It is important for healthcare professionals to provide support and validation to individuals experiencing grief, helping them cope with their emotions and facilitating the healing process.
An expected finding in a client experiencing an uncomplicated grief reaction is persistent dysphoria. Dysphoria refers to a general feeling of sadness, unhappiness, or emotional discomfort. It is commonly experienced during the grieving process as individuals mourn the loss of a loved one or experience other significant losses.
While anger and low self-esteem can be part of the grief process for some individuals, they are not typically considered expected findings in an uncomplicated grief reaction.
Openly expressing anger may occur in certain cases, especially if the client is dealing with complex emotions or struggles with unresolved issues related to the loss. Low self-esteem can also emerge if the individual experiences feelings of guilt, self-blame, or a sense of inadequacy in relation to the loss.
However, persistent dysphoria is a more characteristic and commonly observed feature of uncomplicated grief reactions. It reflects the deep sadness and emotional distress that individuals often experience as they navigate the grieving process.
Thus, it is important for healthcare professionals to provide support and validation to individuals experiencing grief, helping them cope with their emotions and facilitating the healing process.
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mr. f has advanced cancer with bony metastasis and is not responsive. his son is caring for him at home. you are teaching him about assessing his father's pain. what statement indicates an understanding of his father's pain status?
The statement "I will look for nonverbal signs of pain such as facial grimacing or restlessness" indicates an understanding of his father's pain status.
Assessing pain in a non-responsive patient requires the caregiver to rely on nonverbal cues and observations. In the given scenario of cancer of his father, the son is being taught how to assess his father's pain. Understanding his father's pain status involves recognizing nonverbal signs that may indicate pain, such as facial expressions of distress like grimacing, restlessness, agitation, or changes in body movements. These nonverbal cues can provide important insights into the presence and intensity of pain, allowing the son to provide appropriate care and interventions to manage his father's pain effectively. By expressing the intention to look for nonverbal signs of pain, the son demonstrates an understanding of the need to observe and interpret these cues to assess his father's pain status.
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member of the resuscitation team is preparing to administer medications intravenously to a patient in cardiac arrest. the team member should follow each peripherally administered drug dose with a normal saline flush. how much would the team member give?
The practice of normal saline flushes after each medication dose, the healthcare team ensures optimal medication delivery, minimizing any potential complications and maximizing the chances of a successful outcome for the patient in cardiac arrest.
When administering medication intravenously to a patient in cardiac arrest, it is important for the team member to follow each peripherally administered drug dose with a normal saline flush. The purpose of a normal saline flush is to facilitate the medication's passage through the tubing and into the vein, ensuring that the patient receives the full dose of the medication. The specific amount of saline flush administered depends on the medication being given.
As per the guidelines provided by the American Heart Association, a flush of 20 mL of normal saline should be given after each medication dose. This practice guarantees effective delivery of the medication to the patient and helps clear any residual medication from the tubing, ensuring it reaches the vein. In certain situations, the flush volume may be adjusted based on factors such as the medication type, the patient's age and weight, and other considerations that could influence the medication's effectiveness. It is crucial to adhere to the dosage and administration instructions provided by the medication manufacturer and to consult with a healthcare provider if any questions or concerns arise regarding medication administration.
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what's a way that some offices manage power outages with ehr? close clinic for the day, wait to see patients until power is restored, no documentation performed, use paper documentation
In the event of power outages, offices that rely on Electronic Health Records (EHR) for record-keeping and patient care management need to adopt different strategies. One such approach is to resort to using paper documentation.
Electronic Health Records (EHR) are computerized systems that store and manage up-to-date patient information in an organized and easily accessible manner. They contain medical histories, treatment records, and lab results, replacing traditional paper records and enhancing accuracy, completeness, and efficiency.
When faced with power outages, offices relying on EHR can manage the situation through various methods:
1. Use paper documentation: If the power outage persists, clinics can resort to paper documentation. Staff can utilize pre-printed forms or create ad hoc ones. Patient records, prescriptions, and orders can be handwritten on these forms, enabling the clinic to maintain patient information and facilitate continued treatment.
2. Close the clinic for the day: In cases of sudden and unexpected power outages, clinics may opt to close for the day. This provides an opportunity to seek alternative power sources, minimizing inconvenience and potential risks to patients. Proper communication with patients is necessary, informing them of the clinic's closure and rescheduling their appointments accordingly.
3. Wait until power is restored: If the outage is anticipated to be of short duration, clinics may choose to wait until power is restored before seeing patients. This approach aims to minimize disruption for patients. Advance communication is crucial in notifying patients about the delay, allowing them to adjust their schedules accordingly.
4. Perform no documentation: In some situations, clinics may continue to see patients despite the power outage. However, without electronic means of recording, documentation cannot be performed. Physicians may make handwritten notes in the patient's file once power is restored. It is important to note that the lack of documentation can make it challenging to recall specific treatment details provided to the patient.
In conclusion, offices relying on EHR can manage power outages by resorting to paper documentation, closing the clinic for the day, waiting for power restoration, or temporarily forgoing documentation. It is essential to have contingency plans in place, including alternative power sources, to minimize potential risks to patients during unexpected power outages.
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A 47-year-old male patient was admitted to the hospital at 6:00 am on December 9 due to "paroxysmal chest pain for 8 h and aggravation of 1.5 h". The patient felt chest tightness and chest pain when he went to bed 8 hours ago and continued to relieve for 5-10 minutes. It worsened 1.5 hours ago and continued to be unrelieved. He was in good health, smoking for more than 30 years, and had 30 cigarettes/day. Physical examination: blood pressure 80/50 mmHg, clear breath sounds in both lungs, no dry and wet rales; heart rate 44 bpm, low and blunt heart sounds, no murmur; abdominal softness, no tenderness, liver, and spleen untouched. An electrocardiogram was performed as shown in Figure 1. Troponin I <0.05 μg/L, and after 4 hours it rose to> 25 μg/L. Perform emergency trans-radial coronary angiography, see Figure 2. After treatment, the results of coronary angiography are shown in Figure 3.
