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2023 You are admitting a 19 year old female college student to the hospital for
by adminNursing 2023 DQ 300
You are admitting a 19 year old female college student to the hospital for 2023 Assignment
You are admitting a 19-year old female college student to the hospital for fevers. Using the patient information provided, choose a culture unfamiliar to you and describe what would be important to remember while you interview this patient. Discuss the health care support systems available in your community for someone of this culture. If no support systems are available in your community, identify a national resource.
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2023 End of Life Issues With our framework of ethical theories and principles in hand we begin our look
by adminNursing 2023 Write A 2-3 Page Paper That Examines The Moral And Ethical Issues Involved In Making A Decision Regarding Limiting Life Support.
End of Life Issues With our framework of ethical theories and principles in hand we begin our look 2023 Assignment
End-of-Life Issues
With our framework of ethical theories and principles in hand, we begin our look at some of the critical ethical issues in our contemporary world, starting with end-of-life issues. This assessment covers ethical questions related to end-of-life care. Passive euthanasia is the removal or refusal of life-sustaining treatment. Examples of passive euthanasia include removal of a feeding tube or a ventilator, or forgoing a life-prolonging surgery. Passive euthanasia is legal in all 50 states, and the principle of autonomy gives informed patients the right to refuse any and all treatments. Patients who are unable to make such decisions in the moment (because they are unconscious, for example) might have made their intentions clear beforehand with an advance directive or similar document. Things become more complicated, however, when a patient who is unable to make treatment choices has not made his or her wishes clear, either formally in a written document, or informally in conversations with family members or friends. Another problem concerns cases in which there is disagreement about whether the treatment is sustaining the life of a person in the full sense or merely as a body that, because of severe and irreversible brain trauma, is no longer truly a living person.
Active euthanasia, or assisted suicide, introduces further difficult moral questions. A patient who has a terminal illness and who has refused treatments that would merely prolong a potentially very painful and debilitating death might want the process of dying to be hastened and made less painful. The patient might want to take his or her own life before the disease reaches its horrible final stages. Should patients be legally allowed to have help in this endeavor? If suicide itself is not morally wrong, at least in cases like these, is it wrong for another person to directly help bring about the patient’s death? Is it wrong for doctors, a role we naturally associate with healing and the promotion of life, to use their medical expertise to deliberately end a patient’s life if the patient wants this?
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Preparation
This media piece provides the context for this assessment; make sure you have reviewed the case study thoroughly.
Additionally, it may be useful to think through the following issues as they relate to Mr. Martinez’s case:
Instructions
In a 2–3 page analysis of the case study, address the following:
When writing your assessment submission assume that doctors cannot contact Mrs. Martinez and must make this choice on their own. To help you reach an objective, ethically sound decision, draw upon concepts and arguments from the suggested resources or your independent research. Support your response with clear, concise, and correct examples, weaving and citing the readings and media throughout your answer.
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2023 Many people in the US particularly the elderly take more than one prescribed
by adminNursing 2023 Conduct An Interview Of A Client Who Is Taking Multiple Medications (polypharmacy).
Many people in the US particularly the elderly take more than one prescribed 2023 Assignment
Many people in the US, particularly the elderly, take more than one prescribed medication. CDC (2014) reported that between 2009 and 2012 nearly 48% of persons asked used at least one prescription drug, 22% used three or more prescription drugs, and nearly 11% used five or more.
In a recent study published by the Mayo Clinic, seven out of 10 Americans take at least one prescription drug. The most commonly prescribed drug is antibiotics — taken by 17 percent of Americans — followed by antidepressants and opioids — each taken by 13 percent of Americans. In addition, findings showed that:
When people take multiple medications, there is a greater risk for confusion about which medications are taken, when they are taken, and what they are being taken for. There is also a higher risk for drug interactions and increased side effects and adverse reactions.
Sometimes because of the sheer number of medications being prescribed, they may be forgotten, become too much of a bother, or a financial burden which can significantly impact client compliance and lead to poor health outcomes.
