Joseph Vojnovic is an 80-year old man admitted with diagnosis of possible pneumonia. He complains of general malaise and a frequent productive cough, worse at night. Vital signs T 38.5 C P 92 beats/min R 22 breaths /min BP 150/90 mmHg During your initial assessment he coughs violently for 40 to 45 seconds without expectorating. He exhibits coarse crackles and wheezes at both bases of the lungs. He states, “It hurts'in my chest when I cough.”

The nurse positions Mr Vojnivic in a semi-Fowlers position, encourages him to increase his fluid intake, and gives him acetominophen (tylenol)  650 mg po, as ordered for fever.  One hour later, the client is resting in bed

Vital signs are  T 37.7    P  86  R  22   BP 130/86

He states that he has been able to sleep. His fluid intake over the past hour has been 200 ml of water.

Near the end of the shift, you have identified fluid volume deficit as a nursing diagnosis for Mr. Vojnivic. Since his admission, he has a fluid intake of about 600 ml, and his urine output was 300 ml of dark, concentrated urine. His temperature is back up to T 38.4C, his mucous membranes are dry, and he states he feels very weak.

Several days later, after treatment with IV antibiotics, MrVojnovic is feeling much better, and preparations are bing made for discharge.

He is to take cephalexin (keflex) 500 mg every 6 hours, for the next 10 days; continue to drink extra fluids; and to get rest.. He lives alone.

Although he is generally cooperative, he does not like drinking water or taking pills.

He is to make an appointment with his physician for one week from today and should call the physician if symptoms re-occur.

?) Write a discharge summary that is concise and instructive.

Graded LP6.1 Discussion: Theft

Review your abilities to speak to your co-workers about theft. Is theft only stealing money? Can it be taking other things? How will you handle the issue of theft as a medical office assistant?

1)Provide and explain at least two (2) Elements of Fiction. Choose any two. You must explain the function of each element.

2)Provide and explain at least two (2) Elements of Poetry. Choose any two. You must explain the function of each element.

Predict how biological research will be transformed over the next decade by: 3rd generation sequencing, cyro-EM, and CRISPR-Cas9.

1. Describe the physical manifestations most commonly associated with the various shock states.

2. Describe prevention approaches that can be instituted in the critical care environment.

3. How does the heart work?

4. What causes of increased preload of the blood?

5. What causes of decreased preload of the blood?

Complete the “What Kind of Social Agent Are You?” quiz. Share your results with your peers, and comment on how accurate you think the results are. Are the results surprising? How can you use these results to find opportunities to share your personal vision?

1. A nurse is caring for a client who is to receive liquid medications via a gastrostomy tube. The client is prescribed phenytoin 250 mg. the amount available is phenytoin oral solution 25 mg/5 ml. how many ml, should the nurse administer per dose?
2. A nurse is preparing to administer levothyroxine 0.175 mg PO once every day. The amount available is levothyroxine 88 (0.088 mg) mcg/tablet. How many tablets should the nurse administer dose?
3. A nurse is preparing to administer cefprozil 15 mg/kg PO every 12 hours to a child. The child weighs 45 lb. Available is cefprozil 250 mg/5ml. How many ml should the nurse administer?

Compare the main strengths and weaknesses of the Gantt chart and PERT for project management, and give your opinion on which you believe is the most effective for project management.

25-year-old patient c/o left sided earache for 1 week. Explain how you would complete a focused assessment and what questions you would ask based on their complaints. ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________

65-year-old patient c/o swelling to the right side of his face; Face appears to be swollen, red, and warm to touch (swollen parotid gland). Explain how you would complete a focused assessment and what questions you would ask based on their complaints.

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1. What are some of the problems that could result from wearing contact lenses, and how can they be prevented?

2. Sabrina, who is in her early 30s and having no health complaints, had a regular eye examination with her ophthalmologist. A glaucoma test was not performed. About 6 months later, she was diagnosed with glaucoma and decided to sue the ophthalmology group, saying they were negligent in failing to perform a glaucoma test. What would the defense (the ophthalmology group) argue in this case? What are major risk factors for glaucoma?

Why are the following course objectives important to hospital administrators:

1. Identify the responsibilities of the healthcare administrator.

2. Evaluate various types of healthcare facilities and the different types of services performed in these facilities.

3. Analyze the financial side of healthcare, including reimbursement methodologies.

4. Explain the link between quality of care and health care administration. Please include at least 3 scholarly articles within your response.

Short Case: Decisions - what to do?
There are some individuals that believer these ratios are too heavily relied upon and that they do not truly assess an organization's financial status. In reality, they provide a comparison of where the organization stands to other similar organization within the same industry. If a 100 bed hospital on average has only 50 beds filled each day, there is a possibility that the hospital is generating revenue below its projected budget and has had to reduce staffing. It would not make good business sense to staff for 100 patients when at best you would only occupy 50 of the 100 available beds.
It is probably safe to assume that this hospital is not in a profitable state based on the number of occupied hospital beds? In its best days, it was the only hospital in the area and now there are 2 competing hospitals. The mission of the hospital has not changed since it opened; it is "to be the best primary hospital provider within 60 miles". It offers a full range of ER and hospital care (x-rays, MRIs, clinics, specialty care, etc.)
While the hospital does have an ER, it is not a Level I trauma hospital. Additionally, due the a significant loss of jobs within the local community, many of the residents no longer have health insurance and/or are on Medicare or Medicaid.
I know there is little information to work from, but give it a try.


Short Case
1. As you are the CEO, would you try to turn this situation around or prepare the hospital for closure.
2. What ratios would you use as part of your analysis and why?
3. What are some of the other areas in which the hospital would need to consider reductions to meet its budget. What are some of the other options that the hospital could pursue to address its financial status?
4. Would this hospital be a good candidate for a merger/acquisition? Please explain the rationale for your choice and identify what assumptions your decision was based on.