Figure 1. ECG on admission:
The information provided describes a 47-year-old male patient who was admitted to the hospital due to paroxysmal chest pain for 8 hours, with worsening symptoms over the past 1.5 hours.
The patient has a history of smoking for over 30 years, with a high daily cigarette consumption. Initial physical examination findings include low blood pressure, low heart rate, and abnormal heart sounds. An electrocardiogram (ECG) was performed, showing certain findings. Subsequently, troponin levels, a marker of heart damage, increased significantly. Emergency trans-radial coronary angiography was conducted, and the results of the procedure are not mentioned.
It is important to note that Figure 1 and Figure 2, referenced in the question, are not provided in the text. Without these visual aids, it is difficult to provide a detailed analysis of the ECG and coronary angiography results.
Given the patient's symptoms, history, physical examination findings, and the subsequent rise in troponin levels, there is strong suspicion of acute coronary syndrome (ACS) or a heart attack. Further investigations, such as coronary angiography, can help determine the extent and severity of any blockages or narrowing in the coronary arteries.
It is essential for the patient to receive appropriate medical intervention, which may include medication, percutaneous coronary intervention (PCI), or coronary artery bypass graft (CABG), depending on the findings from the coronary angiography. Timely and accurate diagnosis, as well as prompt management, are crucial in the care of patients with suspected ACS to minimize heart damage and improve outcomes.
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________ consist of ambiguous pictures, sentences, or stories that the test taker interprets or completes. objective tests projective tests personality inventories diagnoses based on the dsm
The correct answer is "projective tests." Projective tests consist of ambiguous pictures, sentences, or stories that the test taker interprets or completes. These tests are designed to assess personality traits, unconscious thoughts, and emotions that may not be readily accessible through direct questioning or self-report measures.
In projective tests, individuals are presented with ambiguous stimuli and asked to project their thoughts, feelings, and perceptions onto the stimuli. The responses are believed to provide insights into the individual's personality, motivations, and underlying conflicts. The interpretation of projective test responses often relies on the assumption that individuals project their own unconscious or hidden aspects onto the stimuli, revealing unconscious thoughts or desires.
Examples of well-known projective tests include the Rorschach inkblot test, Thematic Apperception Test (TAT), and Sentence Completion Test. These tests aim to elicit responses that reflect the test taker's personality traits, emotions, interpersonal relationships, and cognitive processes.
It is important to note that projective tests have been subject to criticism regarding their reliability, validity, and standardization. They are often used in combination with other assessment tools and clinical judgment rather than being the sole basis for making diagnoses or clinical decisions. Diagnostic classifications, such as those based on the DSM (Diagnostic and Statistical Manual of Mental Disorders), typically rely on a comprehensive assessment that includes multiple sources of information, such as interviews, self-report measures, observations, and clinical judgment.
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. the nurse hears in report that the patient has a closed chest drainage system. a. what nursing assessments should be performed for this patient?
When a nurse hears in report that the patient has a closed chest drainage system, they should perform several nursing assessments.
Closed chest drainage systems are medical devices that are used to evacuate air, blood, or fluid from the pleural cavity or mediastinum and maintain negative pressure within the cavity for better lung expansion. Nursing assessments that should be performed for a patient with a closed chest drainage system are as follows:Assess the drainage system's patency and functioning. Inspect the chest tube insertion site for signs of infection, such as redness, swelling, or drainage. Look for any kinks or obstructions in the tubing. Observe the patient's respiratory status and the presence of any shortness of breath or chest painCheck the volume and characteristics of the drainage, such as the color, odor, and consistency, as well as the amount drained in a specific time frame Maintain aseptic technique while handling the drainage system and while assessing the patient's vital signsEvaluate the patient's pain level and administer medication as neededFinally, instruct the patient on how to maintain the closed chest drainage system, as well as provide any necessary patient education on the procedure and any follow-up appointments.
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A personal care attendant tells you she is concerned because she noticed a few bruises on Amy while changing her one morning. Amy is only 10 years old and is looked after by her father, who is a single parent. Amy's dad has been seen on occasion to yell at Amy and he gets easily frustrated with her, which makes her cry. Describe what reporting or action you might take in this situation
In this situation, the safety and well-being of Amy, a 10-year-old child, is a priority. As a responsible adult and healthcare professional, there are several steps I would take:
Document the incident: Make detailed notes about the bruises observed on Amy, including their location, size, and any other relevant information. It is important to have accurate and objective documentation.Discuss concerns with the personal care attendant: Engage in a conversation with the personal care attendant to gather more information about the bruises, their frequency, and any other observations they have made regarding Amy's well-being. Encourage them to provide as much detail as possible.Follow legal and ethical obligations: In many jurisdictions, healthcare professionals are mandatory reporters for suspected child abuse. If there are reasonable grounds to suspect abuse or neglect, it is important to fulfill reporting obligations according to local laws and guidelines. This typically involves contacting the appropriate child protective services or similar authorities.Consult with colleagues or supervisors: Discuss the situation with colleagues, supervisors, or other trusted professionals within the healthcare facility or organization. They may provide guidance, support, and help determine the appropriate course of action.Maintain confidentiality: It is crucial to handle this information with the utmost confidentiality and share it only with those directly involved in ensuring the safety and well-being of Amy. Avoid discussing the situation with others who do not have a legitimate need to know.Provide support and resources: If Amy's father's behavior raises concerns, it may be beneficial to offer information and resources for parenting support, anger management, or counseling services that could help improve the situation for both Amy and her father.Remember, every situation is unique, and it is essential to follow local protocols and guidelines when addressing suspected child abuse or neglect.
