A. True or False? As health care costs have slowed in this decade, the gross domestic product (GDP) has risen since consumers have been able to spend these dollars not going to health care in other areas of consumption.

True

False

B. HIOs allow pharmacy companies to identify which physicians:

are going to which hospitals.

are going to particular specialty conferences and meetings.

are the early adopters of a particular drug.

have particular attitudes that need to be changed or improved toward their formularies.

Surgery Assignment

A 25-year-old female client is being admitted to the postanesthesia care unit (PACU)
following a thyroidectomy for hyperthyroidism. The client had undergone three
months of preoperative treatment with antithyroid medications and iodine
preparations to establish euthyroid status prior to her surgery. At the client's bedside
the nurse has set up a tracheostomy set, endotracheal tube, laryngoscope, and suction
equipment. There are ampules of calcium gluconate on hand. The nurse places the
client in a semi-Fowler's position, and is supporting her head and neck with pillows
and sandbags. The nurse frequently checks the client's vital signs, and assesses her
suture line for strain or bleeding. Once the immediate postoperative period has passed,
the client will be transferred to the surgical ward where she will recuperate and learn
about lifelong thyroid replacement therapy.
a.  Why is it important to support the client's head and neck with sandbags and
pillows?

b. Develop a plan of care for this patient including two actual and two potential

During EHR implementation, how do you get everyone on-board?

Shelly is a 4-year-old preschooler who lives with her parents and younger brother. She and her brother attend a local daycare center during the week while their parents are at work. In the evenings she and her brother take a bath and then their parents read to them before bedtime at 8:00 P.M. Shelly's daycare class includes many children her age and she enjoys playing outside with them, Although snack times are planned, Shelly would rather play and does not always finish her beverages,

Shelly's mother calls the pediatric clinic in town and tells the nurse that Shelly has been "running a fever of 101 0 F for the past 2 days' and although her temperature decreases to 37.20 C (990 F) with acetaminophen, it returns to 38.4 C, (1010 F) within 4 hours of each dose. Further, her mother says that Shelly complains that hurts when “I pee-pee." Shelly's mother also has noticed that her daughter seems to be in the bathroom every hour" She makes an appointment to see the pediatrician this afternoon

6.     Shelly's urine culture returns positive for Escherichia coli. 'What is the significance of this finding?

7.     What are the priorities for Shelly's care?

8.     Shelly is prescribed trimethoprim-sulfumethoxazole 60 mg every 12 hours for 10 days. What is this drug and is her prescribed dose safe? Shelly weighs 33 lb.

9.     What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?

10. Shelly is scheduled for a return visit to the clinic in 2 weeks. What is the purpose of this appointment?

A 61-year-old male is admitted to the hospital for resection of his sigmoid colon and rectum, following discovery of a mass in the sigmoid colon by his physician during a flexible sigmoidoscopy. The patient originally complained of bright red blood in his bowel movements. He reported no significant gastrointestinal symptoms other than the bleeding. He denies any change in his functional capacity. His maximum weight was 167 lb (75.9 kg) at age 46 years. In his late 40s, he lost about 15 lb (6.8 kg) and for the past 12 years has maintained his weight at about 152 lb (69.1 kg). Between 2 and 6 months before admission, his appetite was less than normal and he gradually lost 13 lb (5.9 kg). In the past 2 months before admission, his appetite improved and he gained 5 lb (2.3 kg). On physical examination, there is no evidence of subcutaneous tissue loss, muscle wasting, edema, or ascites. Using SGA,How would you rate her nutritional status?

1. SGA case study

2. Submit report (Each topic is 300 words, non-handwriting) about following topics:

Densitometry (Body composition Assessment)

a. Hydrostatic, or underwater weighing.

b. Air Displacement Plethysmography.

c. Neutron Activation Analysis.

d. Total Body Potassium.

Right atrial pressures are obtained in order to assess?

Real Life Clinical Reasoning Scenario - Type 1 Diabetes Mellitus ISBAR.

