Medication Reconciliation

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a.  Explain the medication reconciliation process

b.  Analyze the client scenario for any omissions, additions, or duplications of medications and discuss the implications to the client.

c.  Analyze the client scenario for potential risks associated with the client’s current condition and currently prescribed home medications

d.  Identify potential drug interaction and prioritize the drug interactions that are most concerning to you.

e.  Identify actions that the nurse should implement and provide a reason for each action.

1.  Mr. H. is being admitted with a broken hip due to falling at home and will be having surgery the next morning.  Past medical history includes hypertension and Type 2 diabetes. Allergies: Penicillin.  The home medication list is provided to the nurse and includes the following medications:

a.  Metoprolol 25 mg PO daily

b.  Atenolol 50 mg PO daily

c.  Garlic 1000 mg PO daily

d.  Metformin 500 mg PO twice daily

e.  Aspirin 81 mg PO daily

2.  The admitting orders include the following medication orders:

a.  Continue all home medications except metformin

b.  Insulin subcutaneous based on sliding scale B

i.  Blood sugar <150= 0 units

ii.  Blood sugar 151-175= 2 units

iii.  Blood sugar 176-200=3 units

iv.  Blood sugar 201-225=4 units

v.  Blood sugar 226-250=5 units

vi.  Blood sugar 251-300= 6 unites

vii.  Blood sugar > 300= notify healthcare provider

c.  Enoxaparin 40 mg subcutaneous daily, first dose tomorrow following surgery

d.  Piperacillin/tazobactam 3 gram/0.375 gram IV every 6 hours, first dose 30 minutes prior to surgery

Shelter for battered women

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Power Point Presentation

Topic: Shelter for battered women.

Research the institution to see first hand what services they provide.

Brief overview of the institution including history, when established, and the population it services.

Describe the vulnerable population you encountered while visiting the facility.

Why is the above population considered vulnerable?

What is this institution doing to assist the population in becoming less vulnerable?

List at least 3 suggestions your group has to improve the quality of life for these vulnerable individuals and how can you can apply them to nursing practice.

Reference slide that includes references in APA format.

Resources

https://www.bhnv.org/

Assessing And Diagnosing Patients With Mood Disorders

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Accurately diagnosing depressive disorders can be challenging given their periodic and, at times, cyclic nature. Some of these disorders occur in response to stressors and, depending on the cultural history of the client, may affect their decision to seek treatment. Bipolar disorders can also be difficult to properly diagnose. While clients with a bipolar or related disorder will likely have to contend with the disorder indefinitely, many find that the use of medication and evidence-based treatments have favorable outcomes.

To Prepare:

  • Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing mood disorders.
  • Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
  • By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
  • Consider what history would be necessary to collect from this patient.
  • Consider what interview questions you would need to ask this patient.
  • Identify at least three possible differential diagnoses for the patient.

Psychiatric Evaluation

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

  • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
  • Objective: What observations did you make during the psychiatric assessment?
  • Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

the evolution of nursing informatics

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Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

To Prepare:

  • Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.
  • Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty. And/or the continued emergence of new technologies might have on professional interactions.

Technology Application

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In the Discussion for this module. You considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined?

Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process. And can help to improve outcomes by improving processes. Identifying at-risk patients, and enhancing efficiency.

To Prepare:

  • Review the concepts of technology application as presented in the Resources.
  • Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics. As a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization. Propose a nursing informatics project for your organization that you advocate to improve patient outcomes. Or patient-care efficiency. Your project proposal should include the following:

  • Describe the project you propose.
  • Identify the stakeholders impacted by this project.
  • Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving. And explain how this improvement would occur. Be specific and provide examples.
  • Identify the technologies required to implement this project and explain why.
  • Identify the project team (by roles), And explain how you would incorporate the nurse informaticist in the project team.
  • Use APA format and include a title page and reference page.
  • Use the Safe Assign Drafts to check your match percentage before submitting your work.

Radiology Discussion

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Radiology Discussion

What happens during the fraction of a second when a technologist presses the exposure button? What is the importance of knowing the steps involved in creating an image? Why can’t the technologist just place the patient under the collimator light and press the exposure button? Reimbursement trends in medicine strongly encourage radiology departments to adopt digital technologies. Provide a rationale for these trends in terms of costs, dose, image quality, and efficiencies. How would you employ exposure indicators to assess image quality and radiation dose management?

  • Your initial response needs to be a minimum of 250 words.
  • The submission must answer all components of the prompt.

Carbohydrates

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Carbohydrates have been wrongly accused of being the “fattening” ingredient of foods. Thereby misleading millions of weight-conscious people into eliminating nutritious carbohydrate-rich foods from their diets.  In truth, people who wish to lose fat, maintain lean tissue. And stay healthy can do no better than to attend closely to portion sizes and calorie intakes and to design an eating plan around carbohydrate-rich fruit, legumes, vegetables, and whole grains.

For this assignment, I want you to do some research on the “Keto Diet”.  Please write a 1 page (double spaced, 12 point – Times New Roman) abstract on the Keto Diet and the benefits and controversy surrounding this “diet fad”.  This assignment is for your knowledge and if the “Keto Diet” is truly something people should be participating in.  For any research articles found and used for this assignment, please cite them in APA style.

Advanced Pharm Opioids

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Advanced Pharm Opioids

Patient rounds involve various disciplines coming together to discuss the patient’s condition and coordinate care. They are used as an educational tool and also help keep everyone on the same page when it comes to the treatment plan. The following case is found in the textbook (Pharmacotherapy: Principles and Practices. Chisholm-Burns et al, eds.  5th edition.  McGraw-Hill.  New York 2019. ISBN-978-1-260-01944-5; Chapter 34. “Patient encounter”).

