Diagnosis code(s) are reported :
F03.90M25.511I11.9E11.9Diagnosis codeTo categorize and identify illnesses, disorders, symptoms, poisonings, negative effects of medications and chemicals, injuries, and other causes for patient contacts, diagnostic codes are employed in the medical field. Diagnostic coding is the process of converting textual descriptions of ailments, injuries, and diseases into codes that fall under a certain categorization.
In the clinical coding procedure for medical categorization, diagnostic codes are utilized with intervention codes. A medical classification expert such as a clinical coder or a health information manager assigns the diagnostic and intervention codes.
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A nurse is caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS). What is most important for the nurse to assess
When caring for an infant with diagnosis of Hypertrophic Pyloric Stenosis (HPS), it is important for the nurse to assess the signs of dehydration.
HPS is the disease of the infants where the entry of food into the small intestine is blocked. This happens because the opening between the stomach and the small intestine thickens. The disease appears in the babies that are less than or up to 6 months of age.
Dehydration is the condition where the body of an individual has less quantity of fluids than normal. Dehydration can arise due to several reasons like inadequate fluid intake, due to some disease or as an effect of medications.
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During an interview, tears appear in the patient's eyes and his voice becomes shaky. Initially, you should:
the main reason that there is no exact definition of the due process guarantees is that the
The Supreme Court only defines the due process guarantees on a case-by-case basis, which is the fundamental reason why there is no precise definition of them.
What distinguishes the Fifth Amendment's and the Fourteenth Amendment's provisions of due process?The Due Process Clause of the Fifth Amendment demands equal protection from the federal government. The Equal Protection Clause of the Fourteenth Amendment mandates that states implement equal protection.
Which of the following rules is the Due Process Clause responsible for?According to the Due Process Clause, no one may be denied "life, liberty, or property, without due process of law." According to the Equal Protection Clause, a state cannot refuse to provide any individual under its authority with the same level of the laws.
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A nurse in the pediatric clinic is taking the health history of a toddler with an exacerbation of eczema. What are the nurse's priority assessments of the child
a toddler with an exacerbation of eczema priority are
Wearing cotton clothes
Tolerance of new foods are the nurse's priority assessments of the child
Children's eczema, a common symptom of allergies, frequently has connections to meals and clothing. Cotton clothing is a sign that the parents are aware of their child's allergy and are making an effort to lessen it. The ability to tolerate new foods is a sign that a youngster has outgrown some food sensitivities. Eczema does not develop due to a lack of appetite. Eczema is a sign of allergies; it is not communicable.Dry, itchy, and irritated skin are symptoms of atopic dermatitis (eczema). Despite being age-neutral, it is frequently seen in young children. The chronic condition known as atopic dermatitis occasionally flares up. Although it may irritate you, it is not contagious.
The full question was :
A nurse in the pediatric clinic is taking the health history of a toddler with an exacerbation of eczema. What are the nurse's priority assessments of the child?
Increase in appetite
Wearing cotton clothes
Tolerance of new foods
Exposure to a viral infection
Recent contact with someone with eczema
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A community health nurse is assigned to work in a different area of the city. Which assessment techniques could be used to develop an overview of the community
A windshield survey and review of demographic assessment techniques could be used to develop an overview of the community
Which elements make up a windshield survey?
Survey elements for walking and using windshields
1) Bounds, include neighborhood, political, and administrative boundaries. 2) Housing structure and zones: Home designs, dwelling types, and neighborhood divisions.Which aspect of the neighborhood would the nurse evaluate while doing a windshield survey?
The nurse will be able to see if people are walking or otherwise exercising using a windshield survey. It will also assist the nurse in locating single- or multi-family private and public housing units, social services agency availability, and other crucial neighborhood characteristics.
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To counter the inflammation caused by a bee sting, your friend Alan takes an antihistamine. What type of blood cell's activity is this helping to counteract
To counter the inflammation caused by a bee sting, your friend Alan takes an antihistamine. The activity of basophils helps to counteract.
The body produces and releases histamine as an inflammatory mediator in response to an allergic or hypersensitive reaction. Mast cells, a kind of basophilic leukocyte involved in the immune response, produce this chemical.
The presence of the bee venom stimulates the mast cells to release the histamine they store, resulting in capillary vasodilation and the indications of inflammation when a person experiences an allergic reaction, such as from a bee sting.
Anti-histamines are a class of drugs that stop the release of histamine from mast cells.
Complete question:
To counter the inflammation caused by a bee sting, your friend Alan takes an antihistamine. What type of blood cell’s activity is this helping to counteract?