In this situation, it is important to document the bruises, have a discussion with the personal care attendant, fulfill legal reporting obligations if necessary, consult with colleagues, and provide support and resources to ensure the safety of the child.
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Our insured was a registered nurse (RN) employed by a home healthcare agency. She was with a patient when she received a telephone call from a certified nursing assistant (CNA) who was employed at the same agency.
The CNA was at the home of a mutual patient and reported that her gastrointestinal (GI) tube had come out sometime during the night. The RN informed the CNA that the patient would need to go to the emergency department to have the tube re-inserted as it would be several hours before she could see the patient. The patient’s family didn’t want to take the patient to the emergency department but would instead wait for the RN to see the patient.
The CNA informed the RN that she had re-inserted several GI tubes when she was employed at a nursing home, so felt comfortable re-inserting this patient’s tube. The RN agreed to let the CNA insert the tube but advised her to not restart the feedings.
Approximately 45 minutes later, the CNA contacted the RN and affirmed that tube was re-inserted without difficulty and proper placement was confirmed.
When the nurse arrived at the patient’s home several hours later, she noticed that the patient was receiving tube feeding. When questioned, the daughter confirmed that she resumed the tube feedings shortly after the CNA left and denied being told to wait. The RN noted that the patient was complaining of abdominal pain and reported feeling nauseous.
On physical assessment, the patient’s abdomen was distended and positive for pain with abdominal palpation. After stopping the feeding, the nurse called 911 and the patient was transferred to the nearest hospital where she was diagnosed with peritonitis due to the GI tube being accidentally placed in the peritoneal space.
The family filed a lawsuit against the RN and the home healthcare agency.
The allegations against the RN included:
Wrongful delegation of patient care to unlicensed assistive personnel (e.g. CNA);
Failure to follow the agency’s policies and procedures on proper delegation, GI tube insertion and supervision of unlicensed assistive personnel;
Failure to contact the referring provider and obtain an order to reinsert the GI tube; and
Failure to assure that the patient and family had received appropriate communication related to re-inserting the GI tube and holding the GI feedings.
Write a two-page summary (plus a title page and a references page) of the case, including details of the case, the case outcomes, your analysis of the case, and the ethical principle that applies to the case.
Case Outcomes:
The family filed a lawsuit against the RN and the home healthcare agency, alleging negligence and breach of duty. The outcomes of the case are not provided in the given information.
However, it is likely that the case resulted in legal proceedings, potential financial compensation, and potential professional consequences for the RN. Analysis of the Case:The RN's actions raise concerns regarding wrongful delegation and failure to follow proper procedures:1. Wrongful Delegation: The RN delegated the task of GI tube insertion to a CNA, which exceeds the scope of practice for unlicensed assistive personnel (UAP). Only licensed professionals should perform this procedure.2. Failure to Follow Procedures: The RN failed to adhere to the agency's policies and procedures regarding delegation, GI tube insertion, and supervision of UAPs.
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A new nurse has been working in the ER for 2 months. In her first month of working she was chastised twice by her peers for not disposing a medication properly and for incorrect documentation. She is on duty when 2 unrelated patients with similar sounding names, John Bowman and John Bauman, present themselves to the ER. She accidentally administers a medication that is meant for John Bauman, to John Bowman. Jon Bowman has a reaction but it is mild so the nurse decides not to report it.
What are the barriers preventing the nurse from reporting this incident and what are the risk management issues? Describe what strategies and approaches should be applied to improve the practice at this hospital. (2-3 short paragraphs maximum)
The barriers preventing the nurse from reporting the incident could include fear of repercussions or disciplinary action.
Additionally, the nurse may underestimate the severity of the incident and believe that the patient's mild reaction does not warrant reporting.The risk management issues in this scenario include medication errors, lack of adherence to proper documentation procedures, and failure to report adverse events. These issues can compromise patient safety and quality of care, and they indicate potential gaps in training, supervision, and communication within the healthcare team.
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General Question: Choose a maxim that you think can be made to a Universal Law and defend your argument. General Question: Is Social Justice attainable in a world wherein the decisions mostly by the world's system rely on fulfilling the needs that are inclined to the pleasures of man?
Maxim: "Treat others with fairness and equality." This maxim can be made into a universal law because it aligns with the principle of social justice.
Treating others with fairness and equality implies that everyone should be given equal opportunities, rights, and access to resources, regardless of their background or social status. By universalizing this maxim, we can create a world where social justice is upheld and individuals are treated fairly and equitably. While it is true that many decisions in the world's system are influenced by the pursuit of pleasure and self-interest, social justice can still be attainable. Social justice requires a shift in mindset and a collective effort to prioritize the well-being and rights of all individuals, especially those who are marginalized or disadvantaged. It involves recognizing and addressing systemic inequalities, advocating for equal opportunities, and ensuring fair distribution of resources.
While it may be challenging to achieve complete social justice in a world driven by self-interest, progress can be made through education, raising awareness, policy changes, and promoting empathy and compassion.
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Question 11 Calculate the flow rate to be administered by an infusion pump: Ordered: 300 mL D5W over 5 h Answer: 60 ml
The flow rate to be administered by the infusion pump is 60 mL/hour. To calculate the flow rate to be administered by an infusion pump, the following formula is used: Flow rate = Volume / Time.
In this case, the ordered volume is 300 mL and the ordered time is 5 hours. So, we can plug these values into the formula: Flow rate = 300 mL / 5 hours Flow rate = 60 mL/hour Therefore, the flow rate to be administered by an infusion pump is 60 ml/hour.
