Scenario

Patient Introduction Location: Surgical Unit 0800

Report from night nurse:

Situation: Mr. Hayes is a 43-year-old white male who underwent a laparoscopic abdominal perineal resection with a permanent sigmoid colostomy 3 days ago for rectal cancer.

Background: Mr. Hayes experienced weight loss, increasing fatigue, and narrowing stools with blood, which led to the diagnosis of rectal adenocarcinoma and the recent surgery.

Assessment: Vital signs have been stable with a saturation of 94%–97%. Pain level is currently 1 after pain medication was administered an hour ago. The colostomy appliance is an open-ended pouch attached to a skin barrier. The stoma is red and moist with liquid, brown stool output. The three small abdominal incisions are open to air. There is a clean pad covering the perineal incision. Mr. Hayes has been up and ambulating and is taking full liquids.

Recommendation: It is time for Mr. Hayes's morning assessment. Assess his colostomy, and empty the pouch, if necessary. He can advance to a regular diet as tolerated. Start providing patient education to prepare him for discharge in 2–3 days.

Questions

1) State 2 actual nursing diagnosis for this patients case scenario

2) State 2 risk diagnoses for this patients case scenario

What are the benefits described in the USP 800 safety updates?

What are some potential solutions to the issues discussed based on Sterile compound regulations (USP 797, 800)

Purpose of the Assignment

Identify strategies to reduce the risk for injury to clients in various environments.

Course Competencies

• Select appropriate nursing interventions when providing multidimensional care to clients experiencing alterations in mobility.
• Strategies for safe effective multidimensional nursing practice when providing care for clients experiencing sensory and perception disorders.

Instructions

In a one page Word Document, plan interventions with rationale which will promote an environment of safety for the described client below. Consider the client’s medical history and medications.

Mr. Joe Smith, 75-year old man, recently suffered a left cerebrovascular accident. He has right visual field deficits and residual weakness in this right arm and leg. He uses a walker for mobility. He takes Metoprolol for his blood pressure and the physician started him on Coumadin because he has recently been diagnosed with atrial fibrillation.

Use at least two scholarly sources to support your interventions and rationale. Be sure to cite your sources in-text and on a reference page using APA format.

• What is defined as law? How does a biblical worldview frame how you approach business law? And what is the relationship between a Christian and the law, particularly business law?

Question 1 Discuss the Goals of Healthy People 2020.

Question 2 Discuss Government Influences on Health Care

Question 3 Discuss Cultural Considerations Across the Lifespan and in Health and Illness

Question 4 Discuss The Influence of Family on Developing a Lifestyle

Prompt #1 for this Discussion: Reply to everyone for consideration by answering the following question(s): Is there such a thing as sugar addiction? (nutrition 101)

Some seniors want to retire to communities that serve only seniors, the so-called 55+ communities. Others want to remain in the at-large mixed population, to interact with people of a variety of ages.

1. What are the pros and cons of each?

2. Which would you personally prefer to live in, and why?

3. If you were managing a senior services program, what would be the managerial challenges in each? How would you navigate those challenges?

4. In which environment would you prefer to manage senior services? Why?

re-write all 5 question in your own word please

1. Name of the organism - francisella tularensis. Name of the disease – tularemia
2. Handling of the infected rabbit, most likely without gloves
3. Doctors may check for F. tularensis in a blood or sputum sample that's cultured to encourage the growth of the bacteria. Sometimes tularemia can be identified by antibodies to the bacteria in a sample of blood, but these only develop several weeks after infection. You're also likely to have a chest X-ray to look for signs of pneumonia.
4. Tularemia can be effectively treated with antibiotics such as streptomycin or gentamicin, which are given by injection directly into a muscle or vein. Depending on the type of tularemia being treated, doctors may prescribe oral antibiotics such as doxycycline (Oracea, Vibramycin, others) instead.
5. You'll also receive therapy for any complications such as meningitis or pneumonia. In general, you should be immune to tularemia after recovering from the disease, but some people may experience a recurrence or reinfection.

Case Study: 52-Year-Old Female Presents with Chronic SOB, and Cough

History of Present Illness: Casey, who is 52-year-old female presents after admission to the San Francisco General 7E Medical/Surgical Hospital. Her chief complaint of shortness of breath on exertion. She reports that she was seen for similar symptoms previously at her primary care physician’s office three months ago. At that time, she was diagnosed with acute bronchitis and treated with bronchodilators, empiric antibiotics, and a short course oral steroid taper. This management did not improve her symptoms, and she has gradually worsened over six months. She reports a 20-pound intentional weight loss over the past year. She denies camping, spelunking, or hunting activities. She denies any sick contacts. A brief review of systems is negative for fever, night sweats, palpitations, chest pain, nausea, vomiting, diarrhea, constipation, abdominal pain, neural sensation changes, muscular changes, and increased bruising or bleeding. She reported persistent cough and shortness of breath upon exertion.

Social History: Her tobacco use is 35 pack-years; however, she quit smoking shortly prior to the onset of symptoms, a year ago. She denies alcohol and illicit drug use. She is married, in a monogamous relationship, and has one adult daughter who leaves in Florida.

Allergies: NKDA

Past Medical History: HTN

Past Surgical History: Cholecystectomy

Medications: Lisinopril 10mg by mouth every day

Physical Exam:

Vitals: Temperature, 96.8 F; heart rate 86; respiratory rate, 20; blood pressure 142/82;

body mass index, 34

General: appears anxious, a pleasant female lying on a hospital stretcher. She is conversing freely, with respiratory distress causing her to stop mid-sentence.

Respiratory: She has diffused rales and mild wheezing; tachypneic.

Cardiovascular: She has a regular rate and rhythm with no murmurs, rubs, or gallops.

Gastrointestinal: Bowel sounds X4. No bruits or pulsatile mass. Reported last BM was 2 days ago.

Explain why health promotion, community health, and prevention are important.

How do national organizations like the CDC influence and support policy making, and what is their role in health promotion?

How is the CDC currently addressing the Millennium Development Goals (MDG)?

How do organizations like the CDC and the WHO work together to influence health and healthcare delivery?