Medicaid participation can affect a hospital's finances in a number of ways, both positively and negatively.
The following are the effects of Medicaid participation on a hospital's finances:
Effects on Finances of Hospitals: The Affordable Care Act (ACA) has made significant changes to Medicaid eligibility requirements, which has resulted in a substantial increase in Medicaid enrollment. This has increased the financial burden on hospitals because Medicaid reimbursement rates are significantly lower than those paid by private insurers.
Increased revenue: As more patients become insured under Medicaid, hospitals' revenues increase. Additionally, the ACA includes provisions for the expansion of Medicaid, which has resulted in more funding for hospitals to offset the cost of providing care to the uninsured.
Prioritize preventive care: Hospitals can prioritize preventive care to reduce the need for costly hospitalizations. This may involve offering preventive services, such as screenings and vaccinations, and providing education to patients to help them manage chronic conditions more effectively. Pursue alternative payment models: Hospitals can pursue alternative payment models, such as bundled payments, which can help to reduce costs while maintaining quality of care provided.
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Medicare is technically managed care. While it works well in large urban/suburban areas where there are a lot of providers (health services) available, it does not work well at all in rural areas. Thoughts on how to integrate managed care concepts in rural areas?
Integrating managed care concepts in rural areas can involve strategies such as telehealth, collaborative partnerships, provider incentives, and community engagement to improve access to healthcare services.
Integrating managed care concepts in rural areas requires careful consideration of the unique challenges and limitations present in these areas. One approach could be to establish collaborative partnerships between healthcare organizations and providers in rural communities. This can involve forming networks or alliances that enable shared resources, coordination of care, and economies of scale.
Telehealth and telemedicine can play a crucial role in bridging the gap in access to healthcare services in rural areas. By utilizing technology, patients can remotely connect with healthcare providers, receive consultations, and access specialized care without the need for long-distance travel.
Another strategy is to incentivize healthcare providers to practice in rural areas. This can be achieved through loan forgiveness programs, financial incentives, or targeted recruitment efforts. By attracting and retaining providers, the availability of healthcare services can be improved.
Community health workers or mobile healthcare units can be deployed to bring care directly to rural communities, ensuring accessibility for those who have limited mobility or transportation options.
Collaboration with local community organizations and stakeholders is essential to understand the unique healthcare needs and develop tailored solutions. Engaging community members in decision-making processes and involving them in healthcare planning can help ensure that the integrated managed care concepts align with the local context.
In summary, integrating managed care concepts in rural areas requires a multifaceted approach that combines technology, collaboration, recruitment incentives, and community engagement. By addressing the specific challenges faced by rural communities, it is possible to improve access to quality healthcare services and promote better health outcomes.
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John Carver was admitted with acute tonsillitis. He was treated with antibiotics and made a full recovery. John has a history of asymptomatic HIV and is maintained on antiviral meds. He is also on medication for hypothyroidism and hypertension. Need to provide the correct ICD 10 codes.
John Carver has a medical history of asymptomatic HIV, hypothyroidism, and hypertension. He was diagnosed with acute tonsillitis and treated with antibiotics.
ICD-10 Codes are as follows:
acute tonsillitis: J03.90
asymptomatic HIV: Z21
hypothyroidism: E03.9
hypertension: I10
ICD-10 codes are used to describe medical conditions and are important for insurance and billing purposes.
J03.90 represents an acute pharyngitis of an unspecified nature, which can include tonsillitis.
Z21 represents a patient who is known to be infected with HIV but is asymptomatic.
E03.9 represents an unspecified hypothyroidism.
I10 represents essential hypertension, which means that there is no underlying medical condition that is causing the high blood pressure.
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Order: theophylline 300 mg PO q6h. The strength available is 150 mg/
15 mL. How many milliliters of this bronchodilator will you administer
to the child? please use full dimensional analysis with units thank you
Answer:
30 ml q6h
Explanation:
The amount of theophylline needed: 300 / (150/15) = 30 ml
Clinically, many medications are administered intravenously. These drugs are often dissolved in NaCl solution. Why can drugs be given safely in NaCl solution but would be deadly if given in KCl solution?
a. KCl can cross the blood-brain barrier to affect the brain, where NaCl cannot.
b. Medications bind to KCl and therefore would not work properly.
c. The K+ ions in KCl would bind to the cell membrane of neurons and prevent the propagation of action potentials.
d. KCl could cause excitable cells to stop transmitting action potentials due to increased K+ in the ECF.
The answer to this question is option D. KCl could cause excitable cells to stop transmitting action potentials due to increased K+ in the ECF. Intravenous administration of medications is a common clinical practice. These medications are usually dissolved in NaCl solution to administer to the patient.
However, it is deadly if given in KCl solution. The reason behind this is that KCl is not an isotonic solution and can increase the potassium ions in the ECF (extracellular fluid), leading to depolarization of the cell membrane which might result in excitable cells to stop transmitting action potentials. As a result, it might cause cardiac arrest. NaCl, on the other hand, is an isotonic solution that balances the electrolyte concentration in the ECF with the concentration of sodium ions.
It doesn't cause depolarization of the cell membrane. Thus, intravenous administration of medication in NaCl solution is safe.
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Demonstrate the proper use of gastrointestinal medical
terms.
Include the following aspects in the discussion:
Add prefixes and suffixes to the root GI term to create
words
Compose a 5-6 sentence par
Gastrointestinal medical terms combine root words, prefixes, and suffixes to create a specialized language for describing digestive system conditions and disorders.
Gastrointestinal (GI) medical terms consist of root words, prefixes, and suffixes. By adding these components, we can create specialized words related to the digestive system. For example, let's consider the root term "gastro" which refers to the stomach.
