How Joseph Stalin(1879-1953) affect the world? How he was able to increase his power and keep his leadership. Why did he want to increase the power of government?

Taking into consideration all of his health problems, what are the top 5 priority nursing diagnoses for him?

What would be appropriate outcomes for each diagnosis?

What are some appropriate interventions for each diagnosis (remember to include MD orders as well as nursing actions, and note that there might be a lot of overlap in terms of interventions for different diagnoses)?

Your 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

How will EHRs impact public health?

Basic concept template: psychosocial integrity abuse and neglet the eldery (legal respomblities indications of abuse, need related content, underlying prinicples, nursing intervention

A.S. is a 70-year-old white woman who presented to the emergency department because of a 4-day history of increased shortness of breath and generalized weakness. A.S. stated that she has been able to do her daily chores at home independently, but for the past few days, it was getting difficult for her to get around and that she needed to take frequent breaks because she was short of breath and had no energy. She has a long history of heart failure, type 2 diabetes, and hypertension. She is admitted with a tentative diagnosis of acute kidney injury (AKI).

Subjective Data

• Has been having headaches on and off, with nausea and dizziness
• Reported that she had not been taking her medications regularly at home because of “forgetfulness”
• Has not been urinating a lot
• Feels “puffy” in her legs and hands

Objective Data

Physical Examination

• Blood pressure 178/96, pulse 110, temperature 98.9°F, respirations 24, and an oxygenation of 93% on room air
• Alert and oriented to person, place, and time
• Mild jugular venous distention
• Fine crackles in bilateral lower lobes
• Heart rate regular, no murmurs
• Bowel sounds normoactive and present in all four quadrants
• 2+ edema bilateral lower extremities and hands

Diagnostic Studies

• Echocardiogram shows decreased left ventricular function
• Urinalysis: Urine dark yellow and cloudy, protein 28 mg/dL, negative for glucose and ketones, positive for casts, red blood cells and white blood cells
• 24-hour urine output = 380 mL
• Laboratory Tests:

Case Study Questions

1. Explain what might have contributed to A.S.’s present condition as described above? What are two evidence-based preventive health care provisions/programs that if put in place early might have prevented this from occurring?

Explain what might have contributed to A.S.’s present condition:

Evidence-based Preventive Health Care Provisions/Programs:

1.

2.

2. What is the significance of A.S.’s Hemoglobin, Hematocrit, and RBC levels being significantly decreased?

3. You are planning discharge for A.S. What would you include in your discharge instructions/teachings and what other interdisciplinaries/health professionals would you include? Student must list at least five each:

Nursing Teaching/Instructions                       Other Health Professionals

1.                                                 1.
2.                                                 2.
3.                                                 3.
4.                                                 4.

5 5

How is the imitation gap hypothesis and the product life cycle hypothesis applicable to the cost of a coronavirus vaccine?

Word count 1000-1500

Use relevant diagrams

The Karnofsky prognostication scale (KPS) is a tool that clinicians use to score a patient on a scale of 0-100

How does medical tourism relate to cost, access, quality? What are the implications of medical tourism from a market justice perspective? From a social justice perspective? Should medical tourism (between states) be used within the U.S. to improve cost, access, and/or quality? Why or why not?

There are many times that a nurse will encounter conflicting ethical principles at play, especially when administering care near the end of life. Check all the challenges below that lists as common dilemmas.

1.Who would be the stakeholder in a nursing program and what would their roles be?

2.Provide reasons why the problem occurs in a nursing program?

3List three possible suggestions for changing/correcting that can be may in a nursing program?

4.Choose a top or suggestion for improvement this program.

Public health practice involves working with issues of illnesses and diseases of populations. Because of this, unique ethical issues are involved. Generally, public health practices and policies try to improve the overall health of the public; this position often conflicts with the principle of autonomy for individuals. This conflict might be clinical, as in the case of immunization, or legal, as in the case of required medical reporting and treatment of communicable diseases. Furthermore, public health involves recognizing health and illness in the wider context of social, environmental, political, and economic factors, while ensuring that the ethical principles are not violated.

Considering this, respond to the following:

• What are the features that distinguish public health ethics from conventional medical ethics or bioethics?
• Are ethical principles and values, or the methods of ethical analysis, materially different when applied to populations rather than to individuals?

Give examples and reasons in support of your responses.

Develop a table that addresses the phases of pharmacokinetics (absorption, distribution, metabolism, excretion) for the following developmental stages:

Children

Older Adults

FOR QUESTIONS 1-5 INVOLVING PROFESSIONAL SERVICES, ASSUME A REPORT WAS PRODUCED UNLESS THE QUESTION STATES OTHERWISE. ALSO, FOR ALL SERVICES FURNISHED IN A HOSPITAL SETTING, ASSUME THAT THE HOSPITAL (AND NOT THE PHYSICIAN) FURNISHED THE TECHNICAL COMPONENT (EX. EQUIPMENT, NON-PHYSICIAN PERSONNEL, ETC.)

1. A primary care physician took a two view chest x-ray (frontal and lateral views) in his office. The films were sent to a radiologist (who was not affiliated with the primary care physician) to be interpreted. The radiologist billed separately for her services. How should the radiology-related services provided by the primary care physician’s office be reported?

2. How should the radiologist in the above questions report her professional services?

3. A radiologist interpreted a head CT scan taken by the hospital. The study included both films taken without contrast and films taken with IV contrast material. How should the radiologist’s professional services be reported?

4. A mammography was performed for a patient with a suspicious breast lump. Only one breast was studied. The service was provided in a freestanding women’s imaging center owned by a large radiology practice. The study confirmed a neoplasm. A copy of the radiology report was sent to the patient’s primary care physician. How would the radiology practice’s services be reported?

5. A radiologist interpreted a MRI without contrast of the orbit, face, and neck taken by the hospital. The radiologist also interpreted a soft tissue x-ray of the neck taken by the hospital. The interpretations of both studies were included in a single radiology report under separate headings. How should the radiologist’s professional services be reported?  

**Per CPT Assistant, the -51 modifier is generally not reported with Radiology codes**

6. Supervision and interpretation of an aortography, thoracic, by serialography

7. Uterine ultrasound in real time with image documentation of a 32-week pregnant female with twins

8. Therapeutic radiology treatment planning; simple

9. Teletherapy, isodose plan, to one area, simple, for cancer of the prostate, primary malignant

10. Five radiation treatments

11. Simple application of a radioactive source, interstitial

12. Which category in the Nuclear Medicine subsection would you reference to locate codes for the following?

1. Liver - ______________________________

2. Thyroid - ____________________________

3. Spleen - _____________________________

4. Bone - ______________________________

5. Brain - ______________________________

Let's say there is dysfunction in a family where the parent believes in God but the children do not and the parent wants them to. In the family, there were domestic violence and child abuse, PTSD, ANXIETY. how do traditions (beliefs and behavior) influence self-esteem, marriage, parenting, sexuality/familiar responsibility, and loyalties?