To calculate the flow rate to be administered by an infusion pump, you can use the formula:
Flow Rate = Volume / Time
Volume (V) = 300 mL
Time (T) = 5 hours
Substituting the values into the formula:
Flow Rate = 300 mL / 5 hours
Flow Rate = 60 mL/hour
Therefore, the flow rate to be administered by the infusion pump is 60 mL/hour.
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water loss can occur from each, except one. which is the exception? group of answer choices respiration inflammation strenuous exercise diarrhea perspiration metabolism of fat
Inflammation is the exception as it does not cause water loss.
Water loss can occur from various factors, including respiration, strenuous exercise, diarrhea, perspiration, and the metabolism of fat. However, the exception among these is inflammation. Inflammation is a response by the body to injury, infection, or irritation, characterized by redness, swelling, warmth, pain, and sometimes loss of function. Unlike the other factors listed, inflammation does not cause water loss. In fact, inflammation often leads to fluid accumulation and swelling in the affected area.
Therefore, the exception to the factors causing water loss is inflammation. Respiration, strenuous exercise, diarrhea, perspiration, and the metabolism of fat can contribute to water loss, but inflammation does not have the same effect.
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When lung tissue swells as a result of distention and loss of elasticity in the alveoli, the condition is called:
When lung tissue swells as a result of distention and loss of elasticity in the alveoli, the condition is called Emphysema.
Emphysema is a chronic pulmonary disease characterized by permanent enlargement of the alveoli, air sacs within the lung, due to distension and loss of elasticity caused by destruction of their walls as a result of damage to the connective tissue in the lung.
This causes the airways to collapse and obstruct, and the elastic recoil of the lung is reduced, making exhalation more difficult. Because of its effect on the lung's ability to exchange oxygen and carbon dioxide, emphysema is a type of chronic obstructive pulmonary disease (COPD). Chronic bronchitis and emphysema, the two most common conditions, are included in this category.
Cigarette smoking, environmental and industrial pollution, and genetics are all factors that contribute to emphysema development. The condition typically begins with mild shortness of breath, which becomes progressively worse over time. It's tough for patients with emphysema to exhale fully because their airways are clogged with mucus and air sacs have lost their elasticity.
As a result, they can't get enough oxygen, which can lead to serious complications. Emphysema is diagnosed using a variety of methods, including physical examination, blood tests, imaging scans, and pulmonary function testing.
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a nurse is describing what happens at fertilization as the zygote begins life. which statement is most accurate?
During fertilization, the sperm and egg fuse to create a new organism, which is called a zygote. The zygote is the first cell of the new organism that is genetically unique.
Once the sperm and egg meet, the process of fertilization begins.The zygote begins life by rapidly dividing through a process called cleavage. It starts as a single-celled organism and divides into many cells to become a multicellular organism. The division of the cells is necessary for the growth and development of the organism. After a few days, the zygote becomes a blastocyst, which implants into the uterus.
It then continues to grow and develop into a fetus over the course of 9 months. In summary, during fertilization, the sperm and egg fuse to create a zygote, which begins life by rapidly dividing through cleavage and develops into a fetus over the course of 9 months.
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ALL of the following are true regarding normal ovaries EXCEPT
a. They are almond shaped with medium level echogenicity b. They have a dual blood supply c. They often increase in size during the postmenopausal stage. d. They vary in ppsition within pelvic cavity
All of the following statements are true regarding normal ovaries, except for Normal ovaries do not typically increase in size during the postmenopausal stage. Instead, they tend to decrease in size and undergo atrophy.
Statement A is accurate as normal ovaries are indeed almond-shaped with medium level echogenicity when visualized on imaging studies. Statement B is also correct as ovaries receive a dual blood supply from the ovarian artery and ovarian branch of the uterine artery. Finally, statement D is true as ovaries can vary in position within the pelvic cavity, typically being located laterally and posteriorly to the uterus.
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Complete Question:
ALL of the following are true regarding normal ovaries EXCEPT:
a. They are almond shaped with medium level echogenicity
b. They have a dual blood supply
c. They often increase in size during the postmenopausal stage
d. They vary in position within the pelvic cavity
early in pregnancy, a woman especially needs adequate amounts of _____ due to rapid cell division.
Early in pregnancy, a woman especially needs adequate amounts of FOLIC ACID due to rapid cell division.
Folic acid is a B-complex vitamin that aids in the production of new cells, specifically red blood cells, in the body. The active form of the vitamin is called folate. It is found naturally in certain foods like dark green leafy vegetables, beans, and citrus fruits.Folic acid is essential during pregnancy because it aids in the growth and development of the fetus' neural tube. Folic acid is essential for the proper formation of the neural tube. Neural tube defects may result from a deficiency, causing severe brain and spinal cord damage.In addition to folic acid, women who are pregnant need to have a well-balanced diet that includes all essential vitamins and minerals to ensure the healthy growth of the baby. Proper nutrition can help prevent birth defects and ensure healthy development.
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IV fluids are infusing at 19gtts/min. The tubing drip factor is 15gtts/mL. How many mL/hr are the IV fluids infusing? (Round your answer to the nearest whole number.)
Rounding the result to the nearest whole number, the IV fluids are infusing at 76 mL/hr.
Rate of infusionTo calculate the mL/hr rate for the IV fluids infusing, we need to convert the given gtt/min rate to mL/hr. Here's the step-by-step calculation:
Convert gtt/min to mL/min:
Since the tubing drip factor is 15 gtt/mL, we can divide the gtt/min rate by the drip factor to get mL/min.
mL/min = 19 gtt/min / 15 gtt/mL
mL/min = 1.27 mL/min
Convert mL/min to mL/hr:
Since there are 60 minutes in an hour, we can multiply the mL/min rate by 60 to get mL/hr.
mL/hr = 1.27 mL/min × 60 min/hr
mL/hr = 76.2 mL/hr
Rounding the result to the nearest whole number, the IV fluids are infusing at approximately 76 mL/hr.
