How is virtual healthcare organized through government, free market and sole provider?

Patient Profile

R.B. is a 55-year-old woman who presented to the emergency department (ED) via ambulance for acute shortness of breath. Her daughter called an ambulance after finding her mother with an increased respiratory rate and shortness of breath. Upon arrival to the ED, R.B.’s respirations were 40 and shallow with wheezing in the lower lobes and rhonchi in the upper lobes bilaterally. She had positive jugular vein distention and a heart rate of 128. After treatment with albuterol nebulizer via mask, her vital signs were temperature 96.8°F, pulse 98, respirations 28, blood pressure 148/84, and O₂ saturation 94% with 15 LPM via mask. Arterial blood gasses showed her pH 7.19, pCO₂ 90, PO₂ 92%, HCO₃ 38. R.B. was intubated for hypercapnia. After an echocardiogram showed an ejection fraction less than 50%, she had an emergency left heart catheterization done with two stent placements into the left anterior descending artery. A pulmonary artery catheter was placed, and the initial hemodynamic readings show elevated left ventricular preload. R.B. is now being transferred to the intensive care unit (ICU).

Subjective Data

• Lives with her single daughter, who cares for D.B. full time
• Daughter is not present at bedside
• Smokes 1 pack of cigarettes per day
• No longer active outside of the home because of her chronic illness
• Does not drink alcohol

Objective Data

Physical Examination

• Orally intubated #8 endotracheal (ET) tube taped at 26 cm to lip
• Ventilator settings: FIO₂ 60%, tidal volume 700, assist control (A/C), rate 16, PEEP of 5
• Height 5'5", weight 117 kg
• Alert and oriented to person, place, and time
• Fine crackles and wheezes bilateral lower lobes
• 2+ pitting edema bilateral lower extremities

Diagnostic Studies

• Chest x-ray postintubation: ET tube 4 cm from carina. Infiltrates in both bases; left base is worse than right
• 12-lead ECG: ST elevation
• Troponin: 41.94
• Lung V/Q scan negative for pulmonary embolism
• 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

Question 5

You obtain a set of hemodynamic monitoring values. Interpret these results.

Question 6

Describe each of R.B.’s ventilator settings and the rationale for the selection of each.

Question 7

How does PEEP lower CO?

Question 8

R.B. is started on intravenous dobutamine and sodium nitroprusside. How will these medications affect her hemodynamic status?

A 2-year-old female with spinal muscular atrophy type 1 presented to the emergency department in moderate respiratory distress. Physical assessment showed a bell-shaped configuration of thorax and ribs, and moderate intercostal and substernal retractions. The patient was receiving bilevel positive airway pressure (BiPAP) at home with the following settings: spontaneous mode, pressure 18/10 cm H2O, room air, with 4-hour sprints twice a day. BiPAP was initiated on the following settings: spontaneous/timed mode rate of 22, pressure 20/10 cm H2O, and FIO2 0.40. Albuterol and hypertonic saline were administered by jet nebulizer and an aggressive secretion clearance regimen was ordered. Chest radiograph revealed diffuse left lung opacification consistent with left lower lobe pneumonia, clear visualization of the diaphragm, and left upper lobe atelectasis. The right lung was clear. The patient was transferred to the pediatric intensive care unit (PICU). Due to increased work of breathing, the patient settings were increased to BiPAP 24/12 × 28 60% FiO2 around the clock for impending respiratory failure. Albuterol treatments were increased to Q2 hours followed by chest percussion, postural drainage, and cough assist. The patient’s respiratory status continues to deteriorate. She was intubated and mechanical ventilation initiated. A vibrating mesh nebu- lizer was used to deliver medicated aerosol therapy inline with the ventilator circuit.

1. Why was the vibrating mesh nebulizer selected when the patient was intubated and switched from a noninvasive ventilator to an ICU ventilator?

• Describe any two of the following--Ebola, HIV/AIDS, Chagas, or Schistosomiasis--from the standpoint of the relationships between (1) culture/economy and disease; (2) cities/towns and disease; (3) environmental change and disease; and (4) human ecology and disease.
• Within the above framework, how do the two diseases reflect “negative externalities” and “Karl Polanyi’s Paradox” (as defined in GPCC)?

