Questions
Case Study: Urinary Tract Infection You are working in an extended care facility when M.Z.'s daughter...

Case Study: Urinary Tract Infection

You are working in an extended care facility when M.Z.'s daughter brings her mother in for a week's stay while she goes on a planned vacation. M.Z. is an 89-year-old widow with a 4-day history of non- localized abdominal pain, incontinence, new-onset mental confusion, and loose stools. Her most current vital signs are 118/60, 88, 18, 98.4° F (37.4° C). The medical director ordered a post void catheterization, which yielded 100mL of cloudy urine that had a strong odor, and several lab tests on admission. Urine culture and sensitivity results are pending; the other results are shown in the chart.


Chart View Laboratory Test Results:

Complete metabolic panel: Within normal limits except for the following results:

BUN 25mg/dL Sodium 131mEq/L

Potassium 3.2mEq/L

White blood cell count 11,000/mm3

Urinalysis Appearance Cloudy Odor Foul

pH 6.9

Protein Negative

Nitrites Positive

Crystals Negative

WBCs 6 per low-power field

RBCs 3


What condition do the lab reports point toward?

Which assessment findings are typical of an older adult with the condition in Question 1?
Considering her history and laboratory results, what other condition is a possibility?

4.The medical director makes rounds and writes orders to start an IV of D5 ½NS at 75mL/hr. and insert a Foley catheter to gravity drainage. Because M.Z. is unable to take oral medications, the medical director orders ciprofloxacin (Cipro) 400mg q12h IV piggyback (IVPB). Are the type of fluid and rate appropriate for M.Z.'s age and condition? Explain.


While the IVPB ciprofloxacin is being administered, which adverse effects might occur?

You enter the room to start the IV infusion and insert the Foley catheter and find that the nursing assistive personnel (NAP) has taken M.Z. to the bathroom for a bowel movement. M.Z. asks you to help her, and, as you open the door, you observe her wiping herself from back to front. What do you need to do at this time?

Because M.Z. has been having diarrhea, what special instructions should you give the NAP assigned to give basic care to M.Z.?

Case Study Progress:

The next day, you are the nurse assigned to M.Z.'s care. You notice that the NAP emptying the gravity drain is not wearing personal protection devices. You also observe that the drainage port of the drainage bag was contaminated during the process because the NAP allowed it to touch the floor.

What issues need to be considered in protecting M.Z.'s safety? Describe your actions in working with the nursing assistant.

As you assess M.Z., you notice that her catheter tubing is not secured. Why does the tubing need to be secured, and where is the correct place for the catheter tubing?

What changes, if any, will be made to the antibiotic therapy?

In: Nursing

Decide what you would do in each of the following situations: 1.     Mary Thompson calls the...

Decide what you would do in each of the following situations:

1.     Mary Thompson calls the office. She thinks her husband may be having a mild heart attack but he thinks it's heartburn. You are alone in the office. What should you do?

2.     John Ransom arrives with what appears to be a broken wrist. The physician is in an examing room with another patient.

3.     You are alone in the office but the physician should be arriving in about 15 minutes. Diane Sanchez calls and states that she has been having severe daily headaches. What should you do?

4.     Melissa Green shows up without an appointment. She tends to be a bit of a hypochondriac, always thinking something is wrong when she is perfectly healthy. Today she is complaining of severe pain in her lower right abdomen. The physician is with a patient in an exam room. What should you do?

5.     Mr. Anderson comes in for a routine blood sugar check and promptly faints in the Reception Area. The physician and nurse are busy suturing a cut on a patient. You and the insurance biller are the only ones in the front office. What should you do?

6. (Worth 5 points) This was an actual interview question given by a local medical center. Imagine trying to answer this during the stress of an interview! Many interviews now include scenario questions, but this is the most involved one I've ever come across. List the steps you would take in handling this situation:

Your employer has been delayed at the hospital but is expected in the office in 15-30 minutes. You are the only employee in the office. The following people are in your Reception Area:

Mrs. Smith who is with her 2 year old grandson.

Mrs. Jones who has come in for a routine injection.

Mr. Green who is a new patient.

Mr. Johnson who is there for a consultation.

The phone rings and it is Jane Simmons calling in a panic because her four-year-old son has swallowed some kitchen cleaner. While you are talking to her the door to the office opens and in staggers Mr. Franklin. He gasps that he has been "shot by a thief" and collapses on the floor. Seeing the blood coming from Mr. Franklin's chest Mrs. Smith faints. Her grandson starts crying.

How would you handle this situation?

In: Nursing

You are a nurse preparing to receive a new patient, fresh from surgery, to your unit....

  1. You are a nurse preparing to receive a new patient, fresh from surgery, to your unit. The patient is a 71-year-old man who underwent a surgical repair of a fractured femur. As you receive a report from the postanesthesia recovery unit, you learn that his medical history includes hypertension, 40 pack-years of smoking, and COPD. His surgical repair was successful but complicated by excessive bleeding, and he is receiving IV fluids to compensate. He is widowed, and his three children are scattered throughout the United States. He lives alone, receives Meals on Wheels, and pays a cleaning service to keep his home clean. (Learning Objective #6)
    1. What data in this scenario are pertinent?
    2. What potential collaborative problem(s) could be applicable in this situation?
    3. Which nursing diagnoses would you expect to be applicable regarding the medical procedures in this situation?
    4. Which nursing diagnoses would you expect to be applicable regarding the nursing/medical history in this situation?
    5. Which nursing diagnoses would you expect to be applicable regarding the discharge planning in this situation?