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Discuss TWO differences noted with the RN Role vs. the UAP/CNA
role. Describe the EBP, clinical judgement, or critical thinking
required for the RN role in the examples provided .
Two key differences between the RN role and UAP or CNA role are the level of responsibility and the scope of practice. RNs require a higher level of education and licensure, allowing them to perform complex assessments, develop and implement care plans, administer medications, and make critical decisions.
The degree of responsibility is where the RN role and the UAP/CNA function diverge first. Comparatively speaking, CNAs and UAPs have less duty than RNs do. They are responsible for the overall management and coordination of patient care. In complicated assessments that cover social, psychological, and physical components, registered nurses (RNs) use their professional judgment to spot changes in the patient's state and create the best interventions. To protect the safety and wellbeing of patients, you must be able to synthesize information, apply evidence-based practice, and make important decisions.
The scope of practice is the second distinction. Compared to UAPs and CNAs, RNs' areas of practice are more varied. They are knowledgeable and skilled in a variety of nursing interventions, including drug administration, starting and managing intravenous therapies, managing advanced wound care, and educating patients.
Evidence-based practice must serve as a solid foundation for these initiatives. To deliver the most recent and efficient care, RNs must keep up with the best practices and the most recent research. To make judgments that maximize patient outcomes, they must critically assess the available information, take into account the patient's particular requirements and preferences, and use their professional judgment.
RNs utilize evidence-based practice, clinical judgment, and critical thinking to provide safe and effective patient care, including complex assessments, care planning, medication administration, and decision-making. Their advanced education and licensure enable them to handle more complex situations and play a vital role in healthcare teams.
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The RN Role vs. the UAP/CNA role is different in several ways. There are numerous differences between the RN and the UAP/CNA roles. In this context, two differences between the RN and the UAP/CNA roles are discussed. The first difference is the level of education, and the second difference is the type of responsibilities.
Education level: One of the significant differences between the RN and the UAP/CNA roles is the level of education required to work in these positions. The UAP/CNA position requires a high school diploma or equivalent, while the RN position requires a nursing degree from an accredited nursing program.
Responsibilities: Another significant difference between the RN and the UAP/CNA roles is the type of responsibilities that come with each position. The RN role is responsible for patient assessment, developing nursing care plans, administering medications, and providing patient education. The UAP/CNA role is responsible for assisting patients with their daily activities, such as bathing, dressing, and eating. In addition, UAP/CNAs are responsible for taking vital signs, transporting patients, and cleaning equipment.
EBP, clinical judgment, or critical thinking required for the RN role in the examples provided: EBP, clinical judgment, or critical thinking required for the RN role in the examples provided include the following: Patient Assessment: RN must be able to collect and analyze data from patients using clinical judgment, critical thinking, and EBP to ensure that the patient receives the appropriate treatment.
Nursing Care Plans: RN must use EBP to develop nursing care plans that meet the individual needs of the patient. This requires critical thinking and clinical judgment. Medication Administration: RN must use critical thinking and clinical judgment to administer medications to patients safely and effectively. Patient Education: RN must use EBP to provide patients with the necessary information they need to manage their health independently. This requires critical thinking and clinical judgment.
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A patient who was taking sulfonamides develops Stevens-Johnsonsyndrome. Upon assessment, the nurse expects to find whatA.Hypotension B. Bronchospasm C. Temperature of 35.5º C D. Widespread skin lesions
Stevens-Johnson syndrome is a life-threatening condition that can result from the use of sulfonamides. A patient who has been taking sulfonamides and develops Stevens-Johnson syndrome will have widespread skin lesions as assessed by the nurse.
Stevens-Johnson syndrome (SJS) is a severe and rare disorder that affects the skin and mucous membranes. It is considered a medical emergency and can be life-threatening. SJS is often a reaction to medication or an infection, but in some cases, the cause may be unknown.
Widespread skin lesions occur as the primary symptom of Stevens-Johnson syndrome, which is a type of hypersensitivity reaction to medications, such as sulfonamides, that cause severe rashes and skin shedding. The skin lesions, which typically appear first on the face and upper trunk, are usually red or purple and can be painful. As the condition progresses, the lesions can develop into blisters and spread to other areas of the body. Therefore, D. Widespread skin lesions are expected upon assessment by the nurse.
Hypotension, Bronchospasm, and Temperature of 35.5º C are not typical symptoms of Stevens-Johnson syndrome.
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the nurse is assessing a 6 month old infant healthy infant who weighed 7 pounds at birth. the nurse should expect the infant to now weigh approximately
The nurse should expect the 6-month-old infant to weigh approximately 14 pounds.
In the first year of life, infants experience rapid growth and weight gain. On average, infants double their birth weight by around 6 months of age. In this case, the infant weighed 7 pounds at birth, so it is reasonable to expect the weight to have doubled by 6 months, resulting in an approximate weight of 14 pounds. It is important to note that individual growth patterns can vary, and there is a wide range of normal growth for infants. Factors such as genetics, nutrition, and overall health can influence an infant's weight gain. Regular well-baby check-ups with healthcare professionals are essential to monitor growth and ensure that the infant is meeting developmental milestones.
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Case Study 2: A patient had the following results for their spinal fluid work up: 100 WBC counted in 5 large squares of undiluted CSF on one side and 108 WBC are counted on the other side. The differential demonstrates 98% PMN (polymorphonuclear cells which are neutrophils).
What is the cell count?
What do you suspect is the diagnosis for this patient (be specific)?
Predict the total protein, glucose, and lactate for this type of meningitis.
What would you expect to see on the patient’s CSF culture?
Case Study 3: A patient had a CSF that was tinged with bood: The first tube was diluted using 20 ul of sample and 180 ul of saline. Five squares were counted on each side for a total of 250 RBCs total in 10 squares. What is the cell count for tube 1?
