The nurse explains to the patient that the intravenous dose of pain medication is lower than the oral dose because when taken orally, a portion of the drug is absorbed from the gastrointestinal (GI) tract and metabolized by the liver into an inactive form. This process, known as hepatic first pass metabolism.
When a drug is taken orally, the nurse clarifies, it travels through the GI system and is then absorbed into the bloodstream. However, the medicine must travel via the liver to enter systemic circulation. When it comes to the breakdown and modification of numerous chemicals, the liver plays a significant part in drug metabolism.
In the case of the painkiller, a sizeable part of the medicine may be transformed into an inactive form by liver enzymes. Hepatic first pass metabolism is the name given to this metabolic process. As a result, only a small portion of the medication is still in its active state, which lowers the amount of the substance in the bloodstream.
Contrarily, when painkillers are given intravenously, they bypass the GI system and liver and go straight to the bloodstream. As a result, more of the active medicine enters systemic circulation since the drug escapes the hepatic first pass metabolism.
As a result, compared to a greater oral dose, when a sizable amount of the medication is metabolized before to reaching its target site, a lower intravenous dose can produce a similar or more strong impact. The nurse reassures the patient that the right dosage has been chosen by the medical team in order to minimize any potential adverse effects while yet delivering adequate pain relief.
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A 5-year-old boy is brought to the emergency department 10 hours after he accidentally ingested an unknown amount of windshield washer fluid. He is confused. He has tachypnea and tachycardia. Physical examination shows hyperemia of both optic discs. Serum studies show an anion gap metabolic acidosis. His serum methanol concentration is 35 mg/dL. Which of the following is the most likely mechanism of the toxicity in this patient?
A. Covalent attachment of methanol to protein side chains
B. Methanol-induced denaturation of proteins
C. Methanol-induced disruption of cellular membranes
D. Methanol oxidation
E. Methanol reduction
The most likely mechanism of the toxicity in this patient with symptoms of tachypnea and tachycardia is D.methanol oxidation.
What is methanol poisoning?
Methanol is a toxic chemical that can cause poisoning in humans when ingested, inhaled, or absorbed through the skin. Methanol is a byproduct of wood alcohol and is sometimes used as an alternative to ethanol (also known as grain alcohol). Ethanol is used to make alcoholic beverages, while methanol is used to make solvents and antifreeze. Because it is colorless and odorless, methanol is often mistaken for ethanol, and accidental methanol poisoning can occur as a result. Symptoms of methanol poisoning can range from mild to severe, and can even be life-threatening. Tachypnea and tachycardia are symptoms of methanol poisoning. Methanol poisoning causes tachycardia (rapid heart rate) and tachypnea (rapid breathing) as a result of respiratory and metabolic acidosis. Methanol causes acidosis by being converted to formic acid, which is then converted to carbon dioxide and water.
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List four common sites where a pressure ulcer may
develop.
A pressure ulcer, also known as a bed sore, is a skin wound or lesion caused by continuous pressure or friction over time. A pressure ulcer can develop on any part of the body, but some areas are more common than others. In this answer, we will list four common sites where a pressure ulcer may develop.
Sacrum: The sacrum is the most common location for pressure ulcers. The sacrum is located at the base of the spine and is responsible for supporting the weight of the body while sitting. Prolonged sitting or lying in one position can cause pressure to build up on the sacrum, which can lead to a pressure ulcer.
Heels: The heels are another common location for pressure ulcers. This is because the skin on the heels is thin and has very little padding, which makes it more susceptible to pressure. Pressure ulcers on the heels can be particularly dangerous because they can lead to bone infections or even amputations.
Hips: Hips are another location where pressure ulcers commonly develop. When people lie on their sides, they put pressure on their hips, which can lead to pressure ulcers. People who are bedridden or confined to a wheelchair are at particular risk for hip pressure ulcers.
Elbow: Elbow pressure ulcers usually result from prolonged leaning or lying on the elbow. They are also common in people who use crutches or wheelchairs as they use their elbows to support their weight. Elbow pressure ulcers can be difficult to heal because of the constant movement of the elbow joint and the lack of padding in the area.
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Bianca is a 32-year-old sales consultant for a local department store for the past 4 years. She is divorced with two young daughters, 6 and 9 years of age. She is being seen at the clinic for evaluation. The nurse notes a sad affect with no eye contact, no make-up and hair is messy and uncombed. Bianca is teary-eyed and states, "My husband not only left me alone in this world, but left me with all of the bills too. I just can't do this anymore!" 1. "What is the nurse's best response at this point?" 2. What symptoms would support the health care provider's diagnosis of depression? 3. What leading questions might encourage Bianca to continue talking? 4. The provider prescribes the antidepressant drug Escitalopram (Lexapro). What side effects may occur with this drug?
1. In response to Bianca, the best response by the nurse would be to say, "It sounds like you are feeling overwhelmed with your current situation.
2.The following symptoms might support the health care provider's diagnosis of depression: Sad or depressed mood most of the day, nearly every day.
3. What was happening at the time you first started feeling this way? can be a leading question.
4.Some of the side effects that may occur with the antidepressant drug, Insomnia Nausea and vomiting, Headache, Diarrhea.
Brief answers for the question:
A. In response to Bianca, the best response by the nurse would be to say,"It sounds like you are feeling overwhelmed with your current situation. Is there someone you can talk to or is there something that might be helpful to you at this point?" This would encourage Bianca to continue speaking and open up further to the nurse about her condition.
