F.J. is a 70-year-old white woman admitted to the hospital because of a fall at home during the night. She is scheduled for an open reduction with internal fixation (ORIF) of the right hip at 8:00 AM this morning. She has a history of type 2 diabetes mellitus that is well managed with metformin (Glucophage) 5 mg twice daily.

Subjective Data

• States pain is a level 7 on a scale of 1 to 10
• Last dose of metformin was at 6:00 PM the previous evening

Objective Data

Physical Examination

• Blood pressure 120/54, pulse 101, temperature 98° F, respirations 20
• Alert and oriented to person, place, and time
• Lungs clear to auscultation
• Heart rate and rhythm regular, no murmurs
• Height 5’2”, weight 150 pounds
• Bowel sounds active and present in all four quadrants
• Circulation and sensation to bilateral lower extremities intact
• Strength left lower extremity 5/5, right lower extremities not tested because of pain

Diagnostic Studies

• X-Ray reveals a break in the right hip
• Morning blood glucose level was 280 mg/dL

Preoperative Orders

• NPO after midnight
• Type and crossmatch 2 units of packed red blood cells
• Start an IV of lactated Ringer's at 75 mL/hr
• Place in Buck’s traction
• Ensure that surgical consent form is signed and placed in the chart
• Administer ceftriaxone sodium (Rocephin) 1 gram IV when called to OR

1.Name 3 nursing diagnosis, 3 interventions for each diagnosis and patient education

Case Study 1.

Andrew, a 22-year-old male, was involved in a head-on collision. He was not wearing his

seatbelt at the time of the accident. When emergency crews reached the scene of the accident

they found Andrew wedged against the steering wheel. Following a difficult extraction from his

vehicle, Andrew is exhibiting the following symptoms:

- Semiconscious

- Dyspnea

- Inward movement of the left anterior portion of his thorax during inhalation

- Pain in his left thorax and upper left abdomen

- Pale and cyanotic mucous membranes and cyanotic areas around his upper lip and nail beds

- BP 83/51

- CBC HgB 10.1, HcT 30%

- Blood chemistry abnormalities Arterial PO2 65mmHg, Arterial PCO2 55mmHg, Arterial pH 7.27

- Urinalysis: pH 4.0

1. What is the most likely cause of Andrew’s symptoms?

2. Flail chest is a condition which occurs when one section of the ribcage moves inward while

the rest of the thoracic wall moves outward during inhalation. What might be the cause of this

condition?

3. How might this condition affect the breathing process?

4. Why does Andrew have cyanotic mucous membranes?

For each case study, you must develop an appropriate exercise prescription.  Use the FITT recommendations from the ACSM guidelines. You will need to calculate a workload for the particular type of mode of cardiovascular exercise you choose utilizing the metabolic equations. Once you pick an appropriate intensity, use the VO2R equation to calculate the oxygen consumption. Then use that to solve for the workload on the treadmill or cycle, whichever you think is best. Don't forget to indicate frequency and duration as well.  Please note any special considerations or precautions for each of them.

Maria, a 68 year old recently diagnosed with Osteoporosis has been referred to you to help with an exercise program designed to slow the progression of bone loss. Her current weight is 130 pounds. Due to this condition, she has already fractured four ribs and broken her right ankle. She complains of fatigue and weakness most of the time. The results of her GXT showed a maximal VO2 of 25ml/kg/mn.

Based on this information, design an ExRx using VO2R method to choose an appropriate intensity range and include FREQUENCY, TIME and TYPE OF EXERCISE. Based on this VO2R range, use the metabolic equations to help determine the workload. Follow ACSM guidelines for special populations for this ExRx.

This section will discuss the differences between legal and illegal drugs

Read the article that discusses the differences between legal and illegal drugs http://www.differencebetween.com/difference-between-legal-and-vs-illegal-drugs/ First, list as many legal drugs as you can, next list as many illegal drugs as you can

Research in the media examples of the common drugs that are used. Write a brief description (paragraph) of your findings (legal or illegal) Answer the following questions:

What causes substance abuse addition? Why do people avoid seeking substance abuse treatment?

What is substance abuse treatment?

Discuss the various types of treatment programs and the levels of care?

and What is involved in the recovery process?