Adding the prefix "hyper-" (meaning excessive) and the suffix "-emia" (meaning presence in the blood), we form the term "hypergastroemia," which describes an excessive amount of stomach-related substances in the blood.Another example is adding the prefix "hypo-" (meaning deficient) and the suffix "-pepsia" (meaning digestion), resulting in the term "hypopepsia." This term indicates deficient or impaired digestion.By attaching the prefix "sub-" (meaning below) and the suffix "-phagia" (meaning swallowing), we create the term "subphagia." This term describes difficulty in swallowing or a decreased ability to swallow.Adding the prefix "dys-" (meaning abnormal) and the suffix "-enteritis" (meaning inflammation of the intestines) gives us the word "dysenteritis." This term refers to the abnormal inflammation of the intestines.Lastly, let's use the root term "entero" (referring to the intestines) and add the prefix "poly-" (meaning many) and the suffix "-osis" (meaning condition or disease). This results in the term "polyenterosis," indicating a condition or disease involving many areas of the intestines.Learn more about gastrointestinal medical terms at
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A nurse is assessing a client for peripheral vascular disease. What assessment findings would indicate the possible presence of peripheral vascular disease? Select
All That Apply
A. The nurse finds the right foot to be cool and the rest of the leg to be warm.
B. The patient has an increased bleeding time.
C A weak pulse in the right lower extremity.
d The patient has a blister on the left foot.
The assessment findings that would indicate the possible presence of peripheral vascular disease (PVD) include cool right foot, weak pulse in the right lower extremity, and blister on the left foot.
Peripheral vascular disease (PVD) is a condition in which there is a narrowing or blockage of blood vessels that results in reduced blood flow to the limbs. The disease often occurs in the legs and feet, but it can also affect the arms and hands. PVD can be asymptomatic in the early stages, but as the condition worsens, it can cause symptoms such as leg pain, cramping, numbness, tingling, and coldness in the affected limb. In some cases, there may be no pulse or a weak pulse in the affected limb. In this case, the nurse finds the right foot to be cool and the rest of the leg to be warm, which could be an indication of poor blood flow to the foot.
Additionally, a weak pulse in the right lower extremity is another sign of decreased blood flow to the limb. The presence of a blister on the left foot may also indicate peripheral vascular disease, as reduced blood flow can impair the body's ability to heal. Therefore, the assessment findings that would indicate the possible presence of peripheral vascular disease (PVD) include cool right foot, weak pulse in the right lower extremity, and blister on the left foot.
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after prolonged fasting (more than a week), blood glucose is higher than before the fast, and erratic, what is the basis of this?
During prolonged fasting, after a week or more, the blood glucose level increases compared to the level before the fast. The reason behind this erratic rise is gluconeogenesis that is the process by which glucose is generated from non-carbohydrate sources.
The process of gluconeogenesis is the process by which glucose is synthesized from non-carbohydrate precursors in the liver cells. It provides glucose to various tissues when glucose supply is low and energy is required. A few amino acids and fatty acids serve as precursors for the synthesis of glucose in the liver cells. These are either obtained from the muscle or the adipose tissues that have been degraded to produce energy.
Blood glucose level and gluconeogenesis The level of glucose in the blood is essential to maintain a healthy life and to supply energy to the various cells of the body. Gluconeogenesis plays a crucial role in regulating the level of glucose in the blood. During the fast, the body is in need of energy, and the glucose level in the blood decreases. To supply energy to the body, gluconeogenesis becomes active, and glucose is synthesized from non-carbohydrate precursors such as amino acids and fatty acids.
The process of gluconeogenesis continues to keep the glucose level in the blood at an appropriate level. When fasting continues for an extended period, the glycogen stores in the liver also decrease, and the body needs more glucose to provide energy. In such a case, gluconeogenesis may become hyperactive, leading to the production of excess glucose that leads to an erratic increase in the glucose level in the blood.
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Mrs. Thomas, an 82-year-old female, suffered a recent stroke and, as a result, is now having dysphagia (difficulty
swallowing). Her current body weight (CBW) is 88 lbs (40kg) and her usual body weight (UBW) as of 6 months ago was 114
Ibs (52kg). 1. How many pounds did she lose over the course of the past 6 months? Round up/down and enter answer as a whole
number only, no other characters. Example: 14.10 would be entered as 14.
Ibs 2. About what percentage of her UBW did she lose? Round up/down and enter answer as a whole number only, no
other characters. Example: 14.10 would be entered as 14.
%
3. Would her weight loss be categorized as significant or severe? Enter answer as one word only.
Mrs. Thomas who suffered from stroke and is now facing dysphagia experienced a severe weight loss of 26 pounds with 23% loss of UBW.
1. The amount of pounds in her weight loss that Mrs. Thomas has suffered over the past 6 months due to stroke with symptoms of dysphagia now can be calculated by subtracting her current body weight (CBW) from her usual body weight (UBW), which is as follows:
UBW-CBW = (114-88) lbs = 26 lbs.
Therefore, she has lost 26 pounds over the duration of the past 6 months.
2. To calculate the percentage of UBW lost, we need to divide the weight she lost (UBW-CBW = 26 pounds) by her UBW (114 pounds), and then multiply it by 100 in order to obtain a percentage by using the formula:
Percentage of weight loss = ((UBW-CBW) / UBW) x 100%
= ((114-88)lbs / 114lbs) x 100%
=(26/114) x 100% = 22.8% (rounded to the nearest whole number ≈ 23%).
Therefore, she has lost about 23% of her UBW.
3. The weight loss that Mrs. Thomas suffered would be categorized as severe since she has lost more than 20% of her Usual Body Weight (UBW) over the past 6 months.
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Discuss the three tasks; conform and identify potential users
and adopters, specify performance objectives and determinants of
adoption, implementation and sustainability.