B. The following symptoms might support the health care provider's diagnosis of depression:Sad or depressed mood most of the day, nearly every day. Fatigue, a decrease in energy, or feeling tired all the time. Loss of interest or pleasure in hobbies or activities that were once enjoyed.
C. The nurse may use leading questions such as; What was happening at the time you first started feeling this way? Can you tell me more about what you were experiencing at that time?
D. Some of the side effects that may occur with the antidepressant drug Escitalopram (Lexapro) are:
Insomnia Nausea and vomiting, Headache, Diarrhea, Constipation, Dizziness, Dry mouth, Increased sweating, Increased appetite, Reduced libido, Restlessness, Blurred vision. The above list of side effects is not exhaustive. Please consult with your doctor if you experience any of these side effects or have any questions or concerns about your medications.
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MS II: Cardiovascular disorder case study: HF
Scenario: An 82-year-old woman with a history of chronic heart failure is in the Emergency Department with increased dyspnea, extreme fatigue, and a non-productive cough. She states that she can hardly walk to the bathroom from her bedroom without having to stop to rest. Her lower legs are swollen with 3+ edema, and she states that she has gained about 8 pounds over the past few days. When questioned about her medications, she states, "I have been skipping my fluid pill because I hate having to go to the bathroom so much. I get so short of breath."
Vital signs: Temperature 99.9°F (37.7°C), Pulse 110/bpm and regular, Respirations 28/min, Blood Pressure 188/98 mm Hg.
She is admitted to the telemetry unit with a diagnosis of exacerbation of heart failure, and given prophylactic anticoagulant therapy, aggressive diuretic therapy, as well as an ACE inhibitor. After a week, the nurse documents the following assessment findings.
NGN Item Type: Matrix
For each assessment finding, use an X to indicate whether the interventions were Effective (helped to meet expected outcomes), Ineffective (did not help to meet expected outcomes), or Unrelated (not related to the expected outcomes).
Assessment Finding
Effective
Ineffective
Unrelated
Edema in the lower legs is measured at 3+ bilaterally.
Patient can walk to the bathroom and back without becoming fatigued and short of breath.
Patient states that she will take her diuretic every morning by 9 AM.
Body temperature maintained at 99°F (37.2°C) or below.
Weight has increased by 2.2 kg in 2 days.
Patient can balance physical activity with periods of rest to avoid over-exertion.
The patient reports no chest pain with exertion.
The patient’s morning blood pressure is 180/94.
Rationale: Explain your reasons for your decisions
What diagnostic test/procedure should be included in this patient’s care?
An echocardiogram uses ultrasound to evaluate the structure and function of the heart, including assessing the ejection fraction (a measure of the heart's pumping ability),
Based on the provided information, the patient is experiencing exacerbation of heart failure with symptoms such as increased dyspnea, extreme fatigue, non-productive cough, significant lower extremity edema, and weight gain. The nurse is assessing the effectiveness of interventions implemented during the patient's hospital stay.
Assessment Finding | Effective | Ineffective | Unrelated
--- | --- | --- | ---
Edema in the lower legs is measured at 3+ bilaterally. | X | |
Patient can walk to the bathroom and back without becoming fatigued and short of breath. | | X |
Patient states that she will take her diuretic every morning by 9 AM. | X | |
Body temperature maintained at 99°F (37.2°C) or below. | X | |
Weight has increased by 2.2 kg in 2 days. | | X |
Patient can balance physical activity with periods of rest to avoid over-exertion. | X | |
The patient reports no chest pain with exertion. | X | |
The patient’s morning blood pressure is 180/94. | | X |
Rationale:
1. Edema in the lower legs is measured at 3+ bilaterally: This assessment finding is marked as effective because the intervention of aggressive diuretic therapy is aimed at reducing fluid retention and relieving edema.
2. Patient can walk to the bathroom and back without becoming fatigued and short of breath: This assessment finding is marked as ineffective because the patient is still experiencing fatigue and shortness of breath with exertion, indicating that the intervention has not completely relieved these symptoms.
3. Patient states that she will take her diuretic every morning by 9 AM: This assessment finding is marked as effective as the patient expresses compliance with the prescribed medication regimen, which is important for managing fluid retention and heart failure symptoms.
4. Body temperature maintained at 99°F (37.2°C) or below: This assessment finding is marked as effective as the patient's body temperature is within the expected range, indicating stability.
5. Weight has increased by 2.2 kg in 2 days: This assessment finding is marked as ineffective as the weight gain indicates ongoing fluid retention and inadequate response to diuretic therapy.
6. Patient can balance physical activity with periods of rest to avoid over-exertion: This assessment finding is marked as effective as the patient demonstrates the ability to manage physical activity and rest to prevent excessive exertion.
7. The patient reports no chest pain with exertion: This assessment finding is marked as effective as the absence of chest pain indicates improved cardiac function and reduced ischemia.
8. The patient’s morning blood pressure is 180/94: This assessment finding is marked as ineffective as the blood pressure reading is elevated, suggesting inadequate control of hypertension, which is important in managing heart failure.
Based on the information provided, an important diagnostic test/procedure that should be included in this patient's care is an echocardiogram.
An echocardiogram uses ultrasound to evaluate the structure and function of the heart, including assessing the ejection fraction (a measure of the heart's pumping ability), identifying any structural abnormalities, and evaluating the overall condition of the heart muscle.
This test will help determine the underlying cause and severity of the patient's heart failure and guide further management and treatment decisions.
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" Percutaneous endoscopic feeding tubes (gastric or jejunal) do
not require surgery for placement
Select one:
True
False
True: Percutaneous endoscopic feeding tubes (gastric or jejunal) do not require surgery for placement.
