Matthew Sanders is a 69-year-old male who is one day post-op following open radical prostatectomy for treatment of prostate cancer. PMH: presented to PCP two weeks ago with dysuria, hematuria and urinary hesitancy accompanied by back and pelvic discomfort that began six months ago. PSA level was 7.8 ng/mL and DRE showed enlarged prostate: asymmetric, hard and nontender. Biopsy confirmed prostate cancer Stage II, Gleason Score 8, classified as high-risk cancer. Osteoarthritis, Type 2 DM and history of peptic ulcer disease. 0700 Assessment • 130/90 98.8°F- 86-20 pulse oximetry 98% on room air 4/10 incisional pain • HRR, no edema, +2 peripheral pulses, capillary refill < 3 sec, elastic skin turgor, LR infusing at 125 mL/h via right forearm IPID • Abdomen soft, hypoactive bowel sounds x 4 quadrants, 500 mL green liquid emesis – ondansetron given at 2030 with relief of n/v, PO intake ice chips only, abdominal incision dry and intact • CBI infusing – pale pink color with occasional tiny clot, 600 mL urinary output for 11-7 shift, morphine given for bladder spasms at 0415 – pain score 7/10 to 4/10 d.

On first rounds, you discover urine is leaking around the foley catheter tubing. What will you do?

Later in the day, drainage in the foley bag has changed from pale pink to red with multiple clots. What are your next steps?

At the end of your shift, the PCA tells you that Mr. Sanders reports increased cramping and pain in his lower abdomen. What actions will you take?

How can electronic fetal monitoring inhibit the normal progress of labor? What can nurses do as advocates to counteract this effect?

1. Hypophysectomy-patient teaching and nursing considerations?
2. What is continuous bladder irrigation and what are your patient teaching and nursing considerations?

dicuss the topics and conditions in health organizations as it relates to permitted to use and disclosure Protected Health Information. What are some examples of when it is important to share information.

discuss the view that ethics and law is the engine that drives professionalism in health care practice

You are the privacy and security officer for your facility; your background is HIM and you are an RHIA with the Certified in Healthcare Privacy and Security (CHPS) credential. You are part of a team that is reviewing the RFPs received from various EHR vendors. Your emphasis in the review will be the privacy and security issues. You know that there are many privacy requirements, some of which are policy related; however, many impact the functionality of information systems. You are in the process of reviewing the RFPs that were returned to you be various EHR vendors. One of the RFPs states that they are HIPAA compliant, so you decide to comapare their product to the HIPAA security regulations to determine if this is true.

1. What privacy functions should you look for in the EHR?

2. What security functions should you look for in the EHR?

3. Is the fact that the vendor claims to be HIPAA compliant adequate for the system you choose?

Carlton Bates is a 62-year-old male with a family history of prostate cancer. He requested screening and his PSA level was 6.2 ng/mL. He chose to have a biopsy and is now meeting with an oncologist to discuss the results. The provider reports the biopsy was positive for malignancy: Stage 1, Gleason Score 5, classified as low risk, localized cancer. After listening to the options for treatment, Mr. Bates chooses active surveillance.

a. What measures are included in active surveillance for early, localized prostate cancer?

b. Why is this approach used with low risk patients?

c. What is a disadvantage of active surveillance?

You begin a shift in the long-term care facility by assessing a resident that has been there about 24 hours. The doctor states he wants their titers for IgG levels checked. This patient is 93 years old with pulmonary fibrosis and cardiomyopathy. Your facility has two bedrooms so the resident will be in a room with another resident. Question: Apply the concept of adaptive immunity to this person and its ability to protect them.

1.   Mr. Davis

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

Patient Blood pressure is 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 the patient arrives at the floor.

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

With the patient information provided a NANDA Nursing Diagnosis and related to?

Discuss the value of nursing theory to the profession of nursing. Identify one way in which you could use nursing theory to improve your practice (present or future role).

A 9-month-old infant weighing 20 pounds comes to the emergency department with a 3-day history of vomiting, fever greater than 102.5 °F, and significant pain. Physical assessment reveals acute otitis media, for which the doctor prescribed amoxicillin 500 mg three times a day for 5 days and ibuprofen 2.5 ml every 6 hours. 1. How will you instruct the family member to safely administer the drugs?