Conforming and identifying potential users and adopters is the first task when implementing a new system ensuring it conforms to the organization's goals. The system should meet the goals, whether it is a new or an existing design.
The three tasks that are usually performed by organizations while implementing a new system are identification, meeting, and implementing the goals in an organization.
Once it conforms the potential users and adopters of the system should be identified. The group of users likely to benefit from the system is referred to as adopters.
Specify performance objectives and determinants of adoption: This task involves setting performance objectives for the new system. The new system is designed to meet the organization's performance requirements. The determinants of adoption are also specified. These features and functions will make the system attractive to potential users.
Implementation and sustainability: the process of developing, testing, and deploying the system is called implementation. It is done in such a way that it does not disrupt the operation of the organization. Once the system is deployed, it must be sustained to ensure that it continues to meet the organization's goals. The system must be maintained and updated regularly to keep up with changes in technology, business requirements, and user needs.
Early adopters, people who value newness and innovation:
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Calculation of Medications Used Intravenously cont. 3. A physician orders 3,000 mL lactated Ringer's solution to infuse over 16 hours. How many milliliters per hour should be administered?
The lactated Ringer's solution should be administered at a rate of approximately 187.5 milliliters per hour.
To calculate the milliliters per hour (mL/hr) for the lactated Ringer's solution, follow these steps:
Step 1: Determine the total volume of the solution.
Given that the physician ordered 3,000 mL of lactated Ringer's solution.
Step 2: Determine the infusion time.
Given that the infusion is to be completed over 16 hours.
Step 3: Calculate the milliliters per hour.
Divide the total volume by the infusion time:
Ml/hr = Total volume (mL) / Infusion time (hours)
Substituting the given values:
Ml/hr = 3,000 mL / 16 hours
Step 4: Perform the calculation.
Divide 3,000 mL by 16 hours:
Ml/hr = 3,000 mL / 16 hours
Ml/hr ≈ 187.5 mL/hr
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ThemostcommoncauseofCOPDis
A. Bronchiectasis
B. Severe tuberculosis
C. Chronic bronchitis
D. Idiopathic pulmonary fibrosis
E. Bronchogenic carcinoma
COPD is a lung disease that obstructs airflow and makes breathing difficult. The disease is progressive, which means that it worsens over time. COPD affects people's breathing by causing shortness of breath, coughing, wheezing, and chest tightness.
The most common cause of COPD is chronic bronchitis.Chronic bronchitis is a chronic lung disease that causes inflammation of the bronchial tubes, which are responsible for carrying air to and from the lungs. This inflammation causes the bronchial tubes to become swollen and narrow, making it difficult for air to pass through them. Chronic bronchitis is caused by exposure to cigarette smoke, air pollution, or other irritants that damage the lining of the bronchial tubes.Other causes of COPD include emphysema, asthma, and exposure to secondhand smoke.
Emphysema is a disease that damages the air sacs in the lungs, which reduces the amount of oxygen that can be exchanged. Asthma is a chronic lung disease that causes the airways to become inflamed and narrowed, making it difficult to breathe. Secondhand smoke is the smoke that is exhaled by smokers, and it contains many of the same harmful chemicals as cigarette smoke. Overall, chronic bronchitis is the most common cause of COPD.
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Remember that assignments are to be handed in on time - NO EXCEPTIONS. Chronic obstructive pulmonary disorder(COPD) is a major chronic disease. What are the things that we do to manage COPD? What makes this disease so hard to manage?
COPD is a major chronic disease which is managed through medication, pulmonary rehabilitation, and lifestyle modifications. It is hard to manage because it is progressive, incurable, and affects multiple body systems.
Chronic obstructive pulmonary disorder (COPD) is a chronic and progressive lung disease that can make breathing difficult. There is no cure for COPD, but a number of interventions can be used to manage it.
COPD management involves medication, pulmonary rehabilitation, and lifestyle modifications. Medications may include bronchodilators, which help relax the airways, and corticosteroids, which help to reduce inflammation in the lungs. Pulmonary rehabilitation may involve exercise training, breathing techniques, and education on how to manage the disease.
Lifestyle modifications may include quitting smoking, avoiding air pollution and lung irritants, eating a healthy diet, and staying physically active. However, despite the interventions available, COPD can be hard to manage because it is progressive and incurable, and affects multiple body systems. As the disease progresses, breathing difficulties may become more severe, and individuals may experience fatigue, weight loss, and other complications.
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Problem solving frameworks Conduct research to identify and summarise and explain the following problem-solving frameworks used in nursing care: HEIDIE . TIME Your answer should be between 300-400 words in length,
In nursing care, problem-solving frameworks are critical in addressing the issues that patients face. Two of the most common problem-solving frameworks are HEIDIE and TIME. These frameworks help nursing professionals to identify the root causes of the problems and to come up with an effective solution to the problem.
HEIDIE is an acronym for identifying, exploring, developing, implementing, and evaluating. The first step in the HEIDIE problem-solving framework is to identify the issue. The nursing professionals use their assessment skills to determine the problem and the factors that led to the problem. The next step is to explore the possible solutions to the problem. In this step, the nursing professional uses research to gather information about the possible solutions to the problem. The third step is to develop a plan to address the problem. In this step, the nursing professional develops a care plan that outlines the steps that need to be taken to address the problem.
The second step is to identify the type of problem. In this step, the nursing professional uses their assessment skills to determine the type of problem that the patient is facing. The third step is to mitigate the impact of the problem. In this step, the nursing professional takes steps to minimize the impact of the problem on the patient. The last step is to empower the patient. In this step, the nursing professional works with the patient to develop a care plan that empowers the patient to manage their problem on their own.
