures quickly and has further developed his nursing skill set to meet the demands of the position. After working there for two weeks, he is assigned one-on-one to Minta, a 58-year-old woman who coded during valve replacement surgery and is not doing well in the recovery room. Nurses are only assigned one-on-one to the most unstable and critical patients. Several hours after surgery, Minta finally recovers consciousness, although the endotracheal tube remains in place and she is still connected to a ventilator. The surgeons speak to Minta about the severity of her condition and the likelihood that she may die, then they leave the recovery room.

Minta indicates to Tony that she wants a pen and a pad of paper to write on since she is unable to speak with the endotrcheal tube in place. After Tony gives her the pen and paper, she writes about a half page note, folds it and writes an address on it. She also writes on the pad asking if Tony will send it out for her after he gets home. Tony gladly agrees.

As Tony folds the note and places it in his pocket, he notices that the recovery room supervisor has been watching the whole scenario from across the room. The supervisor motions

Tony over to her and asks about what he was doing with the patient.

Tony replies: “I’m just helping the patient write a note to her daughter.”  

The supervisor responds: "Recovery room policies don’t allow it and anyway, it is not part of your job to do such things. You’re here to keep the patients alive after surgery."

Tony answers: “I was only trying to help the patient mail the note to her daughter since the physicians told her she might die soon.”

The supervisor replied with: "We are not running a post office here!"

Tony angrily responds: “Well, what do you want me to do with this note now?”

The supervisor turned her back and walked back into her office. Several days later, the supervisor filed an incident report on Tony stating that he was violating recovery room procedures and was insubordinate because he argued with her. Because Tony was still in his six month probationary period, he was reprimanded and then fired from the hospital.

Questions

• How might have Tony handled the situation differently? What communication skills could he have used dealing with this difficult person?
• Does Tony have any recourse to get his job back since he was on probation? What should he do first in determining if he was wrongfully terminated?
• What other elements might be factors in the supervisor’s severe response to Tony’s actions?
• Was Tony violation any ethical principles? What ethical principles are involved in this case study?
• What should Tony do with the note?

your patient is a 78-year-old female admitted to the neurology unit via the emergency department for observation and pain Management of worsening headache related to a fall 4 days ago what are your primary concerns for this patient and what assessments and interventions would be associated with your concerns and why

2) What strategies can you employ in order to be a smart consumer of science journalism and how can you help your patients do the same?

Spray and Stretch(practice the technique, name the referral pattern) Describe the referral patterns below.

a. Upper Trapezius

b. Levator Scapulae

c. Supraspinatus

d. Gastrocnemius

The patient is diagnosed with acute bronchitis and esophageal atresia with G-tube

Lab test order:

- EGD

- Chest: Posteroanterior and lateral views

- Esophageal function study: Acid Reflux

QUESTIONS

1. PLEASE Give the definition and description of each lab. PLEASE DO NOT COPY AND PASTE. PUT THEM IN YOUR OWN WORDS

- EGD

- Chest: Posteroanterior and lateral views

- Esophageal function study: Acid Reflux

2. PLEASE Give the significance of the test being ordered for this patient for EACH LAB. PLEASE DO NOT COPY AND PASTE. PUT THEM IN YOUR OWN WORDS

- EGD

- Chest: Posteroanterior and lateral views

- Esophageal function study: Acid Reflux

PLEASE DO NOT COPY AND PASTE. PUT THEM IN YOUR OWN WORDS

THANK YOU

Answer the following two questions: What are the major risk factors for cardiovascular disease that you have control over? How many of these risk factors are the same for cancer? Please explain both questions