In: Nursing

Q) Draw A table with 20 Medical terms Total 20 word roots+ suffixes+ interpreting the meaning...

Q) Draw A table with 20 Medical terms Total

  1. 20 word roots+ suffixes+ interpreting the meaning + giving Medical Term examples with interpretation
  2. 10 prefixes+ interpreting the meaning of these prefixes+ Medical Term example for each prefix with interpretation

Hand written not allowed

Draw table

In: Nursing

Name the signs of the most urgent psychiatric emergencies Describe two nursing goals in managing a...

    1. Name the signs of the most urgent psychiatric emergencies

    2. Describe two nursing goals in managing a psychiatric emergency

    3. State three nursing interventions with rationale for this goal

    4. Discuss best practice standards of care in psychiatric emergencies.

In: Nursing

Write from 400 to 500 words and hand written not allowed Provide an example of changing...

Write from 400 to 500 words and hand written not allowed

Provide an example of changing a behavior using the components of the PRECEDE-PROCEED model to improve the health of individuals.

Hints:

  1. Use the 2 attached examples as a guideline.
  2. Create a similar example in a different topic - such as smoking, obesity, drug abuse, or any other health issue - to improve the quality of life

In: Nursing

7 day meal plan for a 55 year old male following the DASH diet?

7 day meal plan for a 55 year old male following the DASH diet?

In: Nursing

1. So, how does the Affordable Care Act work (ACA)? 2. What are the updates as...

1. So, how does the Affordable Care Act work (ACA)?

2. What are the updates as of October 23, 2015?

3. What are the upcoming challenges of the ACA?

4. What, in your opinion, are the ethical issues surrounding the "repeal and replacement" of the ACA? (not discussed in the video).

In: Nursing

HCOs are strongly oriented toward healing the sick, one person at a time. The first word...

HCOs are strongly oriented toward healing the sick, one person at a time. The first word of the body of this chapter—“patient”—is consistent with that tradition. Consider the following reasons for seeking care:

• Your grandmother, well into her eighties, wants a checkup. She has many of the limitations of age—her hearing, eyesight, and mobility are not what they were, and she has diabetes.

• Your father, 55, has acute chest pain that started a half hour ago and seems to be getting worse.

• You (or your partner) might be pregnant.

What constitutes an excellent result for each of these events? What care teams and clinical support teams are likely to be involved? How do the strategic teams help the clinical teams achieve excellence? If the HCO delivers that excellence, what other factors would be important to continued good health?

In: Nursing

total hip arthroplasty. Which of the following statements should the nurse make? a) “ use raised...

total hip arthroplasty. Which of the following statements should the nurse make?

a) “ use raised toilet seat to maintain your hips above the knees”

b) “ twist at the waist when standing from a seated position”

c) “move your stronger leg first when using a walker”

d) “ apply a heating pad to the operative hip to decrease pain”

In: Nursing

video: Hi, I am Dr. Martha Watkins and I am a licensed School Psychologist with the...

video:

Hi, I am Dr. Martha Watkins and I am a licensed School Psychologist with the State Department of Education.

I am working on an important project to help identify potential marijuana use among adolescents and I could really use your help.

How likely is it that a particular adolescent begins to use marijuana? Why?

Those are the questions you will answer when you Make A Decision.

To answer those questions you will Investigate the Evidence I collected from the life of a 15 year-old male high school student named George.

But before you Investigate the Evidence from George’s life, take a minute to Consult the Research I collected for you.

you will be able to come here to Consult the Research anytime you wish.

Researchers have found that certain types of parent, peer, and sibling relationships can place an adolescent at risk for marijuana use. Take a moment to Consult the Research on these factors.

Then you will Investigate the Evidence from the life of 15 year old George before you Make A Decision to predict his risk for using marijuana.Parenting has profound influences on the likelihood of adolescents engaging in drug use.

Both parental influences and sibling influences affect an adolescent’s decision to use or abstain from marijuana.
Parenting, even within the early childhood period, characterized by harsh, punitive and inconsistent discipline methods can be classified as a risk factor for later substance abuse (Dodge et al., 2009).
Parental monitoring (e.g. knowing where your child is) is associated with a decrease in marijuana use (Steinberg et al., 1994).
In fact, Sen (2010) found out that the more often adolescents ate dinner with their family, the less likely they were to have substance abuse problems.

Siblings affect whether or not adolescents will begin using drugs.

Siblings, specifically older siblings, play an additional role in substance use (Windle, 2000).
Frequency of substance use is also predicted by older sibling substance use (Vakalahi, 2002).
Older brothers have an especially salient impact on younger siblings’ substance use.
In fact, older brothers’ substance use has a stronger association with a younger brother’s drug use than does parental drug modeling (Bahr et al., 2005).
Furthermore, the older brother’s advocacy of drugs was associated with his younger brother’s use even if the older brother did not actually use drugs himself (Needle et al., 1986). Having peers and friends that use drugs increases the risk for an adolescent using drugs.