In this written assignment, you will be conducting an interview of a client who is taking multiple prescribed medications (three or more) and submitting a written paper describing the findings from the interview. You will then develop a Client Teaching Plan. Your instructor will assist you in the selection of the client. You must achieve a “pass” in this assignment to satisfactorily fulfill the requirements for the Pharmacology course.
The three parts of this assignment are:
Conduct an interview of a client who is taking multiple medications (polypharmacy). You must prepare the client before the interview by explaining why you are conducting the interview. You can say “my assignment is to find out about the medications you are taking so I can determine if you need more information about what you are taking”. You must always get permission from the client to conduct the interview and you must tell the client how the information will be used. You can say, “I will not be using your name in the information I share and I will be submitting it to my instructor only for this student assignment”. If there is important information that needs to be communicated to you, your doctor, family, or nurse, my instructor will assist me in following up on this”. Tell the client you will take no more than 30-45 minutes for the interview.
There may be a family member or significant other present during the interview. That is fine. Be sure to identify who answered a question and if possible always have the client answer first. Always thank the client (and others) when you complete the interview.
Do not use recording equipment for this interview. Have a notepad and pencil or pen and explain that you will be taking notes. When the interview is over, go to a quiet place and take some time to fill in any information you did not jot down. If you wait, you will not remember.
When setting the environment for the interview, make sure the client (and others) is comfortable and you are comfortably seated facing the client. If possible, do the interview in a quiet place.
Ask questions slowly giving the client time to answer. Pay attention to the client’s hearing and ability to respond to the questions. Be sure your non-verbal communication demonstrates you are calm and relaxed.
Use the following interview question guidelines when conducting the interview. Be aware that the client may not be able to answer each of the questions with detailed information. Collect as much information as the client is able and willing to give you. Remember you are the interviewer so you will be collecting information and not making any comments about the information shared by the client except to ask for further clarification if you are not sure what was said or need more detail if it is available.
(Before the interview research each of the medications. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions).
For the following questions, paraphrase the client’s answers for your written paper.
Ask a final question about whether the client would like to tell you anything further about their medications.
Write a paper describing your research and findings about the medications being taken and the results of the interview. Report your findings in a 3-5 page written paper. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.
Use accurate and appropriate spelling and grammar and APA Editorial Format for sources used in your written paper.
Develop a teaching plan for this client based on your findings. Based on the findings from the interview, develop a 2-3 page teaching plan to include the following:
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2023 Clinical Scenario REASON FOR CONSULTATION Desaturation to 64 on room air 1 hour ago with associated shortness of
by adminNursing 2023 Pulmonary Case Study
Clinical Scenario REASON FOR CONSULTATION Desaturation to 64 on room air 1 hour ago with associated shortness of 2023 Assignment
Clinical Scenario:
REASON FOR CONSULTATION: Desaturation to 64% on room air 1 hour ago with associated shortness of breath.
HISTORY OF PRESENT ILLNESS: Mrs. X is 73-year-old Caucasian female who was admitted to the general surgery service 3 days ago for a leaking j-tube which was surgically replaced 2 days ago and is now working properly. This morning at 07:30, the RN reported that the patient was sleeping and doing fine, then the CNA made rounds at 0900 and Mrs. X was found be mildly dyspneic. Vital signs were checked at that time and were; temperature 38.6, pulse 120, respirations 22, blood pressure 138/38. O2 sat was 64% on room air. The general surgeon was notified by the nursing staff of the hypoxia, an order for a chest x-ray and oxygen therapy were given to the RN. The O2 sat is maintaining at 91% on 4L NC. The patient was seen and examined at 10:10 a.m. She reports that she has been having mild dyspnea for 2 days that has progressively gotten worse. She does not use oxygen at home. Her respiratory rate at the time of visit was 22 and she feels short of breath. She has felt this way in the past when she had pneumonia. She is currently undergoing radiation treatment for laryngeal cancer and her last treatment was 1 to 2 weeks ago. She reports that she has 2 to 3 treatments left. She denies any chest pain at this time and denies any previous history of CHF. Review of her vital signs show that she has been having intermittent fevers since yesterday morning. Of note, she was admitted to the hospital 3 weeks ago for an atrial fibrillation with RVR for which she was cardioverted and has not had any further problems. The cardiologist at that time said that she did not need any anticoagulation unless she reverted back into A-fib.