Percutaneous endoscopic gastrostomy (PEG) is a surgical procedure that involves inserting a feeding tube through the abdominal wall and into the stomach.
Endoscopy, on the other hand, is a non-invasive procedure that involves inserting a thin, flexible tube with a camera and light on the end through the mouth and into the stomach or small intestine. As a result, the percutaneous endoscopic gastrostomy (PEG) process has been largely replaced by percutaneous endoscopic feeding tubes (gastric or jejunal), which do not require surgery for placement.
In conclusion, Percutaneous endoscopic feeding tubes (gastric or jejunal) do not require surgery for placement.
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Whats the difference between hyperpnea vs hyperventilating? What is
the breathing pattern comprision of these two breathing rates
?
Hyperpnea is an increased depth and rate of breathing during physical activity, while hyperventilation is an excessive and often rapid breathing pattern unrelated to metabolic needs.
Hyperpnea refers to an increased depth and rate of breathing that occurs in response to increased metabolic demand, such as during exercise or physical activity. It is a normal physiological response to meet the oxygen demands of the body. On the other hand, hyperventilation is an excessive and often rapid breathing pattern that is unrelated to metabolic needs. It is characterized by breathing faster and deeper than required, leading to decreased levels of carbon dioxide in the blood. Hyperventilation can be caused by various factors such as anxiety, panic attacks, or certain medical conditions. The main difference between hyperpnea and hyperventilation lies in their underlying causes and the breathing patterns exhibited.
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estapé t. cancer in the elderly: challenges and barriers. asia pac j oncol nurs. 2018 jan-mar;5(1):40-42. doi: 10.4103/apjon.apjon 52 17. pmid: 29379832; pmcid: pmc5763438
The study focuses on cancer in the elderly since their bodies already create cells at a slower rate than those of younger people, which causes their tumors to grow more slowly.
The necessity to care for parts of primary and secondary ageing increases as we get older. Age-related increases in cancer risk are exponential, and those 65 years of age or older account for nearly 60% of all cancer cases. Additionally, this stage is where around 70% of cancer-related deaths occur. Cancer is a disease of old age as a result. A unique approach is required for the diagnosis, treatment, and survival of senior cancer patients in light of the rise in cancer incidence and the quality of life among the elderly population.
Because older people's bodies already create their cells at a slower rate than those of younger people, their cancer grows more slowly. Nevertheless, according to certain research, older people with tumours have a worse prognosis due to a delayed diagnosis. Therefore, it is important for seniors to obtain the proper mindset and information to fight cancer. As a result, many treatments for cancer or changes to what it means today don't always come as plainly as their personal experiences, which people frequently interpret as the only source of truth. As a result, any health issue or discomfort is readily attributed to becoming older.
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Complete Question:
Explain the study of estapé t. cancer in the elderly: challenges and barriers. asia pac j oncol nurs. 2018 jan-mar;5(1):40-42. doi: 10.4103/apjon.apjon 52 17. pmid: 29379832; pmcid: pmc5763438
How many grams of dextrose are in the fluid for the label shown? How many minutes will it take to infuse at 2 mL/min? How many drops per minute should be administered with a drop factor of 15 gtt/
Volume: 500 mL, Dextrose: 5%.How many drops per minute should be administered with a drop factor of 15 gtt/mL?
Answer:Grams of dextrose in the fluid:First, we need to find out the amount of dextrose in grams.5% of 500 mL = (5/100) × 500 mL= 25 gSo, there are 25 grams of dextrose in the fluid for the label shown.How many minutes will it take to infuse at 2 mL/min?Time taken = Volume ÷ Flow rate= 500 mL ÷ 2 mL/min= 250 minutesSo, it will take 250 minutes to infuse the given fluid at 2 mL/min.
We need to use the formula,Flow rate = (Volume ÷ Time) × Drop factor= (500 mL ÷ 60 min) × 15 gtt/mL= 125 gtt/minSo, 125 drops per minute should be administered with a drop factor of 15 gtt/mL.Explanation:We are given the volume and concentration of dextrose. We calculated the amount of dextrose in grams using concentration and volume.Next, we calculated the time taken to infuse the fluid at a given flow rate.Using the flow rate formula and drop factor, we determined the drops per minute to be administered with a drop factor of 15 gtt/mL. The detailed solution is given above.
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Nursing Note: Brad Jones, a 54-year-old Caucasian male, is in the emergency department reporting severe diffuse abdominal pain. He told the triage nurse that he swallowed part of a toothpick from his chicken cordon bleu dinner last night. He has profuse diaphoresis; his shirt is drenched with perspitation. While ambulating to his room, he was holding his abdomen and moaning. His vital signs are BP 128/72, HR88, RR 22, temperature of 98.8 ∘
. and SpO298% on room air. His skin is cool and moist, and his abdomen is distended. 1. What are the top three priority assessment findings or cues that must be recognized as clinically significant by the nurse? a. b. 2. What is the underlying cause/pathophysiology? a. 3. What body systems will you most thoroughly assess? a, b. 4. What is a priority nursing diagnosis? a. 5. What is the patient likely feeling right now?
1) The top three are;
Severe diffuse abdominal pain
Profuse diaphoresis and cool, moist skin
Abdominal distention
2) The underlying cause/pathophysiology in this case is likely a gastrointestinal obstruction or perforation caused by swallowing part of a toothpick.
