The vaccinations of children and the the human body

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Although the amounts researched are well above those that are used in the vaccinations of children and the the human body does produce a minute amount of formaldehyde in its regular

Liver biopsy

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The client returns to his room after a liver biopsy. The nurse positions the client on his right side and assesses for bleeding. What is a PRIORITY nursing assessment?

Determine adequacy of urinary output.

Check pretest prothrombin time and partial thromboplastin time values.

Observe for frank bleeding.

 

Benign prostatic hypertrophy

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A client is admitted because of benign prostatic hypertrophy and is scheduled to have a transurethral prostate resection. What assessment data would indicate to the nurse that a complication is developing?

The client has difficulty emptying his bladder.

The client states he feels like he cannot empty his bladder.

The client complains of frequency and nocturia.

Public mental health services

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You work in psychiatry practice, and many of your patients with health insurance prefer to pay cash to protect their privacy. If a patient does submit a mental health claim, in what circumstances might that information be disclosed to a third party without the patient’s authorization? How might this practice of paying “off the grid” affect public mental health services?

Chronic renal failure

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Arterial blood gasses are prescribed for a client with chronic renal failure who has hypotension, cold and clammy skin, and dysrhythmias. The nurse should notify the HCP to report that the client is experiencing which imbalance? (Refer to values in the exhibit)

Respiratory acidosis

Respiratory alkalosis

(There were also 2 other answers but I wasn’t able to get them, if it’s not from the choices above) Thank you

Producing celery and herbs

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Scenario: Mr. Jack Charles owns and manages a Market Garden mainly producing celery and herbs. He and his son “Thomas” share this business together. Thomas has a wife and three young children aged 2, 4, and 6.

Mr. Jack Charles is a 78-year-old type 2 diabetic. He was first diagnosed in 1999 with hypertension then 2 years later as a type 2 diabetic. His wife Gladys has been managing his diet and medications until she died in 2010. He has hypercholesterolemia managed with Lipitor 40mg nocte, hypertension managed with Aldomet 50mg daily, his type 2 diabetes is managed with diet, and Metformin 500mg slow release BD. He has been struggling to manage his health and work on the Farm.

Mr. Charles was admitted to a Private Hospital 65 days ago with unstable ischaemic heart disease. On admission, his BGL was 20 mmol/liter and he had polyuria, polydipsia, and polyphagia.   He required emergency Quadruple Coronary Artery Bypass Grafts (CABGs)that were complicated post-operatively by a Right Cerebrovascular Accident (RCVA).

 

After ten (10) days he was transferred to a Private Rehabilitation Centre to receive specialized post-stroke management. He has L leg weakness, L arm weakness, and dysphasia as a result of his ischaemic stroke.

Medications in Rehabilitation 

Hypertension is now managed by Captopril 50mg TDS

Diabetes is now managed by TDS Actrapid Insulin 10 units

Hypercholesterolaemia us managed by Lipitor 80mg

Clexane 80mg BD subcutaneously

He will require Oral warfarin on discharge, dosage to be determined.

 

 

 

PART 1 – REHABILITATION HOSPITAL CARE 
Q1.1    Identify 2 Priority chronic health problems and describe possible impacts of the conditions on body systems and Mr Charles’ ability to perform daily living activities. 
 

 

 

 
Teacher Feedback: MR FER
Q1.2   Seek information from Mr Charles, and as appropriate, with family or carer to confirm their understandings of the condition and its impact.

What question/s would you ask Mr Charles and his son “Thomas “to determine if they have an understanding of one of Mr Charles’ chronic health conditions and its impact on their life and activities of daily living? 
 

 

 

 

 
Teacher Feedback: MR FER
Q1.3   In the Post Stroke Rehabilitation Program,

identify the current treatments given by teach of the following members of  the interdisciplinary health team

Medical Doctor, Nurse , Physiotherapist , Occupational Therapist, Speech Therapist

 to Mr Charles in rehab and on discharge. 
 

 

 

 
Teacher Feedback: MR FER
Q1.4    Identify community-based care services that are available for Mr Charles with a need for restorative or rehabilitation care. 
 