In conclusion, the HEIDIE and TIME problem-solving frameworks are critical in nursing care. These frameworks help nursing professionals to identify the root causes of the problems and to come up with an effective solution to the problem.
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When there is a decline in blood flow, the hormone renin can be released. Which organ secretes this hormone? O Heart Pancreas Kidney O Liver
When there is a decline in blood flow, the hormone renin can be released by the kidney.
The correct answer is Kidney
Renin is an enzyme that helps regulate blood pressure in the body. It is secreted by the kidneys when blood volume and/or blood pressure are low, and it converts the precursor molecule angiotensinogen into angiotensin I, which is then converted to angiotensin II by angiotensin-converting enzyme (ACE).This reaction produces angiotensin II, which is a potent vasoconstrictor. Angiotensin II constricts blood vessels, resulting in an increase in blood pressure. This causes the adrenal gland to release aldosterone, which promotes the retention of sodium and water in the body, increasing blood volume and restoring blood pressure.
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Which of the following is true about hostility directed at pregnant working women? A. The stereotypes of mothers and pregnant women is that they are less committed to their work, which is found to be a truthful stereotype. B. Employers worry about decreased productivity. C. Employers still worry about how much it will cost in maternity leave, but that is now not an issue in the US because the government pays for parental leaves. D. A, B, & Care all correct answers,
The following is true about hostility directed at pregnant working women: B. Employers worry about decreased productivity. Hostility directed at pregnant working women are real and exists in the workplace. According to studies, pregnant women are perceived as less committed to their
work and are often targets of hostile behaviors directed at them by their coworkers. This is due to stereotypes of mothers and pregnant women that are often not truthful. Pregnancy discrimination can lead to decreased productivity and increases costs associated with replacing skilled workers.
Employers who discriminate against pregnant women can face legal action and penalties. Maternity leave is still a major concern for employers, particularly small business owners who may not be able to afford the costs associated with providing paid leave. The government does not provide paid parental leave in the US, but some employers do offer it as part of their benefits package.
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QUESTION 24 The first requirement for any MCO that wants to offer Medicare Advantage is to be licensed_________in which it operates. In the Borough In the county In the state and certified with local chapters 1:15 PM
The first requirement for any MCO that wants to offer Medicare Advantage is to be licensed C. In the state which it operates.
What is the first requirement for an MCO?The first requirement for any MCO that wants to offer Medicare Advantage is to be licensed in the state in which it operates. This is because Medicare Advantage plans are regulated by the states, not by the federal government.
In addition to being licensed in the state, MCOs must also be certified by the Centers for Medicare & Medicaid Services (CMS). CMS certification ensures that MCOs meet certain standards of quality and financial stability.
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Discuss Cesar Chavez and his impact on California also what were
Cesar Chavez's views on immigration? 1 page, please
Cesar Chavez was a prominent American labor leader and civil rights activist who had a significant impact on California, particularly in relation to farm workers' rights.
What is the view?
He was a proponent of better working conditions, just pay, and improved treatment for agricultural employees and co-founded the United Farm Workers (UFW) organization.
Chavez's initiatives were essential in bringing attention to the struggles faced by farm workers and in uniting them to fight for their rights. Chavez and the UFW intended to better the lives of farm workers and draw attention to their issues through nonviolent rallies, strikes, and boycotts.
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Cesar Chavez was an American labor leader and activist who co-founded the United Farm Workers (UFW) in 1962. He was born on March 31, 1927, in Yuma, Arizona, and passed away on April 23, 1993, in San Luis, Arizona.
Cesar Chavez's impact on California, Cesar Chavez's most significant impact was his role as a labor leader in California's agricultural sector. He worked to promote and protect the rights of farm workers, such as wages, benefits, and better working conditions. His work led to the creation of the National Farm Workers Association, which later became the United Farm Workers. Cesar Chavez's leadership also led to the establishment of the California Agricultural Labor Relations Act in 1975. The act provided farm workers with collective bargaining rights, which meant that they could negotiate better pay, working conditions, and benefits.
Cesar Chavez's views on immigration, Cesar Chavez was the son of migrant farmworkers and grew up as a migrant farmworker himself. He recognized that many farmworkers were undocumented immigrants who worked under terrible conditions and often suffered abuse from their employers. As a result, Cesar Chavez was an advocate for undocumented immigrants. He believed that they deserved the same rights and protections as other workers. He worked to make sure that farmworkers were treated humanely and paid fairly. He also believed that undocumented immigrants should be given the chance to become legal residents and that the government should provide a path to citizenship for those who wanted it. In conclusion, Cesar Chavez was a labor leader and activist who worked to promote and protect the rights of farmworkers in California. He played a significant role in creating the United Farm Workers, and his leadership led to the establishment of the California Agricultural Labor Relations Act. He was also an advocate for undocumented immigrants, believing that they deserved the same rights and protections as other workers.
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you
are a gametic stem cell, decribe step by step how you develop into
a spermatozoon, then describe the path you will take as a
spermatozoon to the outside world
Gametic stem cells undergo mitotic division, followed by meiosis to form spermatozoa. Mature spermatozoa travel through the epididymis, ductus deferens, and urethra, and are ejaculated for potential fertilization.
As a gametic stem cell, my journey toward becoming a spermatozoon, or a mature sperm cell, involves several steps:
Mitotic Division: I undergo mitotic divisions, also known as spermatogonial divisions, which result in the production of identical stem cells called primary spermatocytes.
Meiosis I: The primary spermatocytes undergo meiosis I, a reduction division. During this process, the chromosomes pair up and exchange genetic material through a process called crossing over. This results in the formation of two haploid secondary spermatocytes.