3) Assess the Cardiovascular system
4) The nurse should assess and monitor the intensity of the pain
5) The patient is likely feeling intense pain, discomfort, and anxiety due to the severe abdominal pain
What is the diagnosis?The ingesting of a portion of a toothpick most likely resulted in a gastrointestinal obstruction or perforation, which is the case's underlying etiology and pathophysiology. The digestive tract may become damaged or obstructed as a result of the toothpick, which could result in complications and excruciating abdominal pain.
The patient's vital indicators, such as blood pressure, heart rate, and skin temperature (coolness, dampness), show that the cardiovascular system needs to be regularly monitored. It is critical to look for shock or compromised perfusion symptoms.
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True or false, A lower motor neuron has axons outside of the
brain or spinal cord.
True. A lower motor neuron has axons outside of the brain or spinal cord. Lower motor neurons (LMNs) are motor neurons that originate in either the spinal cord or the brainstem and terminate in skeletal muscle fibers.
They're known as lower motor neurons since they are situated further down in the nervous system than upper motor neurons. Lower motor neurons, which include alpha and gamma motor neurons, have axons that run through the spinal cord's anterior horn and outside of it to the target muscles. These axons can be either thick or thin, and they play a significant role in the contraction of muscle fibers. The number of muscle fibers that a single lower motor neuron controls varies from a few to a thousand, depending on the muscle in question.
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According to state statute, should medical assistants preform
illegal tasks even if asked to do so by the supervising
physician?
Medical assistants should not perform illegal tasks, even if they are asked to do so by the supervising physician. According to state statute, medical assistants must follow the laws and regulations related to their profession.
This means that they cannot perform tasks that are outside of their scope of practice, or that are considered illegal, even if they are directed to do so by their supervisor.
Medical assistants have a specific set of duties that they are trained and authorized to perform. These duties are determined by state laws and regulations, and vary from state to state. In general, medical assistants can perform tasks such as taking patient vital signs, preparing patients for procedures, and performing basic lab tests. However, they cannot perform tasks that require a medical license, such as prescribing medication or performing surgery.
If a supervising physician asks a medical assistant to perform a task that is illegal or outside of their scope of practice, the medical assistant should refuse and report the incident to the appropriate authorities. It is important for medical assistants to protect the safety and well-being of patients, and to follow the laws and regulations related to their profession.
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A 2-year-old child weighing 32 pounds is to take ferrous sulfate (feosol) 6 mg/kg/d po. how many milligram will the child receive per dose?
Since we assumed the dosage is once a day, the child will receive 87 mg per dose.
Therefore, the child will receive 87 mg per dose of ferrous sulfate (Feosol).
To calculate the dosage of ferrous sulfate (Feosol) for a 2-year-old child weighing 32 pounds, we need to convert the weight to kilograms.
1 pound is approximately 0.45 kilograms, so the child weighs approximately 14.5 kilograms (32 pounds × 0.45 kg/pound).
Next, we need to determine the dosage per kilogram. The dosage is 6 mg/kg/day.
So, to find the dosage per dose, we divide the daily dosage by the number of doses per day. In this case, we are not given the number of doses per day. Assuming it is once a day, we will calculate based on that assumption.
The child will receive [tex]6 mg/kg/day × 14.5 kg/day = 87[/tex]mg/day.
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Your patient has never heard of a Hct measurement. Explain to
your patient why and how Hct reflects a person’s iron status.
A Hct (hematocrit) measurement is a measure of the proportion of blood that is made up of red blood cells, and it can be used to determine a person's iron status.
A high Hct measurement can indicate that a person has too many red blood cells, which may be caused by an iron deficiency. Iron is a mineral that is needed to produce red blood cells, so a lack of iron can lead to anemia, a condition in which there are not enough red blood cells to carry oxygen to the body's tissues. If a person has an iron deficiency, their Hct measurement will be lower than normal. This is because their body is not producing enough red blood cells. If a person has too many red blood cells, their Hct measurement will be higher than normal.
This can be caused by a number of factors, including a genetic disorder, dehydration, or smoking. In conclusion, the Hct measurement is an important tool for assessing a person's iron status and can help doctors diagnose and treat a variety of conditions.
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Lesion of the outer portion of the optic chiasm would cause which of the following visual impairments?
A. Nasal (medial) heteronomous hemianopsia
B. Temporal (lateral) heteronomous hemianopsia
C. Cortical blindness
D. Homonomous hemianopsia
E. Anopsia
The lesion of the outer part of the optic chiasm would cause temporal (lateral) heteronomous hemianopsia.
The outer portion of the optic chiasm is called the temporal half of the optic chiasm. A lesion of the outer part of the optic chiasm results in the loss of vision in the medial part of the ipsilateral (same) eye and the lateral part of the contralateral (opposite) eye and is referred to as temporal (lateral) heteronomous hemianopsia.
Temporal (lateral) heteronomous hemianopsia is the appropriate option because it is caused due to a lesion in the outer part of the optic chiasm. The other options are incorrect because cortical blindness would be caused by damage to the visual cortex; homonymous hemianopsia, anopsia, and nasal heteronomous hemianopsia are all linked to damage to the inner part of the optic chiasm.
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List five different labs you might order for a client
presenting with a mental health concern. Explain the rationale for
ordering each lab.
As a medical professional, if you see a patient who has mental health issues, there are several laboratory tests you can order. Here are five different labs that you might order for a client presenting with a mental health concern.
Complete Blood Count (CBC)Metabolic PanelThyroid Stimulating Hormone (TSH)UrinalysisSerum Magnesium LevelsComplete Blood Count (CBC)This test will identify any abnormality in the number of red blood cells, white blood cells, and platelets in the body.
