Study of risk factors for lung cancer

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A longitudinal epidemiological study of risk factors for lung cancer was conducted. 500 smokers who smoked a pack of cigarettes for more than 30 years developed lung cancer, while 14,500 smokers did not develop lung cancer. In the same study, 50 cases of lung cancer occurred among people who never smoked. The remaining 29,950 who never smoked did not develop lung cancer.

 

What is the prevalence of lung cancer in the study?

a.    3.3%
b.    1.2%
c.    0.18%
d.    0.48%

Sources of information about healthcare trends

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Research news and other sources of information about healthcare trends in the United States. Describe one trend and at least 3 implications the trend could have for financial planning within a healthcare organization, such as a hospital or clinic.

include why the trend could have these implications. Support with research and cited statements.

Environment rheumatoid arthritis

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Case Study, Chapter 38, The Healthcare Facility Environment Mr. Simms has been admitted to your extended care facility (ECF). He was transported directly from the hospital. Mr. Simms is highly functional but has been diagnosed with chronic obstructive pulmonary disease (COPD), r

The Healthcare Facility Environment rheumatoid arthritis, and type 2 diabetes. He can no longer live alone and he feels the ECF is his only option. He voices anxiety about his new surroundings, his new routine, and the invasion of his privacy.

The following questions pertain to Mr. Simms. (Learning Objectives 1, 2, 5, 6) 1. While orienting Mr. Simms to his environment, what items will you be sure to show him in his " client unit"?

2. Mr. Simms is concerned about his privacy since he now has a semi-private room in the ECF. In the hospital, he had a private room and had asked for limited visitors.

How can you assure him that his privacy will be respected in the ECF as it was in the hospital? 3. Mr. Simms voices fears about losing his ability to ambulate due to his arthritis.

How can an ECF help Mr. Simms maintain mobility? 4. Mr. Simms asks about his special dietary limitations.

He is concerned that if he doesn’t follow his regular diabetic diet that his blood sugar may rise. How do you respond to his I concerns?

 

Perineal care

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You are a student in the clinical setting. You are helping a support worker position and turning a resident during perineal care. The support worker does not wear gloves, does not use a clean part of the washcloth for each stroke, and wipes from the back (bottom) to the front (top). What has the support worker done wrong? How can you correct the situation?

The philosophy of hospice care

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Hospice 1 The philosophy of hospice care includes A. Providing hospice care free to all clients. B. Making sure every person dies in his own home. C. Meeting a client’s physical, emotional, and spiritual needs. D. Doing whatever it takes to keep a client alive.. Simpson tells you he is worried about paying for his funeral. Which hospice team member would be the best person to help him with this problem? A. A social worker. C. An occupational therapist. B. The chaplain. D. The physician. 3 One definition of palliative care is:

A. Experimental treatments. C. Vitamin therapy. B. Surgery. D. Symptom control. 4 Your hospice client, Mr. Miller, spends most of his time sitting in his “easy chair”. He is at risk for: A. Gaining weight. C. Diarrhea. B. Pressure sores. D. Shortness of breath. 5 TRUE FALSE Hospice is only available to people with Medicare benefits. 6 TRUE FALSE In order to help their clients, hospice aides need to believe in God. 7 TRUE FALSE Hospice care provides services to a client’s family even after the client dies. 8 TRUE FALSE Hospice aides are “on call” 24 hours a day. 9 TRUE FALSE Some physicians feel like they have failed if they suggest hospice care for their patients. 10 TRUE FALSE After being admitted to hospice, most clients live for at least six months.

Health and medical monitoring

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Medical Case Scenario

A Homecare Agency supporting Martin, age 45, to live in an apartment with two housemates. Martin is very social and outspoken and enjoys being around others. He likes to be as independent as possible with household activities such as meal preparation and laundry. You provide staff support for carrying out daily activities including bathing, dressing, meals, transportation, and health and medical monitoring. Martin enjoys participating in his church activities, going to the movie theatre, visiting his family and friends, and going to work each day. Martin works in a flower shop doing simple assembly jobs. Martin has cerebral palsy and uses a wheelchair. He has limited use of his upper extremities. Lately, Martin has developed skin ulcers that require re-positioning every twenty minutes. He is at increased risk for aspirating and thus needs special food preparation and supervision while eating. To avoid constipation and bowel obstruction, Martin needs consistent bowel monitoring.