 

 

 
Teacher Feedback: MR FER
Q1.5    Actively involve Mr Charles in the development of strategies to self-manage his condition. Describe the strategies, or design a program to help teach Mr Charles how to self-manage his Type 1 Diabetes and the introduction of insulin therapy. 

Please make reference to: 

  • Sugar free diet 
  • The importance of BGL’s 
  • The storage of insulin

 
 

 

 

 
Teacher Feedback: MR FER

 

 

 

PART 2 – COMMUNITY CARE 
Q2.1    Identify current contribution of other agencies and professionals in supporting Mr Charles. For the following agencies and professionals, determine their contribution in providing care for Mr Charles in hospital, or following discharge.

Please make reference to the following: 

  • GP
  • Pharmacist 
  • Centrelink 
  • RDNS
  • Physiotherapy 
  • Hydrotherapy 
  • Diabetic nurse educator 
  • Wound care nurse 

 
 

 

 

 
Teacher Feedback: MR FER
Q2.2    Identify the level and type of contribution and support made by family or carer. 
 

 

 

 
Teacher Feedback: MR FER
Q2.3   As a nurse, identify four (4) situations you will communicate with allied health professionals to describe Mr Charles progress.  Provide an example for each situation of how and what is communicated.  
 

 

 

 
Teacher Feedback: MR FER
Q2.4    Respond to variations in Mr Charles needs in the context of a coordinated service approach. Mr Charles is very sad and writes: “I can’t live like this.  I just want to die- and I know how to do it.”  As a nurse, how will you respond and what members of the health care team will you contact to help deal with this situation?   
 

 

 

 
Teacher Feedback: MR FER
Q2.5 After consultation with the Endocrinologist and Diabetic Nurse Educator, Mr Charles has been told he will need to manage his insulin injections to help control his Type 1 Diabetes.  How will you as a nurse, educate and evaluate Mr Charles understanding of his diabetes and new management regime? Please make reference to the following: 

  • Sugar free diet 
  • Checking of BGL 
  • Storage of insulin 
  • Injection of insulin 

 

Pathophysiologic processes of cardiovascular and cardiopulmonary systems

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Please explain the pathophysiologic processes of cardiovascular and cardiopulmonary systems that result from a week post-op patient experiencing shortness of breath, chest pain, new onset afib and inverted T waves on ECG.

Reflect on the importance of interoperability within healthcare delivery

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Reflect on the importance of interoperability within healthcare delivery and the role that informatics technical standards play in the process. Now consider the role that an informatics nurse specialist plays in the development and adoption of, usability, and adoption of informatics technical standards. How relevant to nursing practice are these technical standards? How much does a clinical nurse need to know about these standards? Explain your reasoning. What are some key considerations for an informatics nurse specialist eg., what skills and knowledge are needed to best fulfill job/career roles?

A pediatric oncology unit

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You are the nurse manager of a pediatric oncology unit. You are also the manager of the same day chemo unit that is attached to your inpatient unit. The strategy for delivering chemotherapy to children under the age of 18 is going to change in order to accommodate family schedules and school needs. Children will now be receiving their chemotherapy after 4 PM or on the weekend. This means that many of them will not be finished with their infusions until 10 PM or later and the unit will need to be staffed on the weekend which was not the case previously. This will greatly alter the staffing needs of the unit.

 

1. What is your course of action in the situation?

 

2. What is the fiscal impact of this change?

 

3.  What data will drive this change?

 

4.  Whose responsibility is it to provide education and support in the given situation?

 

5.  How would you evaluate the outcome(s) of this change?

Autosomal dominant pattern

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Donna and Darren have three children. Darren’s father has hypercholesterolemia, which is transmitted in an autosomal dominant pattern. Darren gets his cholesterol levels checked frequently, and they have remained within normal limits; however, two of Donna and Darren’s three children have high plasma levels of total and LDL cholesterol. Darren doesn’t understand why his children are affected when it is clear that he is healthy. 1. Do you see any risk factors or inheritance patterns (include family members in your response)? 2. What could explain why Darren is unaffected but two of his children are affected? 3. What are treatments for familial hypercholesterolemia? 4. When would children be treated?