It is useful because it can help to detect some of the underlying medical conditions, such as chronic infections, anemia, and inflammation that are related to mental health issues.Metabolic PanelThe metabolic panel test checks the blood glucose level, sodium, potassium, chloride, calcium, protein, and creatinine levels. If there is an abnormality in any of these levels, it can indicate an underlying medical condition that can affect mental health.
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75 year old widow female lives alone with home assistance, she recently fell in bathroom and broke her right dominant hand. Her daughter lives 5 miles away. The elderly woman goes to nearby ER for care. Daughter tells Nurse she has recently been slightly confused and is losing weight. PMH: Obesity, Diabetic type 2, HTN. The daughter asked is it safe for her to be living alone? What can be done to keep her independent and safe? Meds: Hydrochloride 25mg daily Diet: regular Wears glasses Ambulates without cane. Think about safety when writing up your PICOT Question. Should she live alone? Move to Assisted Nursing Home? What are the risks of falls for Elderly? Home Safety? How do we keep senior independent safely at home?
A 75-year-old widow with a history of obesity, type 2 diabetes, and hypertension recently fell and broke her dominant hand. Her daughter is concerned about her mother's safety and independence. Potential PICOT questions focus on fall risk, home safety, and independent living for seniors.
In assessing the situation, it is important to consider the patient's physical limitations, cognitive changes, and recent fall. Falls are a significant risk for the elderly and can result in serious injuries. Home safety becomes crucial in preventing falls and promoting independence. Evaluating the home environment, removing hazards, installing grab bars, and improving lighting can help reduce the risk of falls. Assessing the patient's cognitive function and identifying the underlying cause of confusion and weight loss is also essential.
PICOT questions can be formulated to guide further research and interventions. Examples include: "What are the effective strategies to reduce fall risk in elderly individuals living alone?", "How can home modifications contribute to the safety and independence of seniors?", or "What interventions promote independence and safety for seniors with cognitive decline?"
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Kiara is a nurse manager at a busy hospital in Chicago, Illinois. A medical error at the facility by one of the nurses recently resulted in the death of a patient. Kiara has been talking with hospital administration about implementing Bar Code Medication Administration (BCMA) to prevent future medication errors. The hospital administration has decided not to implement this technology? Which are common reasons hospital administrators may be opposed to implementing BCMA? Select all that apply.
A. Will create wasteful redundancy
B. Will take too long to install
C. Will require hours of training
D. Will be too expensive
E. Has not be shown to reduce errors
Kiara is a nurse manager at a busy hospital in Chicago, Illinois. A medical error at the facility by one of the nurses recently resulted in the death of a patient. Kiara has been talking with the hospital administration about implementing Bar Code Medication Administration BCMA to prevent future medication errors.
The hospital administration has decided not to implement this technology. Common reasons hospital administrators may be opposed to implementing BCMA are A. Will create wasteful redundancy B. Will take too long to install C. Will require hours of training D. Will be too expensive E. Has not been shown to reduce errors.
The common reasons hospital administrators may be opposed to implementing BCMA are given below: Will create wasteful redundancy. Will be too expensive.Has not been shown to reduce errors.
Hospital administration may oppose BCMA for a variety of reasons, including cost, time, and whether it is necessary. Some may argue that it is an unnecessary expense, particularly if the hospital does not have a high number of medication errors. Hospitals that are resistant to change may also be hesitant to implement new technology, preferring to stick with traditional methods of managing patient care.
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4. Which values determine blood pressure and pulse pressure? 5- Briefly describe the events that take place during ventricular filling. 17- What is the difference between the innate and the adaptative immune response? 18- What factors determine ABO and Rh types?
Blood pressure and pulse pressure are determined by systolic and diastolic values. Ventricular filling occurs during diastole. The innate immune response is rapid and non-specific, while the adaptive response is specific and develops over time. ABO and Rh types are determined by specific antigens inherited from parents.
Blood Pressure and Pulse Pressure:Blood Pressure:
Blood pressure is determined by two values: systolic pressure and diastolic pressure. Systolic pressure is the higher value and represents the pressure exerted on the arterial walls when the heart contracts during each heartbeat. Diastolic pressure is the lower value and represents the pressure in the arteries when the heart is at rest between beats.
Pulse Pressure:
Pulse pressure is the difference between the systolic and diastolic pressures. It reflects the force generated by the heart during systole and the elasticity of the arterial walls.
Events during Ventricular Filling:Ventricular filling occurs during diastole, the relaxation phase of the cardiac cycle.
Initially, the atria contract (atrial systole), which completes the filling of the ventricles with blood.
The atrioventricular (AV) valves (tricuspid and mitral valves) open, allowing blood to flow from the atria to the ventricles.
As the ventricles expand, blood passively flows from the atria into the ventricles due to the pressure difference.
Towards the end of ventricular filling, the atria relax (atrial diastole), and the ventricles are filled to their maximum capacity.
Difference between Innate and Adaptive Immune Response:Innate Immune Response:
The innate immune response is the first line of defense against pathogens and is present from birth. It provides a rapid, non-specific response to a wide range of pathogens. The key features of the innate immune response include physical barriers (e.g., skin), inflammation, phagocytosis by cells like macrophages, and natural killer (NK) cells.
Adaptive Immune Response:
The adaptive immune response is a specific response to particular pathogens and develops over time. It involves the activation of lymphocytes (B and T cells) that recognize and target specific antigens. The adaptive immune response exhibits memory, allowing the body to mount a stronger and faster response upon subsequent exposure to the same pathogen.
Factors determining ABO and Rh types:ABO Blood Type:
The ABO blood type is determined by the presence or absence of specific antigens (A and B antigens) on the surface of red blood cells. The ABO blood type is inherited from parents, with possible combinations of A, B, AB, or O blood types.
