physician orders

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NSG110 Math Homework #6

1)

Demerol - Sanofi-aventis U.S. LLC, Page 3

What is the brand name? ____________________________________

What is the generic name? ___________________________________

How many pills are in the bottle? ______________________________

How many milligrams are each pill? ____________________________

 

2) The doctor prescribes 750 micrograms of a medication. The pharmacy sends 0.5milligrams pills of the medication. How many pills will you give the patient? ____________________________________

 

 

 

3) Total your patient’s intake and output for your 12 hour shift.

At 08:00 the patient consumed 1 cup of coffee, 1 pint of milk and 6 ounces of orange juice, 08:30 he voided 200mL of urine and vomited 150 ounces of emesis. And 11:45 he vomited 100 mLs of emesis and states he is very nauseated. You notify the health care provider who orders normal saline 100ml/hr IV, which is started at 12:00. The patient consumed ½ cup of ice chips. For dinner the health care provider ordered clear liquids. 14:00 the patient voided 225 mL of urine. At dinner the patient took 1 cup of chicken broth, ½ cup of jello and 8 ounces of tea. At 18:00, the patient voided 100ml of urine. Your shift ends. What is the intake and the output of this patient?

 

 

 

 

4) A parent brings in their infant for fever and ear infection. The physician orders 300mg of Amoxicillin. The pharmacy sends you this NDC 0781-5060 Amoxicillin Amoxicillin

How many mL do you give your patient? Round to the nearest tenth.

 

5) The physician has ordered 500 mg of XX medication. The pharmacy sends 0.25 g pills of XX medication. How many pills should you give?

 

 

 

 

6) The OR calls and tells you to have your patient ready for surgery at 13:00 today. What time is this in standard time? (Be sure to include am/pm)

 

 

7) The physician orders Doxycycline 10 mL for a child with a sore throat.

The pharmacy sends this medication Vibramycin® Calcium (doxycycline calcium oral suspension, USP) oral suspension SYRUP Vibramycin® Hyclate (doxycycline hyclate capsules, USP) CAPSULES Vibramycin® Monohydrate (doxycycline monohydrate) for ORAL SUSPENSION Vibra-Tabs® (doxycycline hyclate ...

The mother complains that you gave Vibramycin and that is not what the doctor ordered. What do you tell her? ______________________

8) The physician orders 250 mcq of digoxin po daily for your patient. The pharmacy sends digoxin 0.25mg per mL. How many mL do you administer? ____________________________________________

 

 

 

9) Your patient is to receive 6 mg of Ketorolac every 6 hours as needed for postoperative pain. How many mL’s will you give per dose?NDC 25021-701 Ketorolac Tromethamine Ketorolac Tromethamine

 

 

10) Your patient’s IV is infusing at 100mL/hr. Halfway through your 12 hour shift the IV infiltrates, you stop the infusion and cannot restart a new IV. How many mL’s did your patient receive for your shift?

Quality Patient Care And Health Outcomes

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4 DQ 1

The health care sector in the United States consists of an array of clinicians, hospitals and other health care facilities, insurance plans, and purchasers of health care services, all operating in various configurations of groups, networks, and independent practices. Some are based in the public sector; others operate in the private sector as either for-profit or not-for-profit entities. The health care sector also includes regulators, some voluntary and others governmental, according to Institute of Medicine.

Health care reform

Health care reform typically attempts to expand the population that receives health care coverage through either public sector insurance programs or private sector insurance companies. It would benefit the public if all health establishments and pharmacies post the cash prices of their products or services. Price transparency. Prices up front for the public so they can shop around different facilities instead of guessing what their insurance will be charged and what they are left to pay out of pocket. Currently these prices are negotiated with the government and insurance companies.

They are secret. Patients should be able to easily compare prices at different hospitals and doctor’s Offices. This is the beginning of promoting competition among healthcare providers.
It is the responsibility of the federal government to lead a national effort to examine the options available to achieve stable health care coverage of individuals and families and to assure the implementation of plans to achieve that result.

Using 200-300 APA formats with references supporting the discussion.

Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.