The patient is a 92-year old male who was just admitted to your med/surg unit through the ED for dehydration, hypokalemia, and gastroenteritis of unknown etiology. His past medical history indicates that he has had COPD for 26 years. His COPD has been characterized by a mixture of emphysema, chronic bronchitis, and reactive airway symptoms. 8 years ago he developed right-sided HF, and after a knee replacement 5 years ago his HF became bilateral, and he developed atrial fibrillation. He has HTN, chronic renal insufficiency, and Type 2 DM. His meds include: 3 inhalers - tiopropium, salmeterol/fluticasone, and albuterol prn; and the following PO meds - digoxin, furosemide, warfarin, prednisone, theophylline, lisinopril, metoprolol, metformin, and glipizide. Upon admission his VS were P 108, RR 32, BP 98/52, T 99, and O2 sat by pulse oximetry 90% on room air. He is oriented, but states he is too tired to answer questions. Lung sounds diminished bilaterally, extra heart sounds noted, bowel sounds hyperactive and high-pitched. His wife states he has had approximately 12 loose BMs in the last day, and that this is the third day of severe diarrhea, nausea, and vomiting. She does not know when the last time he voided was, and states that he has continued to take all of his medications, except his diabetes pills, which he stopped taking because he hasn’t been eating . He also had the following diagnostic results:

ABGs:

pH: 7.25

CO2: 50

HCO3: 25

PaO2: 84

SaO2: 90%

CXR: changes consistent with COPD, enlarged heart

EKG: atrial fibrillation

2-D Echo: left ventricular hypertrophy with 25% EF

CBC & METABOLIC PANEL:

HGB: 19

HCT: 58

WBC: 8

BUN: 59

CREAT: 2.8

Na: 155

K: 2.8

Cl: 110

Ca: 8

PO4: 5.1

Mg: 1.2

Glucose: 987

Pre-Albumin: 15

Albumin: 2.9

Total protein: 4.8

INR: 3.5

Digoxin level: 1.9

Theophylline level: 24

Analyze and explain the rationales for each of these orders listed below (Hint: keep the same things in mind here as when analyzing assessment data). Are there any additional orders that you think would be appropriate? Why?

Orders include:

O2 2L via NC

IV ½ NS with 30 mEq KCL @ 125 mL/hr X 1 liter, then change to NS with 20 mEq KCL @ 75 mL/hr

Regular insulin IV 10 unit bolus, FSBS q 15 min with IV bolus scale until FSBS under 250, then FSBS ac + hs with sliding scale SQ lispro insulin

Clear liquid diet

Heparin 5000 units SQ q 12 hrs

furosemide 20 mg PO daily

lisinopril 10 mg PO daily

metoprolol 50 mg PO BID

inhalers as at home

prednisone 5 mg PO daily

vitamin K 10 mg IM X 1

ondansetron 4 mg IV q 4 hrs prn/nausea

loperamide 2 mg PO q 4 hrs prn/diarrhea

Repeat CBC, basic metabolic panel, & INR in the AM. 24-hour urine for creatinine clearance, stool for OB, C&S, O&P, C Diff.

Alcohol, Tobacco, and Other Drugs: Assignment

The use of alcohol tobacco and other drugs continue to take a toll on the economy, life expectancy and health care delivery system of the United States.

1. What are the 3 most common reasons individuals start using drugs?
2. Explain how “people, places and things” are related to continued drug use and explain what needs to be done regarding people, places, and things to start changing drug behavior.
3. Explain what happens in the brain when a person takes a drug. Include the terms neurotransmitters, synapse, axon, and dendrite in your answer.
4. Explain the science of how the brain can become addicted to a drug (chemical substance).

The second task

Choose a nutrition related problem and describe it in a flow chart (This should include a small paragraph defining it in 500 words)

After readings chapters 1-5, discuss the presence of race and gender in American history leading up to the American Revolution. Consider the changing role of women, the issues of race and slavery, and the idea of American identity. Discuss the varying perspectives that existed throughout this period. Please write between 300-350 words, or more, and please provide examples from the text.

what do you need to know about supervising UCP's ? Give an example of something you would need to supervise a UCP for and explain what the CNO expects from you as the nurse doing the supervising for that example ?