Low potassium level patient

A physician hands you a critical lab value result for a female patient with a low potassium level (an electrolyte important in heart function). He asks you to contact the patient right away and gives you a list of instructions to give to the patient. It is Friday evening and the office does not open again until Monday morning. The physician is late to a special dinner and leaves you all alone. You call the patient’s home phone number only to find the number disconnected. The patient does not list a cell number. You try to reach her daughter, who is listed as a contact but there is no answer and no voicemail. It’s getting late and you want to go home. What would be your most logical solution? What are the possible consequences of waiting until the following Monday to contact the patient? Discuss with your classmates your answers to the above questions. Be sure to respond to their post by explaining why you agree or disagree with their post.

Importance of healthcare determinants

Health is influenced by many factors, the social determinants of health encompasses economic and social conditions that influence the health of people and communities. Social determinants of health such as poverty, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities. Why is addressing the social determinants of health important for individual and community health?

Imminent delivery condition

Describe that pathophysiology behind one of the key pharmacological options used post-delivery in the management of this imminent delivery condition? What is your concern at this point, and outline and discuss the likely potential cause of this substantial blood loss?

Obstetric emergency

You are a paramedic in your first-year post-qualification, working with a graduate who has only been on road for 2 months. You are dispatched to a 28-year-old female, with imminent delivery. The information you have is:
  • G3: P1, 41 weeks gestation
  • Membranes ruptured 2 hours ago at home
  • Onset of regular painful contractions 30 minutes ago, she called the hospital and was advised to come in; it’s approximately a 20-minute drive from her home.
  • She is unable to move herself to the car between contractions as she has developed a sudden and overwhelming urge to push. Her partner calls 000.
  • You are 15 km from the location with a 9-minute response time
  • Backup 15 minutes away and dispatched at the same time
  • Unremarkable antenatal history, except for well-controlled gestational diabetes
  • Regular check-ups with general practice nurse and midwife.
  • Previous normal singular vaginal births.

On arrival, you find the woman, Sophie, lying on her bed actively pushing and the baby’s head is beginning to crown. Her partner, Tom, is relieved to see you. You only have time to place your equipment down before the head is birthed with Sophie’s next push.

One the next contraction you then recognise:

  • there is no restitution of the head
  • the chin is firmly on the perineum and retracting
  • Sophie continues to push with significant pain

1) Provide a definition and overview of the obstetric condition the patient is presenting with?

2) List and discuss the pertinent risk factors that this patient has when considering the presenting condition?

3) Describe one of the manoeuvres or actions that is linked with this obstetric emergency and provide a pathophysiological rationale?

Invisible illnesses

Do you know anyone with an invisible illness? Invisible illnesses are everywhere and you might not know about them. How can we be more open to the possibility that someone might be in pain or suffering?

Lobectomy for lung cancer

Discuss the normal functions of the lungs that help filter the air coming into the lungs and push any dust or particulate matter out of the lungs. If the physician recommends that a patient have a lobectomy for lung cancer, how many lobes could be excised from each lung, while still leaving at least one lobe?

Health care barriers

Explain how race, socioeconomic status, or gender determines the quality of health care in the United States. As a health care provider, describe how you will conquer the treatment and health care barriers that may exist with patients. In replies to peers, discuss additional strategies for overcoming health care barriers.

Substance dependence

Jax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount “doesn’t give me the same buzz as it used to.” She denies ever experiencing “the shakes” or any other withdrawal symptoms if she skips a day of drinking.

Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions.

  1. Describe the presenting problems/issues. Is there any information that was not provided that you would need to formulate a diagnosis?
  2. Generate a primary and differential diagnosis using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM5)  and International Center for Diseases 10 codes.
  3. What physiological and psychological processes lead to substance dependence?

Client education during assessment

 

Explain nursing interventions (pre, intra, post) during the gastrointestinal assessment and also client education during the gastrointestinal assessment. State nursing Interventions during the gastrointestinal assessment.

Volunteering in a health center

You have an opportunity to volunteer at your community health center. You know it is a good cause but wonder if you can find the time with all your other commitments at school and home. Do you believe that being a volunteer can contribute to your physical and social well-being? Would volunteering in your chosen field add value to your resume? Explain your reasons.