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causes of liver disease worldwide

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causes of liver disease worldwide

2 REFERNCES

Alcoholism is one of the leading causes of liver disease worldwide and the goal for these individuals is abstinence. There are many treatment modalities that can be employed for alcoholism. Including a 12-step program such as AA where they can find the support of people who have the same goal. Brief interventions such as cognitive behavioral therapy to address any misguided thinking, motivational enhancement therapy. And one of the many FDA approved medications that can be given to reduce craving of alcohol (Leggio & Lee, 2017).

One of the most important part of treating an individual with alcohol use disorder is addressing withdrawal symptoms as these can be deadly. Symptoms of withdrawal include nausea. Vomiting, tremors, anxiety, insomnia, and in severe cases, delirium and seizures. Withdrawals protocols typically include the use of benzodiazepine to reduce symptoms of withdrawal. And prevent seizures. There are three drugs currently that are approved for the treatment of alcohol use disorder, these include, disulfiram, acamprosate, and naltrexone. While these medications can be helpful in reducing cravings and deter drinking. Psychiatric treatment to address underlying issues is necessary for there to be any meaningful recovery (Witkiewitz, Litten, & Leggio, 2019).

References

Leggio, L., & Lee, M. R. (2017). Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease. The American Journal of Medicine, 130(2), 124–134. https://doi.org/10.1016/j.amjmed.2016.10.004

Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. Science Advances, 5(9). https://doi.org/10.1126/sciadv.aax4043

Family and Medical Leave Act

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400-600 words APA 6 format, in-text citation, Use at least 1-2 scholarly references to substantiate your work. Please provide a copy of all references used.

Assignment Description:

You are a Human Resources Manager for Green Branch Coffee, a national chain of urban-style coffee shops. Employees need to work with the human resources (HR) department to ensure a fair, safe, and legal workplace. In this discussion, you will explore the Family and Medical Leave Act (FMLA). The FMLA provides time off for employees so they can deal with a serious medical condition of their own or one of a family member. Employees in companies such as Green Branch Coffee that have at least 50 employees are generally eligible for FMLA. Please review the Employee’s Guide to FMLA from the U.S. Department of Labor, and discuss the following:

  • What is the process of requesting FMLA leave?
  • What are some examples of how the FMLA provides employees with job protection during their FMLA leave?
  • What are some of the responsibilities that employees have during their FMLA leave?

https://www.dol.gov/agencies/whd/fmla/employee-guide

 

Current Healthcare Issue/Trend

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Current Healthcare Issue/Trend

The article must be peer-reviewed, a research study, and related to the current healthcare issue/trend.

The article must have been published within the last 3-5 years.

Identify and discuss the research question, hypothesis, sampling size, and research finding.

100 to 150 word maximum synopsis for the article, identifying the points stated above; as well as the APA formatted reference.

Timberline Health Case_Study

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Timberline Health, an integrated delivery system serving residents in five counties in eastern Washington, is considering new opportunities to increase community awareness of the organization’s outpatient health services. As the new business development manager of hearing health services, Jack Andrews is responsible for evaluating the feasibility of marketing activities for the hearing service line and must allocate resources to promotional activities that forecast positive return on investment. One option under consideration is to sponsor the health and wellness pavilion at the Spokane County Fair. Research from comparable markets has shown

that wellness fairs are not only effective at educating communities about potential risk factors for health problems, including hearing loss, but also increasing consumer awareness of new or existing health services provided by local health organizations. These activities are essential to Timberline Health’s mission within the community.

public health data

Since little is known about the hearing status of residents in the market area, Jack enlists the services of his organization’s epidemiologist, Dr. Ruth Litchfield, to help him evaluate the potential return on investment for this marketing campaign. Dr. Litchfield incorporates several factors into her analysis. She reviews public health data on hearing loss, occupational and age distribution data for local residents, as well as a query of Timberline Health’s patient databases.

Based on this research, she estimates the prevalence of hearing loss in the five-county service area at 18 percent, slightly higher than the national average (NIH, 2010). Jack receives information from the fair’s sales and marketing department to help in his calculations. Specifically, sponsorship consists of an investment of $50,000 for the design and production of promotional materials and rental of pavilion space for the duration of the twelve day fair. Data from the previous three years shows on average 250,000 people attend the fair, of which 1% visit the wellness pavilion and participate in health screening services.