Adolescents specifically report that they choose to use marijuana for social reasons (Patrick et al., 2011).
Motivations include trying to fit in with peer groups and to have fun with friends (Cooper, 1994).
These social motivations to use marijuana seem to predict marijuana usage up to a year later, indicating some long-term impacts of social influences on marijuana usage (Newcomb et al., 1988).
Peers not only facilitate the acquisition of substance use but also its escalation over time (Dishion et al., 1995). You will Investigate the Evidence from a 15 year-old male high school student named George, who lives with his parents and his 23 year-old brother Michael.

You may continue to Consult the Research to learn about the risk factors for marijuana use. George: So what’s going on this weekend?

Alan: I heard there’s a house party happening Friday night.

Benjamin: Cool, let’s check it out
Any parents?

Alan: Nope.

Benjamin: K but I’m not drinking this time.
Last weekend I puked and felt horrible the next day.

George: I had the worst headache and my parents kept asking if I was getting sick, l o l.

Alan: Yeah, drinking sucks but weed doesn’t get you sick.

Cris: Sounds good.
I’ll ask if I can buy some off my older brother.

Alan: Sweet, make sure you get enough for all of us.

Benjamin: I dunno you guys.
Maybe we can do something else, or go to the party and just hang out.

George: My parents are really strict. I can’t go home smelling like weed.
They’d freak out.

Alan: No biggie you can stay at my house.
My parents are cool and won’t even know.

George: That might work but I dunno.

Alan: Come on guys it’ll be fun.
Not like you’ll get addicted from doing it once.

Cris: Really, it’s no big deal. It’s natural and even legal in some states. As long as your parents don’t find out, it’ll be a good time.

Alan: It’d be lame if we smoked and you didn’t George. Maybe you just shouldn’t come.

George: Well, I could hang out and just not smoke right.

Alan: I guess.... Question:
So how would you describe your parenting style?

Father:
I come from the old school, know what I mean? I tell the boys: “My house, my rules.” That's why Michael's on his way out. And George will be right behind him if he acts the same way - especially about drugs.

Mother:
We have seen smoking weed take all the initiative out of Michael and we are determined not to let the same thing happen to George, and he knows it. Question:
How do you monitor your children’s activities?

Mother:
With Michael it's hard; he's grown up now, at least legally.

Father:
With George, he has to check in every afternoon when he gets home. And when he's out, we know where. And we talk to his friends' parents a lot.

Mother:
And we have dinner together almost every night. And the computer… he doesn't know it, but we have the passwords and we check it, and he doesn't know it. At least… I don’t think he does. Question:
Tell me about George's brother Michael. What is his history with marijuana?

Mother:
Well! All he wanted to do in high school was party and hang out with his friends. He got busted once, and I'm pretty sure he's still smoking. He lost his job recently and will not give us a straight answer. And now where does that leave him? Still at home and no prospects.

Father:
I told him, he better work on finding a job fast. He didn’t go to college, so he needs to find a job or find another place to live... soon. We're done babying him.

questions:

1-----Using the evidence and research from the case, give reasons for why you assessed George’s marijuana use as you did. Consider the following factors in your reasons:
1-Parental monitoring and attitudes
2- Sibling factors
3- Peer factors

2---- What does George do?
a. Frequently uses marijuana
b. Occasionally uses marijuana
c. Never uses marijuana

In: Nursing

.C. is a 41-year-old man who comes to the emergency department with complaints of acute low...

.C. is a 41-year-old man who comes to the emergency department with complaints of acute low back
pain. He states that he did some heavy lifting yesterday, went to bed with a mild backache, and awoke
this morning with terrible back pain, which he rates as a 10 on a 1-to-10 scale. He admits to having had
a similar episode of back pain years ago "after I lifted something heavy at work." J.C. has a past medical
history of peptic ulcer disease (PUD) related to nonsteroidal anti-inflammatory drug (NSAID) use. He is 6
feet tall, weighs 265 pounds, and has a prominent "potbelly."

Please help me write an SBAR for this case

In: Nursing

How does a high or low granulocytes level relate to a patient that has atrial fibrillation...

How does a high or low granulocytes level relate to a patient that has atrial fibrillation and chronic kidney disease?

In: Nursing

How does a high or low Eosinophils level related to a patient with chronic kidney disease...

How does a high or low Eosinophils level related to a patient with chronic kidney disease and atrial fibrillation?

In: Nursing

This term we have studied the Digestive, Nervous, Urinary, Integumentary and Respiratory Systems. For your written...

This term we have studied the Digestive, Nervous, Urinary, Integumentary and Respiratory Systems. For your written assignment this week list the major body systems for these systems. Describe the normal function of each of these and where the anatomically lie in the body. Describe common pathology, including signs, systems and what may cause these disease or condition.

Lastly, what diagnostics are there to identify these diseases and conditions, and what treatments are currently available.

In: Nursing