Adopting Electronic medical records

Which one of the following is not a significant reason for adopting electronic medical records (EMR)?

A. increasing productivity

B. Increased patient satisfaction

C. Increased ability to benchmark with other hospitals

D. Securing financial incentives and avoiding penalties

Extensive Thoracic surgery

An LPN is working in a critical care area and has been assisting in the care of a client who underwent extensive thoracic surgery. The client’s condition has deteriorated, and the need for ventilation is being considered. Assigning responsibility for care for this client to the LPN in this case would be inappropriate based on: (provide a rationale for your answer please)

 

  1. Level of Supervision
  2. Extent of patient interaction
  3. Stability
  4. Potential for harm

3. What patient would you consider a priority and provide a rationale as to why?

  • A Patient asking for Morphine with a broken wrist or
  • A patient with a pressure ulcer/wound in need of an antibiotic

 

4. Please prioritize the order in which you would see these patients (1-4) and provide a rationale for your #1

  • A diabetic patient whose blood sugar at 6:50 A.M. was 40 and who just received 50% dextrose for a hypoglycemic episode.
  • A patient with pneumonia who was treated for a temperature of 100.5 °F at 4:00 A.M. Current vitals include SpO2 of 96% on 2 L oxygen via nasal cannula
  • A patient who was admitted 2 days ago with chest pain; his troponin I results have been normal in the 48 hours since admission.  He is currently watching TV.
  • A patient with peptic ulcer disease who has pulled out the peripheral IV catheter and is scheduled to receive a dose of famotidine (Pepcid) at 8:00 A.M.

5. A LPN is given a patient assignment for the day. Which of the following clients should be re-assigned to the RN? (Please provide a rationale)

    1. A patient with an NG/OG tube and the pH aspirate is 3
    2. A patient with asthma that requires a non-rebreather mask

6. Define the following and name and example for each

    1. Proton Pump Inhibitors
    2. Antacids

Left Knee replacement surgery

The RN is reviewing the exercise program for a client being discharged after left knee replacement surgery. Which client statement indicates that further teaching is necessary

State-mandated reporter statute

Review your state-mandated reporter statute. Provide details about this in your post. If faced with a mandated reporter issue, what are the steps in reporting the issue? Create a mandated reporter scenario and post it. Respond to one of your peer’s scenarios using the guidelines for submission/reporting in your state.

Be sure to include a reference to your state’s website related to mandated reporting.My state is Texas.

Provide Reference.

Details about Child abuse or neglect In Texas

Provide details about child abuse or neglect In Texas and if faced with a mandated reporter issue, what are the steps in reporting the issue as a nurse. provide reference  from Texas website related to mandated reporting.

The Work of the course

How well did you do the work of the course? How do you think you might have performed better (if applicable)?

 

(I did okay, not great.)

Severe Abdominal pain

A 25-year-old female presents to the emergency room (ER) with complaints of severe abdominal pain for 2 weeks . The pain is sharp and crampy It hurts if I run, sit down hard, or if I have sex

PMH: None

Drug Hx: Birth Control

NKA

Subjective Data:

Nausea and vomiting, Last menstrual period 5 days ago, New sexual partner about 2 months ago, No condoms, he hates them No pain, blood or difficulty with urination

Objective Data:

B/P 138/90; temperature 99°F;  (RR) 20; (HR) 110, regular; oxygen saturation (PO2) 96%; pain 5/10

acute distress and severe pain

Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip.

CTA AP&L

S1S2 without rub or gallop

• INSPECTION: no masses or thrills noted; no discoloration and skin is warm to; no tattoos or piercings; abdomen is nondistended and round
• AUSCULTATION: bowel sounds (BS) are normal in all four quadrants, no bruits noted
• PALPATION: on palpation, abdomen is tender to touch in four quadrants; tenderness noted on light palpation, deep palpation reveals no masses, spleen and liver unremarkable
• PERCUSSION: tympany heard in all quadrants, no dullness noted in abdominal area

• EXTERNAL: mature hair distribution; no external lesions on labia
• INTROITUS: slight green-gray discharge, no lesions
• VAGINAL: normal rugae; moderate amount of green discharge on vaginal walls
• CERVIX: nulliparous os with small amount of purulent discharge from os with positive cervical motion tenderness (CMT)
• UTERUS: ante-flexed, normal size, shape, and position
• ADNEXA: bilateral tenderness with fullness; both ovaries without masses
• RECTAL: deferred
• VAGINAL DISCHARGE: green in color

no cyanosis, clubbing or edema

intact without lesions masses or rashes

No obvious deficits and CN grossly intact II-XII

  1. What other subjective data would you obtain?
  2. What other objective findings would you look for?
  3. What diagnostic exams do you want to order?
  4. Name 3 differential diagnoses based on this patient presenting symptoms?
  5. Give rationales for your each differential diagnosis.

Access to Health care for the uninsured

As health care costs continue to rise dramatically in the United States, one major issue that must be addressed is access to health care for the uninsured and underinsured. Which plan’s expanded health care coverage to uninsured Americans is aimed at controlling costs and improving the quality of health care?

Medicaid

Medicare

Diagnosis-related groups (DRGs)

The National Drug Strategic Framework

The National Drug Strategic Framework in Australia provides a national policy framework to reduce the harm caused by drugs. This national strategy identifies several ‘priority areas for action, including ‘preventing use and harm’ As a response to this harm-minimization approach, several states across Australia have implemented Medically Safe Injecting Centres (MICs).

Sydney was the first state to do so. For this assessment, you are required to essay using the case study of Sydney’s Medically Supervised Injecting Centre (MSIC) in Kings Cross Sydney.

In this essay, you should relate this policy response to the stages of the policy process, analyzing the extent to which the introduction of the MSIC in Sydney conformed to these stages. Would you say this has been a successful policy response to the National Drug Strategy? Use relevant theory, research and evidence to support your discussion. Subject Aged ( community service) Code dal duo nursing

The Evaluation of nursing interventions

An important part of the nursing process is the evaluation of nursing interventions in which the nurse uses critical thinking to evaluate effectiveness of the care are plan. What should the nurse document in the electronic medical record (EMR) after implementing nursing interventions like suctioning a tracheostomy? Select all that apply.

New finding of yellow, frothy sputum

Description of the suctioning procedure

Oxygen saturation level after suctioning

Patient reports of improvement in breathing

Amount of urine collected from drainage bag