Meiosis II: Each secondary spermatocyte then undergoes meiosis II, resulting in the formation of four haploid spermatids. At this point, the spermatids contain half the number of chromosomes as the original gametic stem cell.
Spermiogenesis: The spermatids then undergo spermiogenesis, a process of maturation and differentiation. During this phase, the spermatids undergo significant structural changes to develop into spermatozoa.
As a mature spermatozoon, I am now ready to embark on my journey toward the outside world to potentially fertilize an egg. Here is the path I will take:
Epididymis: I move from the testes into the epididymis, a coiled tube located on the posterior surface of the testes. Here, I undergo further maturation and gain the ability to swim.
Ductus Deferens: From the epididymis, I enter the ductus deferens, also known as the vas deferens. The ductus deferens is a muscular tube that transports sperm from the epididymis to the ejaculatory duct.
Ejaculatory Duct: The ductus deferens merge with the seminal vesicle to form the ejaculatory duct. This duct passes through the prostate gland and carries sperm and seminal fluid into the urethra.
Urethra: The urethra serves as a common pathway for both urine and sperm. I travel through the urethra and eventually reach the external urethral opening.
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What is the relationship between the Endocrine system and
Autoimmune disorders?
The endocrine system and the immune system are closely connected, and maintaining a healthy immune system is essential for maintaining a healthy endocrine system.
The endocrine system is a series of glands that produce and secrete chemical messengers called hormones that regulate a variety of body functions. These hormones are released into the bloodstream and travel throughout the body and signal the organs and tissues to perform their designated functions.
The immune system is the body's defense system, which is made up of various cells, tissues, and organs to protect the body from harmful pathogens like viruses, and bacteria. Autoimmune disorders arise when the immune system mistakenly attacks healthy cells in the body.
The endocrine system and the immune system are connected and it has a significant impact on the endocrine system. Many autoimmune disorders such as type 1 diabetes, thyroiditis, and Addison's disease can damage the endocrine system by attacking the glands that produce hormones. As a result, this can lead to hormone imbalances and related health issues.
The main function of the endocrine system:
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One important aspect of interprofessionalism is for all team members to have the ability and confidence to contribute to decisions about patient care regardless of hierarchy/profession-based boundaries.
How do hierarchies affect the delivery of patient care?
How can you be mindful of hierarchies or traditional boundaries between professions in the future?
One important aspect of interprofessionalism is for all team members to have the ability and confidence to contribute to decisions about patient care regardless of hierarchy/profession-based boundaries.
Hierarchies affect the delivery of patient care in the sense that these systems create certain professional expectations that a team member of a particular position should or should not do something. This ultimately creates an environment where the overall quality of care may be jeopardized if the healthcare worker does not feel comfortable sharing their thoughts. A lack of communication due to fear of crossing professional boundaries may lead to misunderstandings that could affect patient care negatively.
To be mindful of hierarchies or traditional boundaries between professions in the future, one may need to start by acknowledging the significant role of each member of the health team in patient care. One could respect each other's professions and value each other's input in patient care. Effective interprofessional collaboration requires an attitude of mutual respect for different professions and recognition of the value of diverse perspectives.
Thus, effective communication is the key to achieving better teamwork among professionals. One should keep in mind that no one profession is more important than the other and that the care of the patient is the primary focus of the healthcare team.
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All questions apply to this case study. Your responses should be brief and to the point. When asked to provide several answers, list them in order of priority or significance. Do not assume information that is not provided. SITUATION: L.S. is a 7-year-old who has been brought to the emergency department (ED) by his mother. She immediately tells you he has a history of ED visits for his asthma. He uses an inhaler when he wheezes, but it ran out a month ago. She is a single parent and has two other children at home with a babysitter. Your assessment finds L.S. alert, oriented, and extremely anxious. His color is pale, and his nail beds are dusky and cool to the touch; other findings are heart rate 136 beats/min, respiratory rate 36 breaths/min regular and even, oral temperature 37.3" C (99.1* F). Sa02 89%, breath sounds decreased in lower lobes bilaterally and congested with inspiratory and expiratory wheezes, prolonged expirations, and a productive cough. QUESTIONS: 1. As you ask Ms. S. questions, you note that LS.'s respiratory rate is increasing; he is sitting on the side of the bed, leaning slightly forward, and is having difficulty breathing. Give interventions are appropriate at this time and rationalize it. 2. Identify the nursing responsibilities associated with giving bronchodilators,
1. The appropriate interventions and their rationales in response to L.S. respiratory rate increase, difficulty in breathing and wheezing.
As soon as you have discovered that L.S. is having difficulty breathing and respiratory rate increasing, it is critical to act quickly to avoid further deterioration in his condition. Below are some of the appropriate interventions that should be taken and their rationales: Elevate the head of the bed: Elevating the head of the bed is beneficial in decreasing the workload on L.S.'s respiratory system.
It promotes optimal chest expansion and reduces shortness of breath. It is beneficial to keep L.S. in a semi-Fowler's position as it helps the chest muscles relax and improve oxygenation. Sit him in an upright position: This will facilitate his breathing by allowing his chest muscles to work efficiently and decreasing the work of breathing.
Oxygen administration: The oxygen should be given through a face mask at the rate of 6-8 L/min to L.S. since his SpO2 is low. Adequate oxygen administration will help L.S. breathe and increase oxygen delivery to tissues.
Bronchodilators administration: Since L.S. has a history of asthma, bronchodilators (such as albuterol) should be administered to him through a nebulizer to help alleviate the wheezing and restore normal breathing patterns. Bronchodilators work to dilate the airways and allow better ventilation.
Periodic assessment: Continuous monitoring of his vital signs, especially the respiratory rate, heart rate, and blood pressure, will help detect any deterioration in his condition early and prompt intervention.