Rh Factor:
The Rh factor refers to a specific antigen (D antigen) present on the surface of red blood cells. An individual is Rh positive (Rh+) if they have the Rh antigen and Rh negative (Rh-) if they lack the antigen. The Rh factor is also inherited, and it is either present or absent based on the combination of alleles inherited from parents.
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Explain the pathophysiology of Meningococcal septicaemia?
(200-300 words)
Meningococcal septicaemia is a condition that affects the human body in a variety of ways. It occurs when bacteria invade the bloodstream and cause a systemic inflammatory response.
Pathophysiology :
It is a serious illness that can lead to death if not diagnosed and treated early enough. This disease affects people of all ages and is more common in children and young adults.
It is caused by bacteria Neisseria meningitidis
(
meningococcus) enters the bloodstream and starts multiplying.
Once it enters the bloodstream, the bacteria triggers a systemic inflammatory response in the body.
The bacteria produces lipopolysaccharide (LPS) on its cell surface that can trigger an inflammatory respons. It bind to LPS-binding protein and then binds to CD14 which present on the surface of monocytes and macrophages.
Once the LPS binds to CD14, it activates a cascade of events that lead to the release of pro-inflammatory cytokines like interleukin 1 (IL-1) and tumour necrosis factor-alpha (TNF-alpha). The pro-inflammatory cytokines released cause an increase in vascular permeability which results in leakage of fluid and plasma into the tissues.
The plasma leakage is responsible for the characteristic rash seen in the disease. As it progresses, it can lead to multiple organ failure due to the activation of the coagulation cascade due to the presence of endotoxins in the bloodstream
The formation of microclots in the capillaries of various organs. leading to ischemia and infarction of organs finally leads to the failure of multiple organ systems and can ultimately lead to death.
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Which is the correct statement regarding the use of electromagnetic radiation in the treatment of cancer?
A. Low frequency X-rays are used because they kill cancer cells before healthy cells. B. High frequency X-rays are used because they kill cancer cells before healthy cells.
C Low frequency gamma rays are used because they kill cancer cells before healthy cells.
D. High frequency gamma rays are used because they kill cancer cells before healthy cells.
The correct statement regarding the use of electromagnetic radiation in the treatment of cancer is B. High frequency X-rays are used because they kill cancer cells before healthy cells.
In cancer treatment, ionizing radiation, such as X-rays and gamma rays, is utilized to target and destroy cancer cells. The goal is to deliver a sufficient dose of radiation to the tumor while minimizing damage to surrounding healthy tissues.
High frequency X-rays are preferred over low frequency X-rays because they have greater energy and shorter wavelengths. This allows them to penetrate tissues more effectively and deliver a higher dose of radiation to the tumor. The high energy of these X-rays enables them to damage the DNA of cancer cells, impairing their ability to divide and grow.
While healthy cells can also be affected by radiation, they possess some degree of resilience and repair mechanisms that aid in their recovery. The goal of radiation therapy is to strike a balance between eradicating cancer cells and minimizing harm to normal tissues. Treatment plans are carefully designed to deliver the necessary dose while sparing healthy cells as much as possible.
Low frequency gamma rays (option C) are not commonly used in cancer treatment as they have less energy and longer wavelengths, resulting in reduced tissue penetration and lower effectiveness in targeting tumors. High frequency gamma rays (option D) have very short wavelengths and extremely high energy, making them more suitable for sterilization purposes rather than cancer treatment.
Radiation therapy plays a significant role in the treatment of cancer, but it is a complex and specialized field. Understanding the principles of radiation therapy, including the types of radiation used, their interactions with cancer cells and healthy tissues, and the techniques employed to optimize treatment outcomes, is crucial. Further exploration of radiation therapy modalities, including external beam radiation and brachytherapy, can deepen our understanding of how electromagnetic radiation is harnessed to combat cancer.
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Right-sided heart failure tends to present with signs and symptoms of pulmonary edema such as "crackles or rales" in the bases of the lungs. True False
The statement "Right-sided heart failure tends to present with signs and symptoms of pulmonary edema such as crackles or rales in the bases of the lungs" is true.
Right-sided heart failure occurs when the right ventricle of the heart is unable to pump blood to the lungs effectively. As a result, blood may back up into the body, causing swelling in the legs, ankles, and abdomen.
Right-sided heart failure typically presents with signs and symptoms of pulmonary edema, such as crackles or rales in the bases of the lungs. It can also lead to fluid accumulation in the legs and feet, as well as swelling in the abdomen.Therefore, the given statement is true as the right-sided heart failure does tend to present with signs and symptoms of pulmonary edema such as crackles or rales in the bases of the lungs.
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Name one medical condition for which a DNA test is available.
One medical condition for which a DNA test is available is Cystic Fibrosis (CF). Cystic fibrosis is a hereditary disorder that affects the lungs, pancreas, and other organs.
A CF DNA test detects changes or mutations in the gene that encodes the cystic fibrosis transmembrane conductance regulator (CFTR) protein, which helps regulate salt and fluid movement across cell membranes.Cystic fibrosis is a genetic disorder caused by a mutation in the CFTR gene.
Individuals who inherit two copies of the mutated gene, one from each parent, have the condition. A DNA test can help identify carriers of the gene and those at risk of having a child with the condition.
The test analyses the individual's DNA to see if they are a carrier of the CF gene. If both parents are carriers of the gene, there is a 25% chance that their child will inherit two copies of the defective gene and develop cystic fibrosis.