A. neutrophils
B. lymphocytes
C. erythrocytes
D. basophils
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As a nurse manager, you trial a new pain scale on your unit that is supported by numerous research studies. You compare the patient outcomes with the new scale against the existing scale. Feedback from staff suggests that the new scale is too difficult for patients who have limited language skills and who are already under duress to understand. The difficulty in implementing the new scale refers to testing:
Testing the effectiveness of a new pain scale involves several steps. First, the nurse manager must compare the patient outcomes associated with the existing scale to those associated with the new scale.
This comparison should include both short- and long-term outcomes, such as patient satisfaction, pain relief, and any other relevant measures. Second, the nurse manager should collect feedback from staff on the new scale's usability and understandability.
This would include assessing staff's comfort level with the new scale, as well as patient feedback on the same. Finally, the nurse manager should assess the difficulty of implementing the new scale. This may include determining the amount of training required for staff to effectively use the new scale, as well as any issues related to patient comprehension.
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this form of treatment uses sound energy from high-frequency sound waves to treat pain, relax muscles spasms. stimulate circulation, and break up calcium deposits and scar tissue.
Ultrasound therapy is a form of treatment that utilizes sound waves to relieve pain, relax muscles, stimulate circulation, and break up calcium deposits and scar tissue.
What is ultrasound therapy and its purpose?Ultrasound therapy is a form of physical therapy that uses sound waves to treat pain and other musculoskeletal conditions. It is a non-invasive procedure which uses high-frequency sound waves to penetrate deep into the body, delivering heat to the muscle and soft tissue. This heat increases circulation, which can reduce inflammation and increase healing. Ultrasound therapy is used to treat muscle spasms, tendonitis, bursitis, arthritis, and other musculoskeletal conditions. It can also help to reduce swelling and promote healing by increasing the production of collagen, a protein found in connective tissue. In addition, ultrasound can be used to reduce pain and improve range of motion. Ultrasound therapy can be used in conjunction with other physical therapy to help speed up the healing process. It is a safe and effective form of treatment that can provide significant pain relief and improve mobility in those suffering from musculoskeletal conditions.To learn more about treatment refer to:
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the nurse is assessing a child with cyanosis. the. nurse observes that there is clubbing of the finger in the child. which condition does the nurse sispevt int he chidl
The thickening and flattening of the finger and toe tips are called clubbing. It results from persistent tissue hypoxia and is a sign of a cardiac problem. So, the nurse will suspect a heart disease condition in the given situation.
When you have cyanosis, your skin, lips, and/or nails take on a bluish hue. It happens when your blood doesn't have enough oxygen to go to all of the tissues in your body. Nail clubbing is a structural change to the fingernails or toenails that causes them to resemble an upside-down spoon and turn red and sponge-like. It might happen by itself or in combination with other symptoms like coughing or shortness of breath. All these symtpoms together indicate that the heart is not able to pump enough blood into the system which is causing oxygen deficiency.
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The DRIs tell you how much of each nutrient you need and help you choose foods that will meet these needs. T/F
The DRI tells you how much of each nutrient you need and helps you choose foods that will meet these needs. This is true because DRI will provide recommendations according to our body's nutritional needs.
What is DRI?The Dietary Reference Intake (DRI) is a nutritional recommendation system from the Institute of Medicine (IOM), National Academies (United States).
DRI is an umbrella term for a set of reference values used to plan and assess the nutritional intake of healthy people that varies according to age and sex.
Dietary Reference Intakes (DRI) include two sets of nutritional intake goals for individuals, namely the Recommended Dietary Allowance (RDA) and Adequate Intake (AI).
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A client with hypertension and type 2 diabetes has recently started taking chlorthalidone. Which report by the client is most concerning to the nurse?
High blood pressure becomes substantially hazardous when diabetes is present. Diabetes is a long-term condition in which your body is unable to produce or use insulin properly. The body's numerous cells may use blood sugar as fuel, and insulin helps move it from blood vessels into those cells. Therefore, the nurse should pay more attention to blood pressure reports.
Chlorthalidone is used either alone or in conjunction with other drugs to treat high blood pressure (hypertension). High blood pressure makes the heart and arteries work harder.The heart and arteries might not work correctly if it persists for a long time. The kidneys, heart, and brain's blood vessels may be harmed as a result, which may cause renal failure, heart failure, or a stroke. High blood pressure may also raise the risk of heart attacks. Controlling blood pressure may reduce the likelihood that these issues will arise.Chlorthalidone is also used to treat severe liver disease (cirrhosis), kidney disease, congestive heart failure, and medications for hormone or steroid therapy that cause fluid retention (edema).