Frequent assessment of breath sounds is essential to evaluate the effectiveness of interventions and adjust them accordingly.
2. The nursing responsibilities associated with giving bronchodilators:
Bronchodilators are medications used to help dilate airways in the lungs and ease breathing. Below are the nursing responsibilities associated with giving bronchodilators:
Verify the correct medication: It is essential to check the medication name, dose, and expiry date before giving it to the patient.
Ensure that it is the correct medication and dose that has been prescribed.
Administer the medication as per the doctor's orders: This involves placing the medication into the nebulizer cup and administering it via a nebulizer. You must monitor the patient's vital signs and observe for any adverse reactions that may occur.
Documentation: It is essential to document the administration of medication and any adverse reactions that may occur. The documentation should include the date, time, medication, dose, route of administration, and patient's response to the medication. This documentation will help track the patient's progress and adjust the medication regimen accordingly.
Inform the patient:
Before administering bronchodilators, you must inform the patient about the medication, its purpose, and any potential side effects that may occur.
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What are your
responsibilities as a health care worker in caring for someone who
has any significant change in their vital signs?
My responsibilities revolve around timely assessment, continuous monitoring, accurate documentation, effective communication, appropriate interventions, and compassionate patient care to address any significant changes in vital signs.
As a healthcare worker, my responsibilities in caring for someone who has any significant change in their vital signs are crucial in ensuring their well-being. Here are some key responsibilities:
Assessment: I will promptly assess the patient's vital signs, including heart rate, blood pressure, respiratory rate, and temperature, to determine the extent and nature of the change. This helps in identifying any immediate threats to the patient's health.
Monitoring: I will closely monitor the patient's vital signs at regular intervals to track any further changes or trends. This continuous monitoring enables early detection of any deterioration or improvement in their condition.
Documentation: Accurate and timely documentation of the patient's vital signs is essential. This includes recording the values, time of measurement, and any associated symptoms or interventions.
Such documentation aids in communication with other healthcare professionals and helps track the patient's progress.
Communication: I will communicate any significant changes in the patient's vital signs to the healthcare team, including physicians, nurses, and other relevant staff. Effective communication ensures a coordinated response and appropriate interventions for the patient.
Interventions: Based on the specific vital sign changes, I may need to initiate appropriate interventions. This can include administering medications, adjusting oxygen levels, initiating resuscitative measures, or calling for urgent medical assistance.
Patient comfort and support: I will provide emotional support and reassurance to the patient during the assessment and monitoring process. Maintaining their comfort and addressing any concerns helps promote their well-being and aids in their recovery.
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Why do you think ICD 9 was change to ICD 10? How many codes were
in ICD 9 versus ICD 10.
ICD-9 was changed to ICD-10 to improve accuracy, specificity, and international compatibility in medical coding.
Accuracy and specificity: ICD-9 had limited space for new codes and lacked detail, leading to less accurate representation of diagnoses and procedures.
ICD-10 offers a more comprehensive classification system with greater specificity, enabling healthcare providers to capture a wider range of conditions and procedures in a more accurate manner.
Advancements in medical knowledge and technology: With medical advancements, the need for more detailed and specific codes became evident.
ICD-10 accommodates these advancements by providing an expanded set of codes that reflect the current understanding of diseases, treatments, and procedures.
International compatibility: ICD-9 was primarily used in the United States, making it difficult to exchange and compare healthcare data on an international scale. ICD-10 aligns with global standards, allowing for better international data exchange, research collaboration, and analysis.
Increased number of codes: ICD-9 had approximately 13,000 diagnosis codes and 3,000 procedure codes. In contrast, ICD-10 expanded significantly to around 68,000 diagnosis codes and 87,000 procedure codes.
This expansion enables healthcare providers to capture more specific and detailed information, resulting in improved patient care, research, and healthcare management.
By transitioning to ICD-10, the healthcare industry sought to address the limitations of ICD-9 and ensure that medical coding adequately reflects the evolving nature of healthcare practices.
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Mr. Stellas is a 54-year-old man with a known history of alcoholism. He has been admitted numerous times to the hospital. Today he is again admitted with complications of
cirrhosis.
What assessment findings should the nurse anticipate?
Mr. Stellas is a 54-year-old man with a known history of alcoholism. He has been admitted numerous times to the hospital. Today he is again admitted with complications of cirrhosis.
The assessment findings that the nurse should anticipate in Mr. Stellas, as a result of the complications of cirrhosis, include:
Yellowing of the skin and eyes (jaundice), Ascites (build-up of fluid in the abdomen), Fatigue and weakness, Loss of appetite, Nausea and vomiting, Spider angiomas (spider-shaped blood vessels under the skin), weight loss, bruising, Itching, confusion, and coma if liver function worsens further.
In cases where Mr. Stellas' condition has progressed to acute liver failure, there may be symptoms of hepatic encephalopathy (HE), including confusion, irritability, agitation, seizures, and eventually coma if left untreated.
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SLo 9: Applies advanced communication skills and processes to collaborate with caregivers and professiona to optimize health care outcomes for adults with acute, critical, or complex chronic illnesses. 12. Identify use of internal or external agencies and resources to improve
As part of the learning outcome SLo 9, to apply advanced communication skills and procedures to work with caregivers and professionals to improve healthcare outcomes for adults with acute, severe, or complex chronic diseases, identifying the use of internal or external agencies and resources to enhance healthcare services is critical.