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A sphincter at the junction of the stomach with the duodenum a. Cardiac sphincter b. lleocecal sphincter c. Pyloric sphincter d. Fundus sphincter
The sphincter at the junction of the stomach with the duodenum is known as the pyloric sphincter. It is situated at the outlet of the stomach, connecting the stomach to the duodenum.
It controls the passage of food from the stomach into the small intestine by regulating the amount of food that is released into the intestine at one time. The pyloric sphincter is made up of a ring of muscle tissue that contracts and relaxes to allow food to pass through. When food enters the stomach, it is broken down into smaller pieces by stomach acids and enzymes. The chyme that is formed by the digestion of food then enters the pyloric sphincter, which allows small amounts of chyme to pass through at a time into the small intestine. This allows for the optimal absorption of nutrients from the food. In summary, the pyloric sphincter controls the passage of food from the stomach into the small intestine and regulates the amount of food that is released into the intestine at one time.
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"Define in your own words what autonomic dysreflexia is.
Autonomic dysreflexia, often known as hyperreflexia, is a medical emergency that occurs in individuals who have sustained an injury to the spinal cord above the T6 level.
Autonomic dysreflexia is a condition that affects people who have had spinal cord injuries. It's characterized by a sudden spike in blood pressure that can cause headaches, blurred vision, sweating, and other symptoms. It can be caused by something as simple as a full bladder or bowel movement, or it can be brought on by something more serious like a kidney infection or blood clot. There are a variety of symptoms that can occur as a result of autonomic dysreflexia, including sweating above the level of the injury, headache, flushing of the skin above the level of the injury, a stuffy nose, a slower heart rate, high blood pressure. In rare cases, it may cause convulsions or even loss of consciousness. Autonomic dysreflexia is a medical emergency that should be treated immediately. Treatment involves determining the cause of the episode and taking steps to lower blood pressure, such as emptying the bladder or bowel or using medications.
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A cohort study (n=1200) exploring the association between second-hand smoke
exposure and lung cancer risk found a moderate increase in risk (RR 1.85 p = 0.07).
Which of the following is correct regarding the result?
a) The association may not be true in the study population.
©b) Random sampling error is not occurring in this study.
O c) We can reject the null hypothesis.
O d) The p-value suggests there is no association in the study sample.
A cohort study (n=1200) exploring the association between second-hand smoke exposure and lung cancer risk found a moderate increase in risk (RR 1.85 p = 0.07).
Regarding the result, the following is correct:
a) The association may not be true in the study population.
b) Random sampling error is not occurring in this study.
c) We can reject the null hypothesis.
d) The p-value suggests there is no association in the study sample.
The correct answer is that the association may not be true in the study population.
A p-value is the likelihood of obtaining the observed effect or a more extreme outcome if the null hypothesis is true. If the p-value is less than or equal to 0.05, it is commonly stated that there is a statistically significant effect, and the null hypothesis can be rejected. If the p-value is higher than 0.05, the result is not statistically significant, and the null hypothesis is not rejected.
A p-value of 0.07 is insufficient to reject the null hypothesis in the study sample. A relative risk of 1.85 suggests that the risk of lung cancer among people exposed to second-hand smoke is 1.85 times that of people who have never been exposed to second-hand smoke. However, as the p-value is greater than 0.05, it may indicate that the association is not statistically significant and may not be true in the study population.
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Respond to this discussion post in a positive way in 5-7 sentences
'A stable finance system; a well-trained and suitably paid personnel; trustworthy information on which to base decisions and policies; well-maintained facilities and logistics to supply quality medicines and technology' are all similar features in service delivery around the world (WHO 2013a). The healthcare system in Australia includes a complex web of public and private providers, settings, participants, and support mechanisms. Medical practitioners, nurses, allied and other health professionals, hospitals, clinics, pharmacies, and government and non-government entities are among the organizations and health professionals who provide health services. They provide a wide range of services in the community, including public health and preventative services, primary health care, emergency health services, hospital-based treatment in public and commercial hospitals, rehabilitation, and palliative care. The health system in Australia is a complex web of services and locations that includes a wide range of public and private providers, funding systems, participants, and regulatory procedures. This chapter examines how much money is spent on health care, where the money comes from, and who works in the industry. It also gives a high-level overview of the system's operation. The governance, coordination, and regulation of Australia's health services are complicated, and all levels of government are responsible for them. The government (public) and non-government (commercial) sectors collaborate on service planning and delivery. The Australian, state and territory, and local governments provide public health services. Private hospitals and medical practitioners in private practices are examples of private-sector health service providers.
The healthcare system in Australia is complex and includes both public and private providers, funding systems, participants, and regulatory procedures. It is impressive to see how the system works together to provide quality health services to citizens.
The healthcare system in Australia is one of the most complex systems around the world, as it includes a range of public and private providers, funding systems, participants, and regulatory procedures. The Australian government and non-government sectors collaborate on service planning and delivery. All levels of government are responsible for governance, coordination, and regulation of the health services.
The healthcare system in Australia has similarities to other systems around the world in terms of having a stable finance system, well-trained and suitably paid personnel, trustworthy information, and well-maintained facilities. It is impressive to see how the healthcare system in Australia is working together to provide quality health services to their citizens. The collaboration of the government and non-government sectors is impressive, as they work together to plan and deliver services to the citizens.
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When you search in CINAHL, you will find articles that have been tagged with Medical Subject Headings (MeSH). True False
When you search in CINAHL, you will find articles that have been tagged with Medical Subject Headings (MeSH). This statement is true.
