Managed care is a system of health care delivery that aims to provide a generalized structure and focus when managing the use, access, cost, quality, and effectiveness of health care services. There are various ways in which the managed care organization reimburses hospitals for their services. Examples of Managed Care Reimbursement Methods include the following:

• Percent-of-charge payment
• Per diem payment
• Case rate payment (DRGs and MS-DRGs)
• Ambulatory Patient Grouper (APG)
• Ambulatory Payment Classification (APCs)
• Other types of reimbursement (carve-out, stop-loss, and withhold pools)
• Please use your own words and do not copy another source.

the charge nurse on the unit has posted the vacation schedule for the month of December, as a recent graduate, have requested to be off during the week of Christmas holidays. You notice on the schedule that none of the recent graduates has received the Christmas holidays off. You feel that this is unfair, because you will not have an opportunity to be with your family during the Christmas holidays. How can you resolve this conflict?

Competition

This is an example of the win-lose situation. In this situation, force—or the use of power—occurs. It sets up a type of competition between you and your charge nurse. Typically, competition is used to resolve conflict when one person has more power in a situation than the other. In the given situation,

the charge nurse refuses your request for Christmas vacation, explaining that the staff members with more seniority have priority for vacation at Christmas time.

Question : From this Scenario, Write an appropriate dialogue ( conversation ) between two people explaining the type of conflict which is Competition ?

What are the Strengths, Weaknesses, Opportunities, and Threats of utilizing preventive care services?

Who would be considered a competitor for a preventive care service in the healthcare field?

What would their strengths and weaknesses be?

A stereotype can be defined as a preconceived notion, usually about a group of people. It is a widely held oversimplified image, behavior or idea of a group or people, a type of person, or a thing. Stereotypes and references to them can be seen in all aspects of society. Although the idea of stereotypes has been a part of history for many years, many of the stereotypical ideas have changed and adapted to modern times.

For your assignment, you will focus on modern stereotypes that you see in your culture and environment. You will first explain 2-3 different stereotypes that you feel are predominant, and look at them more in-depth. They might relate to technology, behaviors of your generation, or other new themes.

Then, in your 650-750 word essay, you will respond to the following questions:

• Why do you feel popularly mentioned and used stereotypes change over time?
• Throughout history, race and gender played a large role in stereotypical designations. Are those still a large issue in society today? Why or why not?
• As you learn more about stereotypes and gender/race relations, do you feel that stereotypes are positive or negative to an individual or group? What leads you to that conclusion?

Answer only ONE of the questions below. In your own words.

1- The importance of physical activity, along with nutrition, is a key component of a healthy lifestyle. Find an article that studied the effects of physical activity on reducing the risk of a particular disease, or on improving one's health following a specific disease.

2- Proper nutrition plays a big role in improving athletic performance. Find an article that discusses specific nutritional needs for a particular type of athlete (ex. triathlete, gymnast, sumo wrestler...), as it relates to performance.

3- Several ergogenic aids are mentioned in this week's chapter. Select one (not necessarily from the book) and find an article that studied the pros and cons associated with that aid.

• Mr. Grinch is a 68 year old male who presented to the Emergency Department (ED) with severe shortness of breath (SOB), fatigue, and recent weight gain of 5 kg. It is two days after Thanksgiving and Mr. Grinch has been eating salted ham and a large amount of leftovers for every meal. He is having trouble speaking, but reports he has been having difficulty sleeping and states, “I feel like I’m drowning. I’ve tried using multiple pillows to get rid of this feeling, but the only way for me not to feel so SOB is if I sleep sitting up”. This is Mr. Grinch’s second admission this year for a similar complaint. He has a history of heart failure, Ischemic heart diseases [with his last echo showing an EF 25%], hyperlipidemia, Coronary Artery Disease (CAD) [CABG 2 vessel 2 years prior], hypertension (HTN), and Type II diabetes. The patient’s son, who is also his main caregiver and lives nearby, has accompanied him to the ED and reports that Mr. Grinch is not adherent to either diet nor medication regimens. He also reports that Mr. Grinch likes to eat fast food or frozen dinners for most of his meals a week. He refuses to exercises and generally lives a sedentary lifestyle. Home meds include Lisinopril 5mg, Metoprolol 25mg, Spironolactone 25mg, Atorvastatin 10mg Daily.