REVIEW OF SYSTEMS:
Constitutional: Negative for diaphoresis and chills. Positive for fever and fatigue.
HEENT: Negative for hearing loss, ear pain, nose bleeds, tinnitus. Positive for throat pain secondary to her laryngeal cancer.
Eyes: Negative for blurred vision, double vision, photophobia, discharge or redness.
Respiratory: Positive for cough and shortness of breath. Negative for hemoptysis and wheezing.
Cardiovascular: Negative for chest pain, palpitations, orthopnea, leg swelling or PND.
Gastrointestinal: Negative for heartburn, nausea, vomiting, abdominal pain, diarrhea, constipation, blood in stool or melena.
Genitourinary: Negative for dysuria, urgency, frequency, hematuria and flank pain.
Musculoskeletal: Negative for myalgias, back pain and falls.
Skin: Negative for itching and rash.
Neurological: Negative for dizziness, tingling, tremors, sensory changes, speech changes.
Endocrine/hematologic/allergies: Negative for environmental allergies or polydipsia. Does not bruise or bleed easily.
Psychiatric: Negative for depression, hallucinations and memory loss.
PAST MEDICAL HISTORY:
PAST SURGICAL HISTORY:
FAMILY HISTORY:
SOCIAL HISTORY: She denies any smoking or alcohol use. She denies any drug use.
MEDICATIONS:
ALLERGIES: SHE IS ALLERGIC TO CIPRO, WHICH CAUSES URTICARIA AND HIVES, CONTRAST DYE, HONEY AND BEE VENOM, ADHESIVE, AND SULFAS, WHICH CAUSE HIVES.
PHYSICAL EXAMINATION:
Vital signs: 38.6, 120, 22, 138/38, 64% on room air. O2 sat of 91 on 4 liters nasal cannula.
Constitutional: She is somnolent. Oriented to person and place. Appears ill and mildly dyspneic.
Head: Normocephalic and atraumatic. Nose: Midline, right and left maxillary and frontal sinuses are nontender bilaterally.
Oropharynx: Clear and moist. No uvula swelling or exudate noted.
Eyes: Conjunctivae, EOM and lids are normal. PERL. Right and left eyes are without drainage or nystagmus. No scleral icterus.
Neck: Normal range of motion and phonation. Neck is supple. No JVD. No tracheal deviation present. No thyromegaly or thyroid nodules. No cervical lymphadenopathy noted bilaterally.
Cardiovascular: rapid rate, S1 and S2 without murmur or gallop. Brachial, radial, dorsalis pedis, and posterior tibial are 2+/4+ bilaterally.
Chest: Respirations are regular and even with mild dyspnea.
Lungs are coarse and with some rales posterior bases.
Abdomen: Soft. Bowel sounds are active, nontender, no masses noted. No hepatosplenomegaly noted. No peritoneal signs.
Musculoskeletal: Full range of motion of the bilateral shoulders, wrists, elbows.
Neurologic: Somnolent. Cranial nerves II-XII are intact.
Skin: Warm and dry.
Psychiatric: Mood and affect are normal. Calm and cooperative. Behavior, judgment is intact.
LABORATORIES AND DIAGNOSTICS:
WBC 7.2, Neutrophil 63%
Creatinine 2.5 mg/dL, BUN 45 mg/dL, Na 144 mEq/L, Potassium 4.4 mEq/L, Total Bilirubin is 0.9 mg/dL, Platelets 100,000
BNP 242 pg/mL
Lactate 1.0 mg/dL
All other labs are unremarkable
Chest x-ray: Right lower lobe infiltrate
EKG: NSR, no ST or T wave changes
Questions:
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