The Cumulative Index to Nursing and Allied Health Literature (CINAHL) is an authoritative database for literature on nursing and allied health subjects. This database is used to find and access nursing and allied health articles. CINAHL has an advanced search option, which allows for searching using keywords and Medical Subject Headings (MeSH).
MeSH is a controlled vocabulary used by CINAHL to tag and classify articles. MeSH is made up of terms and descriptors that are used to categorize medical articles according to their subject. MeSH is updated every year to add new terms and descriptors that reflect current research and advancements in medicine. When a user searches for an article using CINAHL, MeSH terms are used to retrieve the relevant articles.
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Alzheimer's is a cause of dementia. Symptoms usually start at the
age of 60 but can be sooner
1: Define Alzheimer and its symptoms (6 points)
2: How is it treated? Include medication; as well as
nut
Alzheimer's disease is a form of progressive dementia that affects memory, thought, and behavior. Its symptoms are as follows: Difficulty in concentrating; difficulties remembering recent events, names, or faces. There is no cure for Alzheimer's disease, but the drugs available can help manage its symptoms. Some of the medications used in its treatment include; Cholinesterase inhibitors (Aricept, Exelon, Razadyne) Memantine (Namenda) Combination therapies (Namzaric) Healthy lifestyle changes, etc.
1. Alzheimer's disease is a form of progressive dementia that affects memory, thought, and behavior. It affects people aged 65 and up in most cases. Still, it can develop earlier in some individuals. Its symptoms are as follows: Difficulty in concentrating; difficulties remembering recent events, names, or faces. Language and communication difficulties; Impaired reasoning, judgment, and problem-solving skills. Confusion and disorientation; Mood and behavior changes Difficulty with familiar daily tasks
2. Treatment of Alzheimer's and Medication, as well as Nutrition. There is no cure for Alzheimer's disease, but the drugs available can help manage its symptoms. Some of the medications used in its treatment include: Cholinesterase inhibitors (Aricept, Exelon, Razadyne) Memantine (Namenda) Combination therapies (Namzaric) Healthy lifestyle changes, such as regular exercise and a balanced diet, can help to manage Alzheimer's disease and improve the quality of life of individuals affected by it. Nutrition can also play a significant role in the management of Alzheimer's disease. The following are some of the foods that can help: Omega-3 fatty acids can be found in oily fish such as salmon, sardines, and tuna. Vitamin E is found in foods such as nuts, seeds, and vegetable oils. Dark-skinned fruits and vegetables (such as spinach, kale, carrots, berries, and cherries) contain antioxidants that help to improve brain function and protect it from damage caused by free radicals.
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Purpose of Assignment: Learning the required components of documenting a problem based subjective and objective assessment of peripheral vascular system. Identify abnormal findings. Course Competency:
The purpose of the assignment is to teach students about the necessary components for documenting a problem-based subjective and objective evaluation of the peripheral vascular system while also recognizing abnormal findings.
This competency focuses on the use of critical thinking to identify nursing interventions for individuals, families, groups, and communities with diverse healthcare needs based on their subjective and objective assessments. The students will get a detailed understanding of how to evaluate the peripheral vascular system based on their subjective and objective assessment.
Objective assessment refers to the assessment of the vascular system that is based on factual and measurable data, such as blood pressure, heart rate, and pulse rate. In comparison, subjective assessment is based on patients’ interpretations of how they feel and their perceptions of their health. The assignment will include recognizing the following abnormal findings: peripheral arterial disease (PAD), deep vein thrombosis (DVT), varicose veins, and lymphedema.Students will learn the procedures for performing physical examination, risk factors, diagnostics, and management of each abnormal finding. These competencies will help students provide optimal nursing care to patients.
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What are the clinical risk factors in specimen collection and procedures designed to minimise those risks for different specimen types as given below?
The risk for different specimen types includes contamination, misidentification, Hemolysis, Hemorrhage, patient discomfort, or injury.
When it comes to specimen collection, there are various clinical risk factors to consider, regardless of the specimen type. Here are some common risk factors and procedures to minimize those risks:
Contamination:
Risk Factor: Contamination of the specimen by external microorganisms during collection, handling, or transportation.
Minimization Procedure: Proper hand hygiene and wearing appropriate personal protective equipment (PPE) such as gloves, masks, and gowns. Using sterile collection containers and following aseptic techniques during collection.
Misidentification:
Risk Factor: Incorrect labeling or identification of the specimen, leading to errors in patient diagnosis or treatment.
Minimization Procedure: Accurate and clear labeling of the specimen container with patient identification details. Verifying patient information, such as name and unique identifiers, before collection.
Hemolysis:
Risk Factor: Hemolysis, the rupture of red blood cells, which can alter the composition and validity of the specimen, particularly in blood samples.
Minimization Procedure: Using appropriate collection techniques, such as proper needle insertion, avoiding excessive pressure during collection, and ensuring adequate filling of collection tubes. Proper mixing of blood samples to prevent clotting or hemolysis.
Hemorrhage:
Risk Factor: Excessive bleeding during specimen collection, particularly in invasive procedures or surgical interventions.
Minimization Procedure: Following proper technique and using appropriate devices during invasive procedures. Applying pressure or using hemostatic agents as necessary to control bleeding. Monitoring the patient for signs of bleeding or hematoma formation post-collection.
Patient Discomfort or Injury:
Risk Factor: Discomfort, pain, or injury to the patient during specimen collection.
Minimization Procedure: Using appropriate-sized needles or instruments to minimize pain or tissue trauma. Providing clear instructions to the patient, ensuring their comfort, and addressing any concerns or questions they may have.
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