The fourth tube was diluted the same way for a total of 75 RBCs in 10 squares. What was the cell count for tube 4?
Make an interpretation based on these results with regards to the blood tinged CSF.
Cell Count - The cell count is calculated using the following formula :Number of cells counted x dilution factor / area counted. Therefore, the cell count for this patient can be calculated as follows:(100+108) x 2 / 10 = 41 cells/µL .Diagnosis - This patient is diagnosed with bacterial meningitis based on the high percentage of neutrophils (PMN) found in the CSF.
Total protein - Elevated total protein level is expected in bacterial meningitis, with values >150 mg/dL considered as significant. Therefore, the total protein value for this patient is expected to be higher than 150 mg/dL.Glucose - In bacterial meningitis, the glucose level is low (often < 40 mg/dL). Therefore, a low glucose level is expected for this patient.Lactate - Elevated lactate levels are expected in bacterial meningitis, typically > 35 mg/dL. Therefore, the lactate level for this patient is also expected to be elevated.CSF culture - Gram stain and culture of the CSF should be performed. A positive culture would indicate the presence of bacteria, helping to identify the causative agent for bacterial meningitis. Case Study 3Cell Count - The cell count is calculated using the following formula:Number of cells counted x dilution factor / area counted.Cell count for tube 1 can be calculated as follows:250 x 10 / 5 = 500 cells/µL.Cell count for tube 4 can be calculated as follows:75 x 10 / 5 = 150 cells/µL.Interpretation - Blood tinged CSF may be indicative of a subarachnoid hemorrhage or traumatic tap. A traumatic tap would be associated with higher RBC counts in the first tube, which should gradually decrease with subsequent tubes. In contrast, a subarachnoid hemorrhage would be associated with high RBC counts in all tubes, with no decline in subsequent tubes. Therefore, further investigation (such as a CT scan) is needed to differentiate between these two conditions.
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1. Describe the key aspects of each of the four frameworks and models (lowa, OMRU, PARIHS, and JBI). What do they share? What is particularly unique about each model?
2. Think about a situation that would potentially benefit from using a model or framework to guide the implementation of evidence. What would you want that model of framework to do for you to be useful?
3. Can you imagine using one of the four models or frameworks in your clinical practice? Using the evaluation criteria, justify your answer.
1. The four frameworks and models LOWA, OMRU, PARIHS, and JBI are all designed to facilitate the implementation of evidence-based practice in healthcare settings.
The Iowa Model focuses on critical appraisal of evidence and guides the decision-making process for implementing changes in practice. The Ottawa Model emphasizes the importance of knowledge translation and creating a supportive organizational culture. The PARIHS framework emphasizes three core elements: evidence, context, and facilitation. The JBI Model provides a comprehensive approach to evidence-based practice, including developing evidence-based guidelines, synthesizing evidence, and implementing changes in practice. While these models share the goal of promoting evidence-based practice, each has unique characteristics.
2. In a situation where implementing evidence-based practice is necessary, using a model or framework can provide structure and guidance. For the model or framework to be useful, it should:
- Clearly define the steps or stages of implementation.
- Help identify barriers and facilitators to evidence implementation.
- Provide strategies to address identified barriers.
- Incorporate a systematic approach to evaluating the impact of the implemented evidence.
- Consider the contextual factors relevant to the specific healthcare setting.
- Promote collaboration and engagement of stakeholders in the implementation process.
3. Yes, I can imagine using one of the four models or frameworks in clinical practice. The choice of model would depend on the specific needs and context of the healthcare setting. For example, if the primary challenge is decision-making and integrating evidence into practice, the Iowa Model may be suitable.
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D Aging has an effect on memory, but it also transforms our abilities to scan for relevant information and establish risks. O True O False Question 15 5 pts Interrupting responses, closed end questions and giving approval or disapproval are examples of Therapeutic communication. True False
The statement "Aging has an effect on memory, but it also transforms our abilities to scan for relevant information and establish risks" is true. As individuals age, they may experience changes in memory function, such as a decline in episodic memory or working memory.
However, research has shown that older adults may compensate for these memory changes by developing strategies to enhance their ability to scan for relevant information and evaluate risks. This is known as the "positivity effect" or "socioemotional selectivity theory," which suggests that older adults prioritize emotional well-being and focus on meaningful and positive information.
Regarding therapeutic communication, the statement "Interrupting responses, closed-end questions, and giving approval or disapproval are examples of therapeutic communication" is false. Therapeutic communication techniques aim to establish a supportive and empathetic environment to facilitate effective communication between a healthcare provider and a patient. Interrupting responses and closed-end questions can hinder open and meaningful dialogue, while giving approval or disapproval can create a judgmental atmosphere. Therapeutic communication techniques include active listening, reflecting feelings, providing empathy, using open-ended questions, and maintaining a non-judgmental attitude.
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if a patient complains of dizziness, this is considered? a symptom, duration, an. exacerbation, chronology
If a patient complains of dizziness, this is considered a symptom
A symptom is defined as any subjective evidence of an abnormal condition or disease that is perceived by the patient and not obvious to others. A symptom is an indication that the body is not functioning properly. It is important to pay attention to a patient's symptoms because they can provide important clues about the underlying cause of the problem.
According to experts, dizziness is a common symptom that can be caused by a variety of factors, including inner ear disorders, medication side effects, low blood pressure, dehydration, and neurological disorders. Patients may describe dizziness as feeling lightheaded, faint, or unsteady. Some patients may also experience other symptoms along with dizziness, such as nausea, vomiting, or changes in vision or hearing.
If a patient complains of dizziness, the healthcare provider will need to take a detailed medical history and perform a physical examination to determine the underlying cause. The provider may also order additional tests or refer the patient to a specialist for further evaluation and treatment.