Internal agencies refer to the various departments or sections that are part of an organization. Internal agencies offer their expertise and services within an organization, and they can work in collaboration to ensure that health care outcomes are optimal for adults with acute, critical, or complex chronic diseases.Internal agencies that collaborate to improve healthcare outcomes are hospital systems, health plans, and government agencies. They also incorporate the expertise of a diverse group of professionals, including nurses, doctors, pharmacists, and other health professionals.External agencies refer to organizations outside the healthcare industry that can work with healthcare organizations to improve healthcare outcomes. They can provide guidance and support, as well as assist in implementing new technologies or procedures to improve healthcare outcomes. Such organizations include community resources, rehabilitation centers, and advocacy groups that offer support and guidance for adults with acute, severe, or complex chronic diseases.Identifying internal or external agencies and resources to improve healthcare services will lead to better healthcare outcomes for adults with acute, critical, or complex chronic diseases. By involving a variety of healthcare professionals and organizations, health care outcomes will be optimized.
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David Montanari is a 19-year-old male who suffered a T4-T5 burst fracture and a right scapula fracture as a result of a motorcycle accident on Sunday. He underwent spinal fusion on Sunday evening and has had an uneventful recovery period. David has no sensation or movement below the nipple line and is bedbound. He is frustrated and anxious about his condition and is refusing postoperative interventions, including pain medication and the use of the incentive spirometer. The scenario takes place Wednesday at 08:00 during the morning nursing assessment.
Charge Nurse (1):
The charge nurse is responsible for ensuring safe, quality patient care. You are the team leader and serve as a resource to all interdisciplinary members and are responsible for the appropriate delegation of duties. You will serve as the point person for communication and can anticipate speaking with the physician or other primary care provider, ancillary support services, and others directly involved with the care being provided. You must be knowledgeable about the patient’s condition and able to dictate orders obtained and assist with implementation if needed. Additionally, be prepared to prioritize care and anticipate future needs.
Documentation Nurse (1):
The documentation nurse is responsible for recording all patient event activities during the simulation with the exception of medication administration. You are responsible for documenting within SimChart® assessments, interventions, and outcomes on the designated tool (paper or electronic). Be prepared to read back and verify your documentation when requested and/or clarify the details. Additionally, you will be part of the interdisciplinary team and will contribute observational assessment findings including but not limited to changes in vital signs, alerts, psychosocial needs, and anticipated care.
Assessment Nurse (1):
The assessment nurse is responsible for overseeing a comprehensive assessment of the patient. This includes but is not limited to obtaining vital signs, head-to-toe assessment of all systems, and psych/social assessment of the patient. You will be prioritizing care, executing independent interventions, collaborating with interdisciplinary team members, anticipating the needs of the patient/family, and re-assessing or continually monitoring the patient for any changes in condition. You are responsible for implementing all non-medication-related interventions, verbalizing your findings to the team, and recommending any actions/interventions required. Additionally, you will be providing appropriate education to the patient and family/significant others.
Medication Nurse (1):
The Medication Nurse is responsible for all actions and documentation related to the safe administration of medications. You will identify and correct any medication errors related to prescribing or distribution. This may include speaking with the physician or primary care provider. Prior to administering medication, you will assure the "Rights of Medication Administration". You must be knowledgeable regarding the action and expected effects of the medications being administered and are responsible for monitoring and reporting any adverse reactions or unforeseen consequences of administration. Part of your role includes verifying medication calculations with a colleague and identifying any incompatible drug combinations.
Observer Nurse:
The observer is a non-participant role and will not communicate directly with the simulation team. The observer nurse will view the simulation in the briefing room through Learning Space as it is occurring. There may be multiple observer nurses in each scenario. The observer nurse will be given an observation guide to complete during the simulation. The data you collect will help the team during the debriefing process and facilitate an open and active discussion regarding the simulation experience. You will be an active participant in the debriefing and will be encouraged to share your observations and thoughts. Please keep in mind that your observations should be conveyed in a respectful, educational manner. The goal is to work together as colleagues in providing safe and effective care.
Questions:
1) What are three nursing interventions for a post-operative patient?
2) What patient findings might you notice for a patient with immobility issues?
3) Describe complications that can occur as a result of immobility for all body systems.
Three nursing interventions for a post-operative patient are: Proper positioning: A postoperative patient's position should be changed regularly to prevent the formation of pressure ulcers or bedsores, improve respiratory function, and reduce the risk of thrombosis.
1) Three nursing interventions for a post-operative patient are: Proper positioning: A postoperative patient's position should be changed regularly to prevent the formation of pressure ulcers or bedsores, improve respiratory function, and reduce the risk of thrombosis. Prevention of infection: A postoperative patient should be kept clean and dry to prevent the formation of infections. Hand hygiene should be practiced before and after every patient interaction and the patient's skin should be inspected for any redness or swelling. The nurse should teach the patient and family members about the importance of hand hygiene and how to maintain a clean environment.
Pain management: A postoperative patient should be assessed for pain regularly. The nurse should assess the patient's pain level, provide pain medication as ordered, and use nonpharmacological interventions such as relaxation techniques to reduce the patient's pain. The nurse should teach the patient about the importance of pain management and how to report any unrelieved pain.
2) For a patient with immobility issues, some patient findings might include the following:
Difficulty moving or turning in bed
Weakness
Decreased appetite or loss of appetite
Decreased bowel movements or constipation
Pressure ulcers or bedsores
Decreased skin turgor or edema
Decreased range of motion in joints
Decreased muscle tone or muscle atrophy
3) Complications that can occur as a result of immobility for all body systems are:
Musculoskeletal system: muscle atrophy, joint contractures, bone demineralization, and osteoporosis.
Cardiovascular system: thrombus formation, venous stasis, orthostatic hypotension, and decreased cardiac output.
Respiratory system: decreased oxygenation, respiratory secretions accumulation, and pneumonia.
Gastrointestinal system: decreased appetite, decreased bowel movements, and constipation.
Integumentary system: pressure ulcers or bedsores, and impaired wound healing.