Discuss and analyze the benefits of Medication Reconciliation and SBAR for improving Quality in systemic, patient safety programs and compliance by health care providers.

information on Health behavior change affecting a vulnerable population

Write at least a 1050-word paper in which you answer the following questions:. Your response must address all aspects of each question, must include your personal opinions, ideas, or thoughts; and must provide examples in any situation where it is warranted.

• What is the typical IT implementation process? What are the roles and responsibilities involved in system implementation?

Please give at least one reference

1. The public interest theory and the special interest theory of government intervention have their similarities and differences. Compare and contrast these two theories and provide a recent example of each. ( Explain in details and add references to support)

2. How are Medicaid and Medicare similar? How are they different? ( Explain in details and add references to support)

3. Increased demand for health care services leads to an increasing need for health care organizations to be cost-efficient. What are the factors that impact an organization's financial viability? ( Explain in details and add references to support)

4. Discuss how the individual demand for health care differs from the aggregate demand for health care. Provide at least one example. ( Explain in details and add references to support)

BEFORE AND AFTER NURSING RESPONSINILITIES FOR WOOD'S LIGHT EXAMINATION

• EVALUATION

1. Why is evaluating a program important?
2. Have you ever evaluated a program or evaluated anything in your life (please share) what it was, how did you do it, what tools/strategies you utilized in your evaluation, what did you find out or what was your conclusion?
3. From your readings recall the concepts of full-and partial-coverage programs.
4. Which evaluation designs are more appropriate for full-coverage programs and which ones are appropriate for partial-coverage programs?

• Mr. Alvis, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately, he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.

1. Relate the pathophysiology of pernicious anemia to the manifestations listed above.

2. Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia.

3. Discuss other tests that could be performed to diagnose this type of anemia.

4. Discuss the treatment available and the limitations.

1. Which parasite is not a louse?
A. Pediculus humanus capitis.
B. Sarcoptes scabiei
C. Pediculus humanus corporate
D. Phthirus pubis

2. is a parasitic infection classified as a sexually transmitted infection (STI).
A. Pediculus humanus capitis
B. scabies
C. Pediculus humanus corporis
D. Phthirus pubis

3. Select the drug for which the FDA requires manufacturers to place a Black Box warning in the package insert
A. lindane
B. permethrins
C. pyrethrins
D. crotamiton

4. Which of the following statements about body lice is false?
A. Body lice infestations are caused by the parasite Pediculus humanus corporis.
B. Adult body lice can survive away from a human host for 30 days.
C. Body lice infestations are a serious public health concern.
D. Body lice may cause epidemics of typhus and louse-borne relapsing fever.

5. In which environmental conditions does scabies thrive?
A. dense populations such as in prisons and nursing homes
B. warm environment
C. moist environment
D. arid environment
E. scarcely populated environment

TRUE OR FALSE

6. Malathion was withdrawn from the market in Canada but is still available in the United States.

7. Permethrins and pyrethrins may be obtained only by prescription.

1. Describe in your own words the impact advances in technology and improvements in medical education had on the growth of U.S. hospitals and healthcare services from 1920 to the current period. (Chapter 2) Include references to:

• The Baylor Plan – (healthcare insurance as a benefit of employment)

• The Hill-Burton Act – (hospital construction in the U.S.)

• Medicare Title XVIII and Medicaid Title XIX – (differences between the two programs)

• TEFRA – (the change in hospital inpatient reimbursement)

• The Affordable Care Act – (merging the House bill with the Senate bill)

Complete the following questions, each in an essay format (no bullets).

Basic Overview of the Healthcare Theory

1. Provide an example of healthcare theory and give a brief description of the sample healthcare theory

2. Provide an assessment of the theory using Box 6.1 in Polit and Beck (2017)

3. Generate a research hypothesis that could empirically be tested in a quantitative research study.

4. Think about the variables and assumptions of your healthcare theory and pick a patient population that you could apply to healthcare theory.

5. Give a brief background and significance of the patient population

6. State your PICO research question

7. State the null and alternative hypothesis o Identify the Independent Variable (IV) and Dependent Variable (DV) (only one DV)

8. Provide a rationale for why you are asking this question.

9. How does the theory or model support why you are asking this question.