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Who is ultimately responsible for ensuring protocol compliance and data integrity? (3.2) A. Principal Investigator B. Study Coordinator C. Study Monitor D. The study research team
The correct option for the question "Who is ultimately responsible for ensuring protocol compliance and data integrity?" is A. Principal Investigator.
The Principal Investigator is ultimately responsible for ensuring protocol compliance and data integrity.
According to Good Clinical Practice (GCP) guidelines, the Principal Investigator (PI) is the individual who has overall responsibility for the conduct of a clinical trial and ensuring that it is conducted in compliance with the protocol, applicable regulations, and ethical principles.
As such, the PI assumes the primary responsibility for ensuring protocol compliance and data integrity throughout the study.
The PI's role includes supervising the study team, ensuring proper training and delegation of responsibilities, and overseeing the collection, accuracy, and completeness of data.
The PI is responsible for maintaining adequate and accurate study documentation, ensuring adherence to the approved protocol, and promptly addressing any protocol deviations or non-compliance issues that may arise.
While other members of the study team, such as the Study Coordinator or Study Monitor, may play important roles in supporting protocol compliance and data integrity, it is ultimately the PI who bears the overall responsibility.
The PI is accountable for the conduct of the study, the protection of study participants, and the integrity and reliability of the data generated.
In summary, the Principal Investigator holds the ultimate responsibility for ensuring protocol compliance and data integrity in a clinical trial. Their leadership, oversight, and adherence to GCP principles are crucial for maintaining the quality and validity of the study.
The correct option is A. Principal Investigator.
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a mother who is visibly upset tells the nurse she wants to take her child home because the child is dying. what would be the nurse's best response?
The nurse's best response in this situation would be to provide empathetic and compassionate support to the mother while addressing her concerns and facilitating open communication. Here is a suggested response:
"I can see that you are upset and concerned about your child. It must be incredibly difficult for you right now. I want you to know that we are here to support you and your child during this challenging time. Let's sit down and talk about your concerns. We can discuss your child's condition, treatment options, and any other questions you may have. Our goal is to provide the best care for your child and help you make informed decisions. Together, we can explore all the possibilities and find the best course of action."
Acknowledge the mother's emotions: Begin the response by recognizing the mother's visible upset and empathizing with her emotions. This validates her feelings and shows that the nurse is attentive and understanding.Express understanding: Reassure the mother that her concerns are valid and acknowledge the seriousness of the situation. Let her know that her child's well-being is the nurse's priority.Offer support: Emphasize that the nurse is there to provide support and assistance. This reassurance can help alleviate the mother's anxiety and provide a sense of comfort.Initiate a conversation: Encourage the mother to express her concerns and fears openly. Create a safe space for her to share her thoughts and feelings without judgment. Active listening and providing undivided attention are crucial during this conversation.Provide information: Address the mother's specific concerns by providing accurate and honest information about her child's condition, prognosis, and available treatment options. Use clear and understandable language to facilitate understanding.Explore options: Discuss various treatment options, potential outcomes, and the available support services. Engage the mother in the decision-making process, empowering her to make informed choices for her child's care.Collaborate and involve the healthcare team: Offer to involve other healthcare professionals, such as the child's physician or a social worker, to provide additional support and guidance. This interdisciplinary approach ensures comprehensive care for both the child and the family.Offer ongoing support: Assure the mother that the healthcare team will be there for her throughout the child's journey. Provide information about support groups, counseling services, or other resources that can help her cope with the emotional challenges she may face.Remember, each situation is unique, and the nurse should adapt their response based on the specific needs of the mother and child. The key is to demonstrate empathy, active listening, and a commitment to providing compassionate care.For more such questions on nurse's best response, click on:
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Electrolyte Imbalance
E.G. is a 73-year-old woman whose daughter brings her to see the health care provider because she has had a case of the "stomach flu," with vomiting and diarrhea for the past 3 to 4 days and is now experiencing occasional light-headedness and dizziness. Her medical history includes hypertension, hypercholesterolemia, and mild heart failure. The patient is alert and oriented to person only, which her daughter reports is abnormal. Her daughter states "Just this morning she was fine and then later this evening she became confused and asking for my father who died 15 years ago!"
Current Medications:
• Captopril 25 mg po twice dailty
• Furosemide 40 mg po daily
• Potassium chloride 20 mEq po daily
• Atorvastatin 20 mg po at bedtime
• Digoxin 0.125 mg po daily
Subjective Data
• Has been following a low-sodium diet
• States her abdomen feels bloated and she has been constipated since the onset of the "flu"
• Has been taking her medications except for the potassium chloride pill because it upsets her stomach.
• Daughter states occasionally takes an extra "water pill" when her ankles are swollen
Objective Data
Physical Examination
• Temperature 98.2°F, pulse 88, respirations 20, BP 138/86
• Lungs clear to auscultation, breathing regular and unlabored
• +1 edema bilaterally in ankles
• Muscle strength in upper extremities normal and equal and in lower extremities weak
• Sensation to all extremities normal
• Abdomen distended with hypoactive bowel sounds
Diagnostic Studies
• Lab values
o Sodium 130mEq/L
o Potassium 3.0mEq/L
o HCO3- 25.4mEq/L
o Chloride 99.5 mEq/L
Please respond to all of the questions below in your response:
Question 1
What is a possible pathophysiologic cause of E.G.’s muscle weakness and dizziness? What other symptom does E.G. have that may be related to this problem?
Question 2
What factors contributed to the development of this electrolyte imbalance?
Question 3
What should you be on an alert for in a patient who is on furosemide and digoxin and why?
Question 4
What additional signs and symptoms should you assess E.G. for?
Question 5
What diagnostic test is indicated and why?
Question 6
Write three nursing diagnoses that are appropriate for E.G.
Question 7
What interprofessional care would you anticipate for E.G.?