Renal system: urinary stasis, urinary incontinence, and urinary tract infections.
Nervous system: depression, anxiety, and sleep disturbances.
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A nurse is assigned to care for a patient who is suspected of having type 2 diabetes. Select all the clinical manifestations that the nurse knows could be consistent with this diagnosis.
Type 2 diabetes is a type of diabetes in which the body becomes resistant to insulin, resulting in high levels of sugar in the bloodstream. When caring for a patient with suspected type 2 diabetes, it is important for the nurse to be aware of the clinical manifestations that may be consistent with this diagnosis.
These clinical manifestations include the following:
1. Frequent urination: This is one of the most common symptoms of diabetes. When the body is unable to regulate the amount of sugar in the bloodstream, the kidneys work overtime to flush out the excess sugar, resulting in frequent urination.
2. Increased thirst: Because the body is losing so much fluid through frequent urination, the patient may feel constantly thirsty.
3. Blurred vision: High levels of sugar in the bloodstream can cause the lens of the eye to swell, resulting in blurred vision.
4. Fatigue: When the body is unable to use glucose for energy, it may turn to fat as an alternative source of energy, resulting in fatigue.
5. Slow-healing sores or cuts: High levels of sugar in the bloodstream can affect the circulation, which can lead to slow-healing sores or cuts.
6. Tingling or numbness in the hands or feet: Diabetes can cause damage to the nerves, resulting in tingling or numbness in the hands or feet.
7. Recurrent infections: High levels of sugar in the bloodstream can weaken the immune system, making the patient more susceptible to infections.
8. Unexplained weight loss: When the body is unable to use glucose for energy, it may turn to fat as an alternative source of energy, resulting in unexplained weight loss.
I hope that helps you.
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Which of the following patients is most likely to be having an ACUTE myocardial
infarction? A> A patient with ST segment elevation, high serum troponin and high CK-MB
levels
B A patient with peripheral edema and a low BNP blood level
C. A patient with a low p02, low SAO2, and absent breath sounds on the left side D.• A patient with burning pain in the umbilical region and high conjugated serum
bilirubin
The most likely patient having an acute myocardial infarction is A: a patient with ST segment elevation, high troponin, and high CK-MB levels.
The most probable patient to have an intense myocardial dead tissue (AMI) is A: a patient with ST portion height, high serum troponin, and high CK-MB levels. ST section rise on an electrocardiogram (ECG) is a trademark indication of AMI and shows myocardial harm. Raised degrees of troponin and CK-MB in the blood are explicit markers delivered during heart muscle injury, further supporting the analysis of AMI.
Choice B, a patient with fringe edema and low BNP blood levels, is more demonstrative of cardiovascular breakdown as opposed to an intense myocardial localized necrosis. Choice C, a patient with low pO2, low SaO2, and missing breath sounds on the left side, proposes a potential lung pathology like pneumothorax or intense respiratory pain disorder. Choice D, a patient with consuming torment in the umbilical locale and high formed serum bilirubin, is more predictable with gallbladder or liver pathology as opposed to an intense myocardial localized necrosis.
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Given the biomedical model of healthcare and considering the rapidly-paced healthcare environment that limit providers by time constraints, providers may be provider- or disease-centric in an effort to quickly diagnose at the expense of recognizing the patient may have needs or goals that are not disease/provider focused. As such:
Providers may prioritize efficiency and diagnosis over recognizing the patient's needs and goals in the biomedical model of healthcare.
Given the biomedical model of medical care and the time limitations in the quickly paced medical services climate, suppliers might focus on effectiveness and determination over perceiving the patient's more extensive necessities and objectives. This methodology, known as supplier or infection driven care, centers basically around recognizing and treating the illness, frequently disregarding the patient's singular requirements, inclinations, and objectives. It might prompt an absence of patient-centeredness and an inability to address the comprehensive prosperity of the patient. Perceiving and tending to the patient's requirements past the illness driven point of view is significant for giving far reaching and patient-focused care that thinks about the patient overall individual with special qualities and conditions.
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Nutritional Issues The client is diagnosed with pnuemonia and is prescribed intravenous antibiotics for treatment. The client's swallow study determined that she should be on honey thick liquids and pureed foods. The spouse comes to visit the client and notices the "Swallow Precautions - thickened liquids" sign and asks the nurse what it means. The nurse explains since the client does not have adequate swallowing ability so thin liquids may go into the trachea and then the lungs instead of the stomach and cause pneumonia. Suddenly, the spouse gets a shocked look on his face and says, "Oh, no! I did that. I gave her pneumonia?" Question 5 of 23 What is the nurse's best response? O"How was she positioned when you fed her?" "Saliva entering the lungs can also cause pneumonia. And you did not have a way of knowing she was aspirating." "You know you did the best you could." "We know it was not intentional on your part."
The nurse's best response would be, "Saliva entering the lungs can also cause pneumonia. And you did not have a way of knowing she was aspirating." It is important for the nurse to provide accurate information and reassurance to the spouse, addressing their concern without placing blame or guilt on them.
By explaining that saliva can also cause pneumonia and emphasizing that the spouse could not have known about the aspiration, the nurse acknowledges the situation while providing understanding and support. Aspiration pneumonia can occur when foreign substances, such as food, liquid, or saliva, are inhaled into the lungs instead of being swallowed into the stomach. In this case, the client's swallow study determined that she should have honey thick liquids and pureed foods due to inadequate swallowing ability. The nurse's response acknowledges that the spouse was not aware of the aspiration risk, as it is not always easy to detect. Furthermore, the nurse educates the spouse that saliva can also lead to pneumonia when it enters the lungs. This information helps to alleviate the spouse's guilt and emphasizes that the situation was not intentional or solely caused by their actions.
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