What is informed consent and why is it important?

Ramona Heart is a 75 y. o. female with a history of osteoarthritis and degenerative joint disease. She lives with her husband in a single family home. She has been active until recent changes related to pain and stiffness in her right hip. After consulting her primary care giver, she has agreed to have a right total hip replacement. She is admitted to the hospital for surgery the next morning at 7:30A. Her husband and daughter are at her bedside.

Post Hip Replacement Assessment:

Vital signs: R 16 HR 88 BP 136/72 T 97.8; skin cool to touch, Ramona is drowsy, but alert. Ramona states pain of 2 out of 10, but stiff. Client is NPO since surgery and has IV fluids infusing: D5W at 100 mL/hr. Wound assessment: large gauze dressing over site, no redness or bleeding noted. A wound drain is draining to suction, 50 mL dark red drainage noted. Foley catheter in place and draining to gravity, 350 mL light yellow urine in bag. Lower extremities are cool to touch, with dorsalis pedis and posterior tibial pulses noted bilaterally, brisk capillary refill < 3 seconds. Ramona states positive sensation, no tingling.

Assignment:

1. Construct in approved NANDA format 3 nursing diagnosis related to care of client having surgery (hip replacement surgery)
2. Determine 5 expected outcomes related to care of client having surgery (hip replacement surgery)
3. Develop a plan of care for Ramona Heart

Identify and describe IT department hospital key leadership positions

Describe how the IT services are organized and governed. At a minimum, discuss centralization versus decentralization, and in-sourced vs. outsource?

this is for the health information system course .

Explain why knowing and utilizing APA formatting is important for nurses professionally and also for nursing students ?

4. During a drought, you discover that finches with large beaks and those with small beaks were more successful due to the food sources available during the drought. Which model of selection is occurring, and how do you know?

Which model of selection is occurring, and how do you know?

Group of answer choices

Disruptive selection, because both extreme phenotypes exhibited higher fitness.

Sexual selection, because beak size is correlated to mating success.

Stabilizing selection, because multiple phenotypes experienced higher fitness retaining their presence in the population.

Directional selection, because only extreme phenotypes are favored in this scenario.

Imagine you observe two species. Both species share a similar feature, and you are trying to decide if the feature is homologous or the result of convergent evolution. What is the BEST strategy to use?

Group of answer choices

Determine if the feature is shared with a third species.

Determine if the feature is vestigial.

Determine if the species' common ancestor also had this feature.

Determine if the feature is used for the same purpose in the two species.

What is a Patient Bill of Rights and Why is it Important?

An older man presents with firm, non-tender, and mobile lymph nodes, recurrent infections, and anemia. What disease does he have?

For this assignment propose a scenario where you or someone you know are confronted with a moral dilemma relating to cultural diversity and multiculturalism.

Question: Pros and Cons of virtual clinical experience in shadow health. At least one page

For this discussion, consider the role of the LPN and RN in the nurse process. How would the LPN and RN collaborate to develop the nursing plan of to ensure the patient is achieving their goal?

What are the expectations for the LPN and RN in nursing process?

Please include references in a APA format.
It should be at least 100 words.

Pros and Cons of virtual clinical experience in nursing. At least one page

NEED ANSWER PART 3

Kate is a 30 year old woman who just delivered her second child two weeks ago. Two weeks after her delivery, Kate comes to your office to be evaluated. She states she has been tired, weak, and has widespread joint and muscle pain. Despite the mild weather, she notes that she is cold all the time, and that instead of losing her “baby weight” she has actually gained about 15 pounds.

Kate has delivered two healthy children. She has no other medical history. It is her intention to breastfeed for at least the first 12 months. She continues to take her prenatal vitamins, and plans on having an intrauterine device placed for contraception at her six week follow up. She is a non-smoker, does not have a history of illicit drug use, and is currently abstaining from alcohol though she has consumed alcohol socially prior to her pregnancies.