250 word minimum; no maximum word count. Display the word count at the end of your post.

Does anyone have the answers or a guide to a case study on i-human for David Douglas? He is a 74 y/o patient, 6' 0" (183 cm), and 165.0 lb (75.0 kg). His admission diagnosis is "Day 1 Rehab for left total hip arthroplasty, post-op day 5"

Explain briefly Principles and Methods of Drug Administration :
1)RIGHT DOCUMENTATION
2)RIGHT ASSESSMENT.
3)RIGHT EVALUATION..
4)RIGHT TO REFUSE..
5)RIGHT CLIENT EDUCATION

1) Which of the following is an example of how the integrity of certain types of clinical specimens can be maintained? Select any that apply. Select more than one: a. None of these. b. Keeping a sample within a specific temperature range. c. Keeping air out of a sample. d. Keeping foil over a sample.

2) What does mycology testing detect? Select one: a. Mold b. Bacteria c. None of the above d. Parasites e. Viruses

3) At what stage of testing are test results interpreted? Select one: a. Pre-analytical b. Post-analytical c. Analytical d. None of the above

4) What is apheresis used for at Boston Children’s Hospital? Select one: a. Gene therapy b. Apheresis is not performed there. c. Diagnostic testing d. Kidney transplants

5) A patient had a biopsy removed that requires analysis. Where should it be sent? Select one: a. Clinical Pathology b. Anatomic Pathology c. None of these

6) At what stage of testing are samples collected? Select one: a. Analytical b. Pre-analytical c. None of the above d. Post-analytical

7) Which piece of equipment would be most appropriate for analyzing whether a patient has leukemia? Select one: a. Electrolyte analyzer b. Flow cytometer c. Mass spectrometer d. None of these e. Blood gas analyzer

8) At what stage of sample testing are errors most likely to occur? Select one: a. None of the above b. Post-analytical c. Analytical d. Pre-analytical

9) Where does most of the blood used in procedures at Boston Children’s Hospital come from? Select one: a. Centers for Disease Control and Prevention (CDC) b. Blood donors at the hospital c. None of these d. Commercial suppliers e. State laboratories

a nurse is monitoring a client during IV urography procedure. Which of the following client reports is the priority findings? a. metallic taste in mouth b. abdominal fullness c. feeling flushed and warm d. swollen lips

Case study evaluation of the pathophysiologic alterations that affect the neurologic and respiratory systems.

Case study: J.S. is a 42-year-old man who lives in the Midwest and is highly allergic to dust and pollen and has a history of mild asthma. J.S’s wife drove him to the emergency room when his wheezing was unresponsive to his fluticasone/salmeterol (Advair) inhaler. J.S. was unable to lie down, and began to use accessory muscles to breathe. J.S. is immediately started on 4 L oxygen by nasal cannula and intravenous (IV) D5W at 75 mL/hr. A set of arterial blood gases is sent to the laboratory. J.S. appears anxious and says that he is short of breath.

Vital signs

BP = 152/84                 HR = 124 bpm                RR = 42       Temp = 100.4⁰F

ABGs

pH = 7.31           PaCO₂ = 48            HCO₃ = 26    PaO² = 55

Focus:

Investigate the pathophysiology of asthma and the clinical manifestations of the disease. Analyze the case study provided and determine what symptoms support the diagnosis of asthma. Identify the treatment provided in the emergency department and determine what additional therapies are needed to mitigate the asthma symptoms and return the client to wellness.

1. Do you have any concerns with the numbers above?
2. Identify what may be causing (etiology) J.S. to have an exacerbation of asthma.
3. Outline the causes of asthma, the symptoms that the client presents and the management of the disorder.

(References are greatly appreciated if possible.)

The topic is Jehovah’s Witness RELATE THE TOPIC TO THE FOLLOWING . If a question is not clear to u dont answer and let someone else who understands answer. . CLEAR HAND WRITTING ONLY. •Wellness and disease prevention AND Illness and medications.

A minimum of one nursing intervention must be included for each of the above

A potential nursing intervention for each of the practices listed above.

PLEASE DO NOT COPY AND PASTE FROM THE NET THANK U

do not post a pic of the answer writtin on a peace of paper

Discuss the importance of confidentiality and Healthcare Insurance Portability and Accountability Act (HIPAA)?