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preparing to begin chest compressions on an infant the nurse should perform compressions using which
Answer:
Place the heel of one hand on the breastbone -- just below the nipples. Make sure your heel is not at the very end of the breastbone. You may need to use both hands depending on your size and the size of the child.
Keep your other hand on the child's forehead, keeping the head tilted back.
Press down on the child's chest so that it compresses about one third to one half the depth of the chest.
Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be fast and hard with no pausing. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off''.
Under MACRA, a medical provider who prescribes a treatment that does not adhere to traditional best-practice protocols may be evaluated negatively in comparison with other providers, even if the treatment is effective.
It is TRUE that if a medical professional recommends a treatment that follows conventional best-practice guidelines, MACRA allows for the possibility that they will be rated less favorably than other professionals.
The Medicare Access and CHIP Reauthorization Act of 2015, often known as the Permanent Doc Fix, is a piece of American legislation. Following the passage of the Affordable Care Act in 2010, the Bipartisan Act, which revised the Balanced Budget Act of 1997, made the most significant changes to the American healthcare system.
With the help of MACRA, a system that rewards high-value patient care and efficiency will replace the fee-for-service model. Medicare's provider payments under MACRA were altered in three significant ways.
Regulations relating to MACRA also cover financial incentives for doctors and other providers to use health IT. The Medicare Quality Payment Program was initiated as a result. The Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs) are two options for clinicians to engage in the Quality Payment Program. For doctors who qualify, MIPS is a scheme that combines three incentive systems into one. Clinicians that take part in cutting-edge payment models can receive rewards through APMs.
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Under MACRA, a medical provider who prescribes a treatment that does not adhere to traditional best-practice protocols may be evaluated negatively in comparison with other providers, even if the treatment is effective. This statement is true.
A treatment plan's key component is the relationship and trust between patients and clinicians. This association is impacted by shifting medical trends. The fundamental standards of conduct for all medical professionals are covered in this article. Medical ethical concerns frequently touch on matters of life and death. Patient rights, informed consent, confidentiality, competency, advance directives, carelessness, and many other topics are highlighted as serious health concerns. The proper actions to take in light of all the circumstances are what ethics is all about. It discusses the difference between what is proper and wrong at a particular moment and in a particular society.
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adaptive equipment are mobility aids or mobility-assistive devices that are designed to enable a patient to _______________.
Adaptive equipment are mobility aids or mobility-assistive devices that are designed to enable a patient to bathing.
An adaptive equipment is a device that assists a impaired or disabled existent in negotiating typical conditioning of diurnal living( ADL), similar as eating, codifying, walking, reading, or driving. Mobility aids, similar as wheelchairs, scooters, trampers, nightsticks, crutches1, prosthetic bias, and orthotic bias.
Adaptive equipment are bias that are used to help bathing, dressing, fixing, toileting, and feeding are tone- care conditioning that are including in the diapason of conditioning of diurnal living( ADLs). An adaptive device is a device that assists a impaired or disabled existent in negotiating typical conditioning of diurnal living( ADL)
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While teaching a patient about drug therapy for diabetes, you review the absorption, distribution, metabolism, and excretion of insulin and oral antidiabetic agents. Which principle of pharmacol- ogy are you describing
Pharmacokinetics is the principle of pharmacology, that is being described to the patient about drug therapy.
Pharmacokinetics, occasionally shortened as PK, is a branch of pharmacology devoted to determining the fate of substances administered to a living organism. The substances of interest include any chemical xenobiotic similar as pharmaceutical medicines, fungicides, food complements, cosmetics,etc.. This is nearly related to but distinctly different from pharmacodynamics, which examines the medicine's effect on the body more nearly.
Insulin is a peptide hormone produced by beta cells of the pancreatic islands decoded in humans by the INS gene. It helps to control our blood sugar level and can be used for energy.
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Individuals should participate in activities __________ to improve cardiovascular fitness. A. twice a day B. three to five days a week C. two to three days a week D. seven days a week Please select the best answer from the choices provided. A B C D Mark this and return
Individuals should participate in activities three to five days a week to improve cardiovascular fitness. Thus, the correct answer is B.
Three to five days a week is the recommendation from the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) for adults to participate in moderate-intensity aerobic physical activity for at least 150 minutes per week, or vigorous-intensity aerobic physical activity for at least 75 minutes per week, or a combination of both, spread across at least three days of the week. This frequency of physical activity is sufficient to achieve cardiovascular fitness and improve overall health.
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Answer: b
Explanation:
A nurse is helping a physician insert a subclavian central line. After the physician has gained access to the subclavian vein, he connects a 10-ml syringe to the catheter and withdraws a sample of blood. He then disconnects the syringe from the port. Suddenly, the client becomes confused, disoriented, and pale. The nurse suspects an air embolus. She should:
Turning the client on his left side and placing the bed in Trendelenburg's position is the most important immediate action to take when dealing with an air embolus.
