Obamacare exchanges in insurance

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The Obamacare has been in operation for a while in the United states. Discuss the reason why some obamacare exchanges end up with only one or two insurance sellers. Link it to mediciad expansion.

Cerumen removal in a diabetic patient

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1.What is the contraindication for irrigation for cerumen removal in a diabetic patient?  Explain step by step on how the states action is conducted.
2.How home healthcare and clinics have helped with healthcare disparities? (Please write 2-3 pages)

Nasogastric tube for paralytic ileus

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A newly graduate nurse is caring for a client with a paralytic ileus who has a prescription for nasogastric tube.Which steps for nasogastric tube insertion should the nurse review with her preceptor?

Study of community and public health

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Think about your own career path. Discuss the ways you believe the study of community and public health relates to your current or future career goals. Share an area of community and public health you are most interested in. Give an specific example of a component of that area you would like to either work in or conduct research on and explain why.

Chronic obstructive pulmonary disease

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The ABC Hospital is a 600-bed community hospital that serves a population of about 800k. One of their key performance measures is 30-days hospital readmission rate for chronic obstructive pulmonary disease(COPD), it has been reported that the readmission rate is twice the expected readmission. This is a major concern for the hospital, funders, and the patients, such as significant cost to the healthcare system, prolong hospital stay, and reduce quality of life for the patients. The medical director asked the respirology team to investigate the increasing rate of hospital readmission from Chronic obstructive pulmonary disease(COPD). Upon investigation, it was discovered that patients are discharged without any education or support in the community. As the respirology nurse you tasked in leading a team to implement an evidence based practice(EBP) approach to reduce hospital readmission.

Building a treatment plan

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Josie was born in Sault Ste. Marie amphetamine-dependent. She was a tiny baby (3.5lbs) and stayed in the NICU for weeks after her birth. Once she was strong enough for discharge she was placed in foster care. Her mother was told by Child Protective Services that she would need to complete treatment prior to being assessed as able to provide care for her child. Josie’s mom completed treatment and was able to provide a safe home for Josie from the age of 1-6 years.
Josie’s mom relapsed after 6 years of recovery. She was using crack and cannabis in the home for the next 5 years. Josie was a victim of neglect and sexual abuse during that time. She was raped by two men before she was 12. She struggled in school but didn’t tell her teachers why she was having a hard time paying attention in class. She was given some extra time to complete tasks but was struggling to comprehend the materials presented to the class.
Josie first used cannabis at age 10 with her friends; her mom knew about her drug use but didn’t consider it out of the ordinary. She provided Josie with her first dose of cocaine at age 12. She told her it would help her focus and get her school work done. Again, mom didn’t think this was out of the ordinary.
When Josie first came into the office at age 21 to ask for help, she said that she was using heroin daily by IV. She had found out she was 16 weeks pregnant and wanted to do something that was healthier for her baby. She was living on a couch at the house of someone she barely knew and there were often many people in the home using drugs. She was unsure who the baby’s father was. She was not sure what to do next and was looking for any kind of help to make life easier for her baby.
Josie was on Ontario Works. She hadn’t graduated from high school. Josie had no contact with her mother; she hadn’t seen her in 3 years. They stopped talking after Josie assaulted her mother during an argument they had about money. Josie was charged and sentenced to probation. She has 3 previous assault charges, one solicitation charge and two possession charges.
Josie describes feeling anxious all the time. She has had a few “sober” days in the past 3 years but states she was withdrawing “so hard” that she doesn’t recall them. She
reports that her decisions are always impulsive, emotionally charged and poorly thought out. Today though, in your office she states that she has been giving a lot of thought to changing her lifestyle. She has been involved with the criminal justice system, but has never accessed addiction support before. You are assigned to her as an addiction counsellor to help assess her needs and build a treatment plan.
1.Which stage of change is this client currently in? How did you come to that assessment of their Stage of Change?
2.What level of treatment would you recommend to build the treatment plan? How does their diagnosis of Fetal Alcohol Spectrum Disorder(FASD) affect your treatment planning?
3.What steps would you take as a counsellor? What would be the next steps for the client? What barriers exist for this client?

Administering antibiotic dose

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A nurse is checking the calculation of an registered nurse who is preparing to administer a loading dose of antibiotic 2mg/kg IV to a patient who weighs 60 kilograms. The amount available is 40 mg/ml. How many ml should the nurse administer. Use a leading zero, not use trailing zero. (Explain step by step)

Removing the inner cannula

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Where should you place your nondominant hand whole removing the inner cannula of a tracheostomy for routine trach care? Describe why you think that is the right way to place your hand.

Side effects of  lamivudine antiviral

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Pharmacology Component : Describe the mechanism of action and possible side effects of the antiviral drug lamivudine ( Epivir) often used to treat this disease.

Reducing risk for aspiration

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A patient you are caring for had a stroke three days ago and is still hospitalized and receiving oral medications. What techniques can you do as the nurse to reduce the patient’s risk for aspiration?