1. What supports would your agency put in place to allow Martin to continue to go to work each day given his increasing support needs?

2. How would you ensure that Martin goes to the movies as often as he likes?

3. How would Martin be supported to spend time with his family, friends, and at church?

4.What supports might enable Martin to be as independent as possible while contributing to household chores?

Protocol-driven replacement

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Protocol-driven replacement protocols are evidence-based tools to give nurses the ability to replace low electrolyte levels in a safe and efficient manner. The electrolytes are replaced according to a goal level set by the provider and kidney function (GFR level). A sliding scale level is used to determine the amount of replacement needed.

Here are some practice questions for electrolyte replacement:

 

The patient is NPO for a procedure and is on the potassium replacement protocol. The goal for the patient is K of 3.5. Morning labs are K of 3.3 and GFR > 60.

The orders are as follows:

Replace potassium with the following sliding scales. The oral route is preferred if the patient is able to take orals.

For GFR > 60 OR

Administer KCl IVPB (if NPO): Administer KCl orally (if taking po):
0.5 or more from goal –

10 mEq /hr for 6 doses

 0.5 or more from goal—

40 mEq q4h x2 doses
0.3-0.4 from goal –

10 mEq /hr for 4 doses

 0.3-0.4 from goal—

20 mEq q4h x2 doses
0.1-0.2 from goal –

10 mEq /hr for 2 doses

 0.1-0.2 from goal –

20 mEq x1 dose

Recheck potassium 4 hours after the replacement is completed.

1) Indicate the amount and how many doses of IV or PO the nurse will administer? __________mEq every ______ hr(s) X__________doses (IV or po) circle

2) The patient has had the procedure and has resumed a diet. The recheck potassium 4 hours after the initial replacement is 3.0. Indicate the amount and how many doses the nurse will administer? __________mEq every ______ hr(s) X__________doses (IV or po) circle

Impaired hepatic function

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Drug toxicity: Select all that apply Can occur when a drug is administered in large doses and blood concentration exceeds therapeutic levels Can occur when impaired renal function impacts the excretion of a drug Results in respiratory depression Cannot be reversed Can occur when impaired hepatic function impacts the metabolism of a drug Is more likely to impact older adults due to anticipated physiologic changes with aging
Question 7 1 pts Controlled substances are categorized by schedule based on their therapeutic use and potential for abuse.
True False The rule of thumb regarding drug use in pregnancy is that medications are contraindicated unless the benefits clearly outweigh the risks. One reason for this is that some medications can cause birth defects in the developing fetus, especially during the first trimester. Medications that cause birth defects are known as Question 9 1 pts Sometimes a medication that a patient has been taking no longer causes the same reaction in the patient. Increasingly higher doses are needed to achieve a therapeutic effect. This is known as Addiction Dynamic equilibrium Tolerance Drug interaction When a medication that is given produces a response different from the intended therapeutic effect this is known as: Select all that apply primary effect secondary effect adverse effect side effect

Important mechanism of action for many drugs

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Receptor-mediated action is an important mechanism of action for many drugs. A drug that interacts with a receptor on a cell by binding to it and stimulating the receptor to perform its function is known as an: Question 5 1 pts A drug reaction that occurs because the host’s body views the drug as an antigen and has developed antibodies to it is a/an:

Compare and contrast immediate to delayed hypersensitivity response

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Sarah has been diagnosed with chronic fatigue syndrome. She asks her nurse to explain it to her. All she knows is, she is tired all the time and doesn’t want to do much of anything. -What does this syndrome mean? – Is there recovery from this disorder or does it simply relapse and go into periods of remission? – What causes this disorder? – How is it treated? – What are the symptoms? – What is the diagnostic testing for this? – Compare and contrast immediate to delayed hypersensitivity response. How are they alike, and how do they differ? What are the symptoms they manifest? What are some treatments for these? How would you manage a client with allergies? -What are the diagnostic tests for allergies, delayed or immediate?