Does social media have a place in the professional health care environment for use with professionals?

How about consumers?

What are some advantages and risks involved for each?

J.H. is a 42-year old male that will be discharged home from the hospital today following a brief admission for abdominal pain. He was diagnosed with a gastric ulcer and GERD and is being sent home on Po omeprazole (Prilosec) 20mg BID for 12 weeks.

1. As the nurse completing his discharge instructions, please list three teaching points regarding omeprazole that you will need to include in his discharge instructions. Be sure that the education provided in your answer is specific to this particular medication and not too general in nature. (3 points)

a.

b.

c.

2. J.H. wants to know whether or not he can continue to take OTC Po antacids if he has breakthough symptoms of GERD while taking omeprazole (Prilosec). How do you as the nurse respond to this patient’s question? (This patient question does not require a phonecall to the provider!) Please include your rationale and reference in APA format. (1 point)

3. The nurse is caring for a P.M., a 78-year old female, in the ER who was recently started on a medication by her primary provider for “bad heartburn”. The patient’s family reports concern that P.M. has been confused and seemed disoriented this morning. When reviewing the patient’s medication list, the nurse knows that which of the following medications can cause confusion and disorientation in the elderly? (1 point)

a. An antacid

b. A PPI

c. An H2 antagonist

d. A mucosal protectant

The patient was admitted to the Med/Surg. Floor for treatment and resolution of fecal impaction. An oncology consult order was entered. The patient stated she has abdominal pain of an 8 out of 10 on the Numeric Rating Scale.

The patient presents to the ER with severe abdominal pain, especially in the left lower quadrant. An abdominal CT was ordered, and it was found that there is a 5-centimeter mass in the lower sigmoid colon with fecal impaction.

In the scenario of Julia Jackson, which areas of care can be delegated to other interprofessional healthcare personnel to help resolve her immediate concerns?

The HIM professional is responsible for facilitating the collection of appropriate information needed to properly assign the correct clinical classification codes to the care provided.

Question 1 options:

true or false

2.The HIM professional must have knowledge of the applicable guidelines and an appreciation and understanding of the requisite compliance programs for hospitals, physicians, home health agencies, long-term care facilities, laboratories, and third-party payers.

true or false

3.HIM professionals are responsible for preventing unethical and fraudulent behavior.

true or false

4.Six Essential Elements Required for Implementation of Compliance Programs (OIG, 2005)

true or false

1. Shirley

Once admitted to the Med/Surg floor, Vital signs are by the nursing assistant. Temp. 99.9 F, Pulse 102, Respirations 32, B/P 165/87, O2 saturation 84% on 2 liters oxygen via Nasal canula.

Shirley’s husband died unexpectedly 2 months ago, which is she entered an assisted living facility. Shirley states she has become depressed form the loss of her husband and the inability to physically do activities she desires due to the COPD. Shirley presents to the ER with difficulty breathing and Shortness of breath at the rest, and increase fatigue. The patient is currently on 2 liters of O2 nasal canula at all times. Shirly smoked cigarettes for 32 years and just recently quit 2 months ago when she was put on full-time oxygen. Hysterectomy at age 48. GERD and Atrial Fibrillation.

What would be the appropriate response for the RN regarding clinical decision making and the pulse oximetry alert?

1. A 56 year-old woman has had Type 2 diabetes mellitus for sixteen years. She now has gross proteinuria and her blood sugars average 256 mg/dl with glycosylated hemoglobin of 10.9%.

a. What recommendations do you have for her?

b. What are your treatment goals and why?

c. Discuss pathophysiology of the disease or physiology of the organism that the drug(s) are addressing.

d. Rationales for using the specified drug(s), emphasize the APRN role in the assessment, diagnosis, and pharmacological interventions of clients.

e. Indications, contraindications of the drug(s)

f. List the prices of three drugs to treat the selected problem from two different pharmacies.

g. Describe in detail the instructions the patient should receive for the selected drug(s). Write this at a fifth-grade level.

A 36-year-old female has a routine physical. She is single, doesn’t smoke and has a few drinks of alcohol a week. She began menarche at age 11 and her first sexual intercourse was at age 14. She has had numerous sexual partners and does not regularly use barrier contraception. Physical examination is normal. The Pap smear comes back as atypical squamous cells of undetermined significance (ASCUS).

a. What risk factors does she have for cervical cancer?

b. Describe the pathogenesis of Human Papilloma Virus.

c. Why should HPV testing be done and what are the tests to be ordered?

d. What HPV subtypes are associated with cervical cancer?

e. Explain the role of E6 and E7 HPV proteins in cervical cancer.

f. Differentiate between Human Papilloma Virus and Herpes Simplex virus

Research Article Critique, Part TwoThe Cognitive Impact of Chronic Diseases on Functional Capacity inCommunity-Dwelling Adults(Kim, Park, & An 2019

Which ones of these questionnaires, scales, or physiologic measures are used in this research study?