Timberline Health

If Timberline Health is to offer mobile hearing screening, the organization must invest in new portable audiology equipment. Jack receives a quotation from his supplier and estimates the total investment in new audiometers and audiometric booths at $16,000. Timberline Health will use existing diagnostic equipment to test people who have failed the initial screening (i.e. test positive for hearing loss), so it is unnecessary to invest in additional equipment for the hearing centers. Vendor specifications for the screening and diagnostic equipment are indicated in Table 1.

Table 1

Vendor equipment specifications

Equipment

Sensitivity

Specificity

Portable audiology equipment for free screening

88%

95%

Clinic-based audiology equipment for follow-up diagnostic testing

99%

99%

Furthermore, Jack calculates that he must provide coverage for three 6-hour shifts per day. And each shift must have three audiologists to meet the demand for screening tests. He anticipates hiring nine people to provide coverage for the duration of the fair. The hourly rate for audiologists is

$37.50.

People who fail the initial screening at the fair are referred to an audiologist for a diagnostic test. Jack assumes in his calculations that all people who are referred for diagnostic testing follow up with an audiologist in one of Timberline Health’s hearing centers. Initial screening tests at the fair are free; however, Timberline Health charges $57.00 for a diagnostic hearing test, which costs the organization $24.00. Using past sales data and industry metrics, Jack forecasts that of

the total number of people diagnosed with hearing loss at hearing centers only 20% will purchase hearing aids (NIH, 2010). He reviews sales and margin data from the prior year to identify the product mix for his calculations as indicated in Table 2.

Assessing And Treating Patients With Bipolar Disorder

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Assignment: Assessing and Treating Patients With Bipolar Disorder

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients often present as depressive or manic but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder.

To prepare for this Assignment:

· Review this week’s Learning Resources, including the Medication Resources indicated for this week.

· Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy.

The Assignment: 5 pages

Examine Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note:  Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

 

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at

https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

 

 

 

The scenario of Asian descendant lady

 

Bipolar Therapy Client of Korean Descent/Ancestry

Brandon and Marilyn Case Study

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PREPARE A POWER POINT FOR THE CASE STUDY

6): Brandon and Marilyn Case Study

Justin Tyme – a registered nurse joins the unit after successfully completing new employee and unit orientation. He had worked for 10 years in a similar unit at St Elsewhere but grew tired of the 2 hour daily commute. He is thrilled to be working closer to home. The staff is ecstatic as the unit has been shorthanded and the census is high. The staff likes working with Justin. He is friendly fellow and frequently brings hot donuts and a huge thermos of Peets coffee for the staff. He is always willing to help with lifting and turning patients and often in the first one to respond to patients lights.

observations and physician orders

Justin does not always follow through on his observations and physician orders; he often misses giving routine meds. The staff has taken to routinely double checking Justin’s orders and the following shift often dispenses the missed meds. One morning, Dr. Tauk comes in to review the speech consult he ordered the day before on his patient, Mrs. Dee Phagia, prior to ordering her a diet. Dr Tauk cannot find the consult and asks Charity N. Able RN to locate it and call him. Charity discovers that the order had never been placed.

On follow up, Charity discovers not to her surprise- that Justin was the nurse who noted the order. Charity does not talk to the manager but does point out the error to Justin who feels terrible about it. Over the next month, Justin continues to make intermittent “small” mistakes which cause no harm to patients and the staff continues to cover. Today, Dr. L. Ovin comes in and notices that her patient, Mr. hart is in atria fibrillation. She orders stat IV digoxin and cancels the scheduled diagnostic procedures. Mr Hart remains in atria fib and as you review his chart, you discover that Justin missed the last two routine digoxin doses.

Advanced Levels of Clinical Inquiry and Systematic Reviews

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Advanced Levels of Clinical Inquiry and Systematic Reviews

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
  • Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

aging population

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aging population

Select an aging population from another country, provide life expectancy, new disease patterns, longer lives, disabilities, cost of aging, health care, work, and the changing role of the family.

The country is France

Minimum 500 words

APA style

More than 3 references no older than 5 years

No plagiarism acceptable