Her vital signs are as follows: Height 5’4”, weight 165 lb, Heart rate slowed at 48 beats per minute, blood pressure normal at 110/56, temperature normal at 98.2℉.

Her lab work is as follows:

Her treatment is:

• Based on laboratory results, Kate is supposed to suffer from Post partum Hypothyroidism. Since the presence of thyroperoxidase antibody is found to be negative, she is free of autoimmune disorder.
• TSH regulates the production of T4 and then conversion to T3 takes place. Increased TSH is released when there is demand by feedback mechanism due to decreased T3 and T4. This happens in hypothyroidism.
• Kate can have primary thyroid malfunction. That is why her TSH is elevated and body lacks feed back mechanism. Pituitary gland is functioning with TSH secretion, and is increased due to lack of thyroid hormone's feedback.

Rationale (part 3)

It’s time to treat Kate, and explain her treatment to her. In a half-page response, explain to Kate what type of treatment she will undergo and why. Be sure to also explain what the treatment will do for Kate’s physiology, and what you expect to happen to her lab values.

49-year-old single Caucasian male with multiple past mental health (PMH) hospitalizations, admitted through ED, secondary to increasing depression with suicidal ideation (SI), and alcohol abuse.  Patient lives alone, has no daytime structure.  Highest level of education is high school.  Past social history indicates possible sexual abuse.  Patient currently denies SI but has had past attempts using knives; details regarding these attempts are unclear. Patient denies any legal history of violent/criminal behaviors.

• Admitting Assessment Data & Mental Status Examination (MSE): Patient appears older than stated age of 49.  He is heavy set with fair grooming.  Mild psychomotor retardation noted.  Maintains eye contact, though at times is staring intently and seems preoccupied.  Concentration is poor.  Mood is reported as depressed and anxious.  Affect is odd, anxious and constricted in range.  Speech halting at times.  Thought process significant for thought blocking.  Denies any visual or auditory hallucinations.  No delusions elicited.  He currently denies suicidal ideation or homicidal ideation.  Judgment and insight are fair.

∙ History of Present Illness (HPI): This is one of multiple hospitalizations for this man who has a diagnosis of schizoaffective disorder.  The patient has a history of alcohol dependence and this intensified after his friend recently died.  Also, the patient’s father died last year on the patient’s birthday, of prostate cancer.  The patient himself was diagnosed with lymphoma in 2010, and underwent biopsy of axillary lymph nodes in 2010; resolved but he states this is contributory to his increasing depression and SI.  He admits to increased drinking of “about 6 beers a day and some vodka”.  He reports having blackouts.  He denies any change in weight or appetite.  He reports his concentration is poor, sleep is decreased. He reports his mood as depressed and he says he feels overwhelmed.  The client self‐admitted to the ED because of feeling unsafe, but upon admission to the unit he denies SI.  He also denies symptoms of psychosis, although he appears preoccupied and guarded during the interview.  He appears to have some thought blocking, but when questioned, reports he is “trying to concentrate”.  No history of withdrawal seizures or DTs.  Patient has been admitted for substance abuse numerous times, at several locations.

Please answer the following questions:

1. Explain how you would perform a brief mental status assessment for client orientation

4. How would you assess potential for withdrawal using CIWA tool

5. Confirm intake information, by asking client additional open‐ended questions pertaining to his HPI and past presentations. What questions would you ask?

6. Assess for SI in patient using therapeutic communication skills: ∙ Assess ideation ∙ Assess plan ∙ Assess means to carry out plan. How would you ask these questions?

7. Educate client on the following topics:

∙ Alcohol use & abuse:  signs and symptoms of alcohol withdrawal (elevated VS, tremors, nausea/vomiting, DTs, diaphoresis, seizures)

∙ substitution therapy using benzodiazepines (side effects, physical assessment indicators of withdrawal)

∙ supportive medications given for alcohol withdrawal and reasons for administration (thiamine, folic acid, magnesium oxide, Wernicke Korsakoff’s encephalitis)