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)

Meningitis bacterial risk factors?

Meningitis Viral risk factors?

Meningitis Viral Priority Interventions?

Meningitis Bacterial Priority Interventions?

Talk about what are the dangers when discovering abnormal vitals. What will the provider would like to know and what would proceed.

look for your assigned topic :  A male teen with a Body Mass Index of 36 and weight of 140 Lbs

make a post, paragraph length. of it

What are the different roles of an ER nurse vs Oncology nurse:

as far as which of these nurses do the following?

•Communicator

•Teacher

•Counselor

•Leader

•Researcher

•Advocate

•Collaborator

What are your thought on female circumcision? What's your opinion on girls who want to get the procedure done in a sanitary environment with anesthesia?

Wk 5 HCS/451

ABC Hospital is a small, privately-owned community hospital. It has been struggling to survive financially, as reimbursement rates have declined and consumers are being drawn to the larger state-of-the-art hospital facilities in urban areas that are perceived to have better quality. ABC Hospital was built in 1960 and has been operating in the same manner for many decades. The hospital meets legal and regulatory requirements but has not kept pace with some of the newer technologies and patient conveniences becoming more prevalent in the health care industry.

Write a 175- to 265-word response to the following:

• What strategies can the organization take to survive, improve its performance, and compete with other hospitals over the next 5 years?
• What are some advantages or disadvantages of these strategies?

1) Amiti currently smokes one pack of cigarettes a day; she typically smokes with her morning coffee, after meals, in her car, and when hanging out with her friends who smoke. Identify five actions or strategies that Amiti can use to increase her chances of success at quitting.

2) Your cousin has confided in you that she thinks she might have a drug problem. She explains that lately she can only think about getting high and seems to need much more of the drug in order to achieve that high. She is having difficulty in school and has been reprimanded at her job for being late. She has tried to cut back on her use of the drug, but she got sick every time she tried to quit. Identify and define the characteristics of drug dependence being manifested by this individual.

Ordered: medication 50 mg/m^2

The patient is 163 cm tall and weighs 118 lbs.

Patient's BSA:_____

Patient's dosage:_____

Prevent healthcare-associated pressure ulcers. (National patient safety goal)

Why do you think this goal is important to support patient safety? What could happen if this goal was not met?

case study chapter 31 nursing care plan hypertension

National Patient Safety Goals Effective January 1, 2015

Goal 14

Prevent health care-associated pressure ulcers (decubitus ulcers)

Pressure ulcers are also called pressure ulcers or bedsores. Its classification ranged from reddening of the skin to the presence of cave-in injuries and muscle or bone injuries (stage IV) (1). Pressure ulcers are injuries caused by pressure, friction or shear, or by a combination of these 3 types of forces, which affect the skin and subsequent tissues. Although skin, fat, and muscle tissue can withstand significant pressures for short periods of time, prolonged exposure to a certain amount of pressure slightly greater than capillary compression pressure (32 mmHg) can cause skin necrosis and ulceration (2, 3 ). As little as two hours of uninterrupted depression can cause irreversible changes (2, 3).

Identify a bedside nursing scenario where this goal could prevent an error and/or pt injury (be specific).