This position helps to move the air bubble away from the heart toward the right atrium where it can be absorbed more easily. It also helps to prevent the air bubble from further entering the vascular system, since the air bubble is lighter than blood and will tend to rise upwards. Trendelenburg's position also helps to increase venous pressure in the lower body to prevent further air from entering the vascular system.
Finally, this position helps to reduce the amount of pressure in the right atrium and ventricle, which helps to reduce symptoms associated with the air embolus. By performing these actions, the nurse is helping to reduce the risk of serious or life-threatening complications from the air embolus.
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a. Describe the three stages of prenatal development your baby will go through during the pregnancy.
Answer:
1. Germinal Stage (First two weeks after conception are known as the Germinal stage)
2. Embryonic Period (The third through the eighth week is known as the Embryonic period)
3. Fetal Period (The time from the ninth week until birth is known as the Fetal period)
Explanation:
In anticipation of a client returning to the room after a subtotal thyroidectomy, which intervention would be highest priority for the nurse to perform
In anticipation of a client returning to the room after a subtotal thyroidectomy, the highest priority intervention for the nurse would be be to set up a tracheostomy kit by the patient's bed.
Sometimes the parathyroid glands are unintentionally removed during thyroid surgery. A subsequent hypocalcemia may cause the glottis to contract, obstructing the airway. Edema at the surgical site may also do the same. Airway obstruction following thyroid surgery is an emergency circumstance, albeit being uncommon. A tracheostomy kit, suction tools, and oxygen should be easily accessible in the client's room. The laryngeal nerve needs to be assessed through speech, so having a pen and paper on hand is appropriate. It is recommended to adopt a semi-Fowler position to increase respiratory excursion. A patent airway, however, takes precedence over these procedures.
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A nurse is asked to start an intravenous line of isotonic 0.9% sodium chloride. He accidentally grabs a bag of hypertonic 9% sodium chloride instead. What will happen to his patient
If the nurse administers the hypertonic 9% sodium chloride solution intravenously, it could cause a severe electrolyte imbalance in the patient and lead to significant fluid shifts. This can increase the risk of cardiac arrest, stroke, or even death. It is important that the nurse double check the correct solution before administering it.
If a nurse were to accidentally start an intravenous (IV) line of hypertonic 9% sodium chloride instead of isotonic 0.9% sodium chloride, it could have serious consequences for the patient. Hypertonic solutions contain a higher concentration of solutes (i.e. sodium chloride) than the cells of the body, while isotonic solutions contain a concentration of solutes that matches the cells of the body.
When a hypertonic solution is introduced into a patient’s body, the cells of the body become dehydrated as the water is drawn out of the cells and into the hypertonic solution. This is known as osmosis. This dehydration can cause cells to become damaged, leading to serious medical complications.
The most common symptoms of a hypertonic IV line include headaches, abdominal cramping, nausea, and vomiting. As the concentration of the sodium chloride increases, the patient could experience more severe symptoms such as confusion, seizures, difficulty breathing and even coma. In extreme cases, death can result from the introduction of a hypertonic solution.
If a nurse were to administer a hypertonic solution, it is important to take immediate action.
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The nurse manager wants to use evidence-based recommendations to prevent ventilator-associated pneumonia. What is the critical first step to effectively gather evidence for guiding practice
The critical first step to effectively gather evidence for guiding practice and prevent ventilator-associated pneumonia is to conduct a thorough and systematic literature review.
This involves identifying relevant research studies, critically evaluating the quality and relevance of the studies, and synthesizing the findings to generate evidence-based recommendations. The nurse manager should start by developing a clear and specific research question related to ventilator-associated pneumonia prevention. Then, the manager should use multiple databases such as PubMed, CINAHL, and Cochrane Library to search for relevant studies. The manager should also use appropriate keywords and filters to ensure that the search is as comprehensive as possible. After identifying relevant studies, the manager should critically evaluate the quality of the studies using established tools such as the Cochrane Risk of Bias tool and the GRADE system. The manager should also consider the relevance of the studies in terms of the population, intervention, comparator, and outcome. The manager should then synthesize the findings from the studies to generate evidence-based recommendations.
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8. Your organization has 5,000 mailboxes in an Exchange Server 2010 deployment. Which of the following migration methods is appropriate given this scenario
The migration method that fits this scenario is remote move migration in a hybrid deployment.