  Assessment in the ED revealed: vitals BP: 198/103, HR 131, RR 22, T 98.4, O2 of 84% on Room Air so the patient is placed on 10L Non rebreather which increases O2 to 94%. The patient is alert, oriented x4, anxious, PERRLA, with facial symmetry and reflexes intact. The EKG shows sinus tachycardia and no new ischemic changes. Cardiac assessment revealed s3, bilateral pitting pedal edema 2+, and 2+ pulses in all extremities. Auscultation of the lungs revealed bibasilar pulmonary rales. There is also use of accessory muscles, nasal flaring, and severe SOB. The abdomen was distended/non tender with positive hepatojugular reflux. All other assessment findings were normal.

  In addition to the EKG, a chest x-ray was performed and showed cardiomegaly, vascular engorgement, and mild interstitial edema. Labs: Na 128 mEq/L, K 5.2 mEq/L, BUN 82 g/dL, Crt 1.8 mg/dL, trop I 0.1 ng/mL , BNP 1300 pg/mL, Glu 140 g/dL.

  Mr. Grinch receives oxygen by non rebreather mask, is placed on fluid restriction and strict I&O. Therefore, it’s imperative that an indwelling foley catheter is inserted. Orders are made for Furosemide 40 mg IV and Nitroprusside 0.3mcg/kg/min IV.  Upon reassessment in 30 mins, Mr. Grinch reports a decrease in SOB and has put out 500 mls of urine. Lung auscultation shows improved, but still present rales. Vitals are now BP 150/96, HR 89, RR18, T 98.5, and O2 of 97% on 10L non rebreather. Mr. Grinch is stable and is now being transferred to a telemetry floor for further monitoring.

  When setting patient goals for Mr. Grinch, the nurse decides the priorities for the patient will be to improve ventilation, maintain hemodynamic stability, and be able to verbalize understanding of his condition and associated treatments prior to discharge. Case management will be consulted as the patient lives alone and may require home health care upon discharge.

  Open Ended Questions

  CV:

  1.What are the modifiable risk factors that placed this patient at risk for CHF and exacerbation?

  2 .What kind of discharge education would this patient require to reduce the chance of readmission for CHF exacerbation?

  3.Which members of the interprofessional team would the patient benefit from collaboration or referral and why?

Neuro:

1. What objective findings upon arrival to the ED could suggest an altered LOC?
2. How would we best identify Mr. Grinch’s LOC on exam?

Pulm:

What potential respiratory process is occurring given Mr. Grinch’s clinical presentation?

FEN:

How can we best define the fluid volume status of Mr. Grinch?

Nursing Diagnosis

What nursing diagnosis would be most appropriate? (give one priority).

According to Tanner, “growth is the mirror that reflects the conditions of society”

Why and how is the study of growth and development potentially valuable to the assessment of public health and societal wellbeing?

I cannot seem to find ANYTHING about how vitamin b10 (PABA) is transported in the body. I think it is stored in the body in small amounts? Does anyone know how vitamin B10 is transported and stored in the body? Thank you in advance will rate

find the following informations for each of the disorders as follows;

1. Nephrotic syndrome
- description of procedures
- indications
- considerations: preoperatve, intraoperative and postoperative nursing interventions
- outcomes and evaluations
- client education
- potential complications
- nursing interventions

2. Cardiogenic shock
- description of procedures
- indications
- considerations: preoperative, intraoperative and postoperative nursing interventions
- outcomes and evaluations
- client education
- potential complications
- nursing interventions

You are caring for a 90 year old retired minister. What age-related changes might the nurse expect to find in his/her vision? How were these consistent with your interviewee? How might they affect activities of daily living for your interviewee? Support your answer with in-text citations from current articles.

As HIM director of Pine Valley Community Hospital, a critical access hospital, you are concerned about a recent decision made by your CEO. He has decided that all patients will be issued an Advanced Beneficiary Notice for outpatient laboratory and radiology services. His rationale is that by doing this, the hospital will be able to collect on all the tests performed that do not meet medical necessity. You know that is an unacceptable practice.

Your job is to:

1. Defend your position.

2. Support your stance through the Code of Ethics.

3. Anticipate the consequences of continuing with the CEO’s decision.

Code the following surgical procedures using current CPT Book:

1. CT of the soft tissue of neck, with and without contrast followed by contrast materials

2. X-ray of the ribs , bilateral. Three views obtained

3. Radiologic examination of chest 6 views done twice (7 am and 12 pm). Both films were interpreted by Dr. Johnson.

4. Lipid panel done twice (7 am and 9 am)

5. Specimen obtained for surgical pathology was obtained. Gross examination was completed for this specimen.

6. Unlisted miscellaneous pathology test

7. Hepatitis A vaccine administered /injected to 21 year old college student

8. Endomyocardial biopsy

9. IV infusion for therapy, 3 hours completed

10. Re-evaluation of athletic training established plan of care consisted of 20 minutes face to face with patient and family