Question 8
What instructions should you give E.G. regarding the signs and symptoms of this electrolyte imbalance and how to prevent it?
E.G.'s symptoms of muscle weakness, dizziness, constipation, and confusion are likely due to an electrolyte imbalance. Electrolyte imbalance refers to an abnormality in the levels of electrolytes in the body, such as sodium, potassium, calcium, and chloride.
The answers to the given questions are as follows:
1. The possible pathophysiologic cause of E.G.’s muscle weakness and dizziness is Electrolyte Imbalance. The other symptom that E.G. has that may be related to this problem is light-headedness.
2. Factors that contributed to the development of this electrolyte imbalance are vomiting, diarrhoea, and not taking potassium chloride medication.
3. In a patient who is on furosemide and digoxin, you should be alert for Electrolyte Imbalance. Electrolyte imbalance occurs because of furosemide’s action on the ascending loop of Henle, which inhibits the reabsorption of sodium, potassium, and chloride ions. Additionally, the use of digoxin may worsen electrolyte imbalance, specifically potassium, which can lead to digoxin toxicity.
4. The additional signs and symptoms that should be assessed E.G. for are confusion, dizziness, and constipation.
5. A diagnostic test that is indicated for E.G. is serum electrolytes. It should include all electrolytes to evaluate if there is a need for replacement therapy and assess if E.G.’s current medications have an impact on the electrolyte levels.
6. The three nursing diagnoses that are appropriate for E.G. are as follows:
Risk for electrolyte imbalance related to poor oral intake and vomitingRisk for falls related to muscle weaknessConfusion related to metabolic acidosis7. The interprofessional care that can be anticipated for E.G. includes medication adjustment to replace potassium and correct electrolyte imbalances, hydration with oral rehydration solution or intravenous fluids, and providing antiemetics for vomiting.
8. The instructions that should be given to E.G. regarding the signs and symptoms of this electrolyte imbalance and how to prevent it include:
Follow the prescribed medicationTake potassium chloride with meals to avoid an upset stomachIncrease the oral fluid intake if experiencing vomiting and diarrhoeaCall the healthcare provider if there is an onset of confusion, muscle weakness, or dizzinessLearn more about Electrolyte Imbalance from the given link:
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12 Please record her intake and output for your hour evening shift on the 1& O record provided Mr. Patel has recorded the following on a sheet of paper at the bedside: 0800: eggs, toast, one cup of coffee; small orange juice 0900 120ml water Sete 1000: Voided 400ml 1230: sandwich, apple, glass of iced tea 1300 120ml water 1400: Volded 700mL SCOAL 1500: 120ml water 1730: chicken, broccoli, rice, 2 glasses of iced tea 1830: Vomited 500ml The nurse caring for Mr. Patel hung a new 1000ml bag of DSW at the start of her shift; it is infusing at a rate of 30ml/hr 1) Calculate Mr. Patel's total input for your 12 hr day shift (0700-1900) 2) Calculate Mr. Patel's total output for your 12 hr day shift (0700-1900) 2) Does Mr. Patel have a positive or negative fluid balance? What is his total fluid balance?
Based on the calculations, Mr. Patel has a positive fluid balance of 960ml. This means that he has taken in more fluids than he has excreted or lost during the 12-hour day shift.
To calculate Mr. Patel's total input and output and determine his fluid balance, we'll review the provided information:
1) Calculate Mr. Patel's total input for your 12-hour day shift (0700-1900):
0800: Eggs, toast, one cup of coffee; small orange juice
0900: 120ml water
1000: Voided 400ml
1230: Sandwich, apple, glass of iced tea
1300: 120ml water
1400: Voided 700ml
1500: 120ml water
1730: Chicken, broccoli, rice, 2 glasses of iced tea
Total input = 120ml water + 120ml water + 120ml water + 400ml voided + 700ml voided = 1,460ml
2) Calculate Mr. Patel's total output for your 12-hour day shift (0700-1900):
1830: Vomited 500ml
Total output = 500ml
2) Determine Mr. Patel's fluid balance:
To calculate the fluid balance, we subtract the total output from the total input.
Fluid balance = Total input - Total output = 1,460ml - 500ml = 960ml
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A nurse is assessing a client who has output of 250 mL in 24 hour period. WHich of the following descriptive terms should the nurse place in the client's electronic record?
a) enuresis
b) nocturia
c) anuria
d) oliguria.
The nurse should document oliguria in the client's electronic record.
Oliguria is a medical term used to describe the condition in which the amount of urine a person produces is much less than the normal level.
The normal output of urine in a day is around 1,500 to 3,000 milliliters.
Oliguria is diagnosed when a person's urine output is below 400 milliliters in a day or 0.5 milliliters per kilogram of body weight per hour.
In this case, since the client has an output of only 250 mL in a 24-hour period, it meets the definition of oliguria.
Therefore, the nurse should use this descriptive term to document this condition in the client's electronic record. Option D) oliguria is the correct answer.
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5 pts What motive is there for battling fragmentation in health care? Prevents lawsuits for health care providers Brings all sub-specialties together for better reimbursement Reduces risks for poor outcomes by treating whole person Reduces health care referrals
The motive for battling fragmentation in health care is to reduce risks for poor outcomes by treating the whole person.
Fragmentation in health care refers to the division and disconnection of care across different providers, settings, and specialties, which can lead to fragmented and disjointed patient care. By addressing fragmentation, healthcare providers aim to improve patient outcomes by ensuring that all aspects of a patient's health and care are considered and coordinated. This approach focuses on the comprehensive management of a patient's health, considering not just specific symptoms or conditions but also their overall well-being. By promoting collaboration and communication among healthcare professionals, sharing information, and coordinating care, fragmentation can be minimized, resulting in more effective and patient-centered healthcare delivery.
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