After reading the assigned chapters in the textbook, resources identified in Dynamed. And Evidence based practice guidelines, please present the case to your peers in the form of a discussion. This will be your initial post. Please be sure to address all parts of the case. And ensure your responses are well researched [including supporting, evidence based guidelines such those of the WHO, CDC, APS, etc.].

 

Part 1:

HPI:  A 78-year-old man who is to undergo a left above the knee amputation due to a limb abscess

PMH: Peripheral artery disease for 18 years; cardiomyopathy, benign prostatic hypertrophy for 13 years

FH: Mother had osteoporosis; father had diabetes

SH: Lives with wife; has two grown children

Meds: Aspirin 81mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; pantoprazole 40 mg daily; tamsulosin 0.4 mg daily

Pain Assessment: Patient rates pain as 8 on a scale of 0 to 10.

  • Based on the type of injury, what type of pain is this patient likely to experience?
  • What type of pain management regimen would you suggest in the postoperative period? Explain your answer

adequate pain control

Part 2:

Following surgery he was placed on morphine patient-controlled analgesia (PCA). He has been using 55 mg of morphine/24 hours with adequate pain control; however, he developed redness and itching on his neck that is believed to be due to the morphine.

Current Meds:  Morphine PCA; aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily; heparin 5000 units twice daily until discharged home. He will be discharged to a skilled nursing facility for rehabilitation therapy.

combination preparation of hydrocodone

You would like to convert him to a combination preparation of hydrocodone and APAP for as-needed pain relief.

  • What dosing regimen would you suggest?
  • What would your monitoring plan include for this patient?
  • How would you assess pain response?
  • The patient is concerned about the redness. And itching that he developed while on morphine. Would you document this as an allergic reaction?
  • What other interventions or education may be necessary at this time?

physical therapy and occupational therapy

Part 3:

The patient was discharged to a skilled nursing facility. And is receiving physical therapy. And occupational therapy 6 days each week.

Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home, hydrocodone/acetaminophen 5/325 mg every 6 hours as needed for pain.

Pain Assessment: Patient reports pain of 7 out of 10; worse with movement.

Physical therapy notes indicate the patient is unable to complete therapy goals due to complaints of pain.

  • Based on this information, what would you recommend to optimize pain control?
  • Prescribers play a critical role in prescription drug misuse and abuse prevention. What steps can be taken to identify signs of dependence and abuse and what education can you provide to the patient regarding the negative effects of medication misuse?

rehabilitation goals

Part 4:

The patient has been at the skilled nursing facility for 4 weeks. And is making progress toward rehabilitation goals; however, he complains that his leg is throbbing and feels like pins and needles. As a result, he requests to rest several times during her therapy sessions. During unit rounds, his therapist inquires whether her previous pain medication should be reordered.

Pain Assessment: 4 out of 10

Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home,

  • What additional recommendations would you have at this time regarding pain management?
  • Are there any other therapeutic issues that should be addressed?

Different Facilities and Certification Options

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Recognize Different Facilities and Certification Options

Description

Directions: Unless otherwise stated, answer in complete sentences, and be sure to use correct English spelling and grammar. Sources must be cited in APA format. Your response should be four (4) pages in length; refer to the “Assignment Format” page for specific format requirements.

Part 1: For this writing assignment, please explain why the following course objectives are important for medical billers and coder to understand:

  1. Recognize different types of facilities that would employ allied health personnel and discuss options available for certification.
  2. Explain the history and impact of health insurance on health care reimbursement process and recognize various types of health insurance coverage.
  3. Identify the key elements of a managed care contract and identify the role HIPAA plays in the health care industry.

Part 2: Choose either the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) and describe the certification process for at least two certifications within the organization that you choose. Please provide information on the following.

  1. Eligibility
  2. Exam costs
  3. Areas of focus
  4. Test information

 

Explanation & Answer length: 4 pages

nursing plan

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Health History Guidelines NR302

EBOOK: Jarvis, C., Eckhardt, A., & Thomas, P. (2020). Physical examination & health assessment (8th ed.). Saunders.

Purpose

Before any nursing plan of care or intervention can be implemented or evaluated, the nurse assesses the individual through the collection of both subjective and objective data. The data collected are used to determine areas of need or problems to be addressed by the nursing care plan. This assignment will focus on collecting subjective assessment data, synthesizing the data, and on identifying health/wellness priorities based on the findings. The purpose of the assignment is two-fold:

•To recognize the interrelationships of subjective data (physiological, psychosocial, cultural/spiritual, and developmental) affecting health and wellness.

•To reflect on the interactive process between self and client when conducting a health assessment.

Course Outcomes:

This assignment enables the student to meet the following course outcomes:

CO 1: Explain expected client behaviors while differentiating between normal findings, variations, and abnormalities. (PO 1)

CO 2: Utilize prior knowledge of theories and principles of nursing and related disciplines to integrate clinical judgment in professional decision-making and implementation of the nursing process while obtaining a physical assessment. (POs 4 and 8)

CO 3: Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)

CO 4: Utilize effective communication when performing a health assessment. (PO 3)

CO 5: Demonstrate beginning skill in performing a complete physical examination, using the techniques of inspection, palpation, percussion, and auscultation. (PO 2)

CO 6: Identify teaching/learning needs from the health history of an individual. (POs 2 and 5)

CO 7: Explore the professional responsibility involved in conducting a comprehensive health assessment and providing appropriate documentation. (POs 6 and 7)

APA format (7th ed.) and is free of errors

Grammar and mechanics are free of errors free of Plagiarism

References: Use your book, the outside source must be within the last 5 yrs, Scholarly Articles,s or Nurse journals within the last 5 yrs.