At the last visit, ultrasound noted that the fetus was in a complete breech position. The woman has been experiencing contractions every 10 minutes lasting approximately 45 seconds. She
feels the baby has not moved into the correct position.

A. What assessments and concerns should the nurse address?
B. What nursing diagnoses are appropriate for this couple?
C. What expected outcomes should the nurse identify?

The patient is a 26-year-old G3P2, who presents to the unit after spontaneous rupture of membranes. Her two previous deliveries were via cesarean, but she is determined to try VBAC. Her husband is supportive but anxious. He’s afraid she will be very disappointed if she is unsuccessful.

Privately, he has told the nurse he doesn’t understand why she wants to go through all this.

On assessment, it appears she will be able to deliver VBAC.

A. What should the nurse be aware of as this labor progresses?
B. How can the nurse help this couple best handle this situation?
C. What changes may indicate the need for a repeat cesarean birth?

Tamika Perry, a patient of Dr. Kowalski, had a gastrectomy (surgical removal of the stomach). A nasogastric (NG) tube is in place to drain all fluids. It is connected to suction and irrigated at times. An intrave- nous (IV) solution is providing liquid intake.

Oral intake is limited to sips of ginger ale or water and ice cubes. a. NG tube was irrigated with normal saline (NS) as follows: 7 AM 10 mL . 9 PM 25 mL with 10 mL withdrawn 11 AM 10 mL 1 AM 10 mL 4 PM 10 mL 4 AM 20 mL with 5 mL withdrawn

b. IV was absorbed as follows: 12 Noon 400 mL 10 PM 200 mL 2 PM 150 mL 3 AM 400 mL 8 PM 500 mL 6 AM 200 mL c. Urine output was as follows: 9 AM 400 mL 9 PM 550 mL 1 PM 250 mL 1 AM 400 mL 5 PM 375 mL 5 AM 200 mL d.

The patient had greenish liquid stool as follows: 11 AM 300 mL 5 PM 200 mL 3 AM 750 mL e. The NG tube suction jar was emptied on each shift. Measurements were as follows: 2 PM 780 mL greenish liquid 10 PM 550 mL golden-brown liquid 6 AM 625 ml golden-brown liquid

Case Study, Chapter 37, Documenting and Reporting A 79-year-old client is a resident in a long-term care facility where you work. She has a history of asthma and chronic bronchitis. She also has a history of diabetes and hypertension.

Her assessment revealed wheezes in both lower lung lobes, 2+ pitting edema of her ankles, her color was pale, and she has had a decrease in appetite over the past three days. The client also states, "I have been so short of breath since early this morning."

(Learning Objectives 4, 5, 6, 8, 9, 10, 11) 1. Utilizing one of the types of charting discussed in this chapter, write a progress note for the client.

Explain why you chose the type of charting that you selected, and also identify any additional assessment data that would be needed for your documentation.

2. You have documented wrong information on this client’s chart.

Describe the procedure for correcting the mistake. 3. The end of the shift has come.

You are preparing to give a report to the oncoming nurse. How would you report on this client and what information would be pertinent to include? 9 W 29%

Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” What are the other dimensions of quality care and why are they important? What has changed since the days when “doctor knows best?”

-Quality in medical care may be defined as achieving the greatest benefit at the lowest risk. How have the priorities of our health care system and the allocation of resources addressed this goal?
-Contrast the definitions of implicit and explicit criteria in assessing health care quality. How is each type of criterion useful in the quality assessment?

Please use scholarly articles within 5 years. Thank you.

A nurse assessing a client with anxiety disorder identifies which of the following physiologic symptom(s) of anxiety? ( Select all that apply) 1-Irritability2- Blurred vision 3-Dilated pupils 4- Hypervigilance 5-Crying 6-Diaphoresis