a. The Katz Index of Activities of Daily Living

b. The Charlson Comorbidity Index

c. The Bandura Self-Efficacy Scale

d. Clinical Skills Self-Efficacy Scale

1. A 28-year-old woman complaining of lower abdominal pain, nausea & vomiting. She has noticed increased white vaginal discharge for 4 days. She is febrile. On pelvic exam, you note CMT (Cervical Motion Tenderness) and abdominal pain with palpation. Her diagnosis is pelvic inflammatory disease.

a. What will you prescribe? She is allergic to penicillin. What would you prescribe if she was not allergic to penicillin?

b. Discuss pathophysiology of the disease or physiology of the organism that the drug(s) are addressing.

c. Rationales for using the specific orders, emphasize the APRN role in the assessment, diagnosis, and pharmacological interventions of clients.

d. Indications, contraindications of the drug(s)

e. List the prices of three drugs to treat the selected problem from two different pharmacies.

f. Describe in detail the instructions the patient should receive for the selected drug(s). Write this at a fifth-grade level.

The prevalence of Hepatitis C virus (HCV) infection is increasing throughout the world. Clinically, acute infections are infrequently recognized because most patients experience minimal symptoms or are often asymptomatic. However, the vast majority of HCV- infected individuals become chronically infected. Advanced Practice Nurses must be able to identify patients at risk for HCV.

a. Explain the pathophysiologic processes involved in this disorder and explain how this infection may go undetected for many years.

b. Describe the laboratory tests (including test results interpretation) used to diagnose and differentiate acute versus chronic infection. Include what tests are needed (and why) to manage a patient receiving treatment. Make sure to include the molecular and genotyping testing.

c. Using current pathophysiological knowledge regarding HCV, explain how the current treatments for this viral infection eliminate the infection. Include cure rates for the various treatment modalities.

An 8-month-old girl who is brought in by her parents because of fever and fussiness. Her appetite is poor and she refuses to eat or take most fluids. On physical examination, she has a bright red right TM, dull without mobility or landmarks. Her left TM is pearly gray and mobile. She has yellow nasal discharge; cervical adenopathy and chest clear to auscultation. Her diagnosis is right otitis media.

a. What will you prescribe, for how long, and what dosage?

b. Discuss pathophysiology of the disease or physiology of the organism that the drug(s) are addressing.

c. Rationales for using the specified drug(s), emphasize the APRN role in the assessment, diagnosis, and pharmacological interventions of clients.

d. Indications, contraindications of the drug(s)

e. List the prices of three drugs to treat the selected problem from two different pharmacies.

f. Describe in detail the instructions the patient should receive for the selected drug(s). Write this at a fifth-grade level.

The patient presents to the ER with recurrent headaches, fatigue, and a blood pressure of 185/102. Patient is a long-time smoker, lead a relatively sedentary lifestyle, and has a BMI of 39. History of acid reflux. Patient is going to be kept for over night observation and administer medications to help control his blood pressure.

Patient Blood pressure taken just before transferring to the Med/Surg. Floor 156/87.

Nursing assistant taking the Vital signs: Temp 98.8, Pulse 101, B/P 178/98 this was just taken when patient arrives to the floor.

The nursing assistant reports to the RN that patient is complaining of chest pain.

1.  What would be the priority nursing intervention for Mr. Davis based on the Electronic Health Record information?

The overuse of antibiotics and CT scanning are not only unnecessary and wasteful, but it may create potential harm for patients. According to Centers for Disease Control and Prevention, of the estimated 154 million prescriptions for antibiotics written in doctor’s offices and emergency departments each year, 30% are unnecessary (CDC, 2016). CDC researchers found that most of these unnecessary antibiotics prescribed are for common colds, viral sore throats, bronchitis, and sinus and ear infections that do not respond to antibiotics. Researchers have estimated the rate of inappropriate antibiotic use in adults and children by age and diagnosis. CDC Director Tom Frieden stated, “Antibiotics are lifesaving drugs, and if we continue down the road of inappropriate use we’ll lose the most powerful tool we have to fight life-threatening infections” (CDC, 2016). According to the Department of Veterans Affairs health care facilities, studies found Medicare recipients were more than twice as likely to receive potentially inappropriate imaging for headaches as those who reported the same symptoms (Joy, 2016). The National Center for Biotechnology Information, stated that one-third of CT scans are medically unnecessary exposing millions of patients to high doses of radiation (NCBI, 2008). The radiation exposure from three or four CT scans is roughly equivalent to that experienced by atomic bomb survivors in Hiroshima, Japan (Schwartz, 2008). CT scanner radiation dose should be reduced as much as possible and alternative diagnostic strategies should be used whenever possible. Excess imaging is an aspect of over testing, over screening, over diagnosis, and over treatment that adds billions of dollars of wasted costs annually.

DO YOU AGREE OR DISAGREE WITH THE MESSAGE ABOVE? WHY?