Exchange Server 2010 is one of the most widely used enterprise email server applications. The IT Department that is responsible for Exchange 2010 management is currently facing a big challenge. In just a few months, in January 2020, Exchange 2010 will officially become EOL or "End of Life" and Microsoft will stop supporting the service. This information has been officially released on Microsoft's official website.
Generally, after the information is released, people believe they only have 2 choices: Upgrade to Exchange 2016 or migrate to Office 365. But both of these options will be very expensive.
The hybrid migration applies to all hybrid environments with on-premises Exchange servers, Exchange Online deployed, and Active Directory synced. This type of migration assumes that some of the data is stored on-premises, and the rest is in the cloud.
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Draw a number line and create a scale for the number line in order to plot the points-2,4, and 6.
The line number and the data plot are shown in the accompanying images. The distance from zero is the same for a number's opposite, but in the other direction.
A number line's scale can be created in several ways.Numbers 0, 1, 2, 3, and 4 must appear on the number line for a scale of 1. The figures on the number line will be 0, 2, and 4, which correspond to a scale of 2. Pick your scale accordingly, leaving an equal space between any two integers, and as a result.
What number line symbol would you use to represent 0 6?Ten equal portions should be taken from the number line's range of 0 to 1. Every piece is worth 0.1. On the number line, indicate the sixth point, which is to the right of 0. The 0.6 decimal place on the chart is represented by this point.
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A nurse evaluates whether a middle-age client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. What would the nurse most likely use to evaluate the client
A nurse evaluates whether a middle-age client with chronic back pain has been performing the recommended things by the physician, so she would use return demonstration to evaluate the client.
Return demonstration is an essential element of the nursing practice that paves way for pupil nursers to gain knowledge of the nursing procedures. It enables them to grasp ideas of what nursers do in the hospitals or communities when they take care of cases and of how they do these procedures to them.
Physiotherapy ( PT) is a healthcare profession, which encompasses colorful treatment modalities similar as massages, heat remedy, exercises, electrotherapy, patient education, and advice for treating an injury, disease, or disfigurement.
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Discuss the organizational structure that you, as the nurse administrator for SLMC, believe would be most appropriate. Use a specific organizational theory to support your decision and discuss how this structure may impact the organization's outcomes
The most appropriate organizational structure for SLMC would be a matrix organizational structure, which is based on the contingency theory.
This structure would allow SLMC to combine the strengths of both functional and divisional organizational structures, allowing for flexibility, improved communication, and the ability to respond to changes in the external environment.
This structure would also allow for more efficient decision-making processes, as well as increased coordination and collaboration between departments.
Additionally, this structure would also enable SLMC to create specialized departments and teams which are better equipped for responding to specific situations and challenges. The matrix structure would also allow for better alignment of resources with specific goals and objectives, allowing SLMC to maximize its outcomes.
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the nurse is providing care for a client with twins during labor. The nurse instructs the client to avoid lying flat on the back. WHich condition does the nurse aim to prevent in the client during labor
The nurse is trying to prevent the condition of Supine hypotension in the client during her labor in pregnancy.
Pregnancy is the condition when the mother's body is nurturing a fetus inside her womb. The responsibility of mother doubles when she is nurturing two fetus inside her. But this also causes number of body aches to the mother because of the heavy weight. It impacts her structure and the way her cervical bone is shaped. In supine hypotension, the blood pressure of the body falls sharply due to which there is lack of breath to the mother. It is advised to the mother to avoid sleeping directly on the back during her pregnancy. Also regular changes in postures helps to keep the vitals intact.
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A patient suffering from typical leukemic symptoms presents to the emergency room. The physician orders a spinal tap after noticing possible central nervous system involvement. What type of cells are indicated by the red arrows
The red arrows indicate abnormal leukemic cells. White blood cells are impacted by a particular type of disease called leukaemia.
During a spinal tap, the physician aspirates a sample of the cerebrospinal fluid (CSF) and examines it for the presence of leukemic cells. Leukemic cells have an abnormal appearance and are usually larger than healthy white blood cells. They are easily recognized by their large, round nucleus and lack of a distinct cytoplasm. The red arrows indicate these abnormal leukemic cells.
The presence of these cells in the CSF suggests that the leukemic cells have spread from the blood to the central nervous system and a diagnosis of leukemia is made. Depending on the type of leukemia, the patient may require chemotherapy, radiation, or a bone marrow transplant.
The spinal tap is an important tool in diagnosing and treating leukemia as it can provide a direct sample of the CSF to help determine the extent of the disease.
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you are called to the home of a female patient in cardiac arrest. as you walk into the scene, you discover the first responders have just performed a combination of cpr and use of an aed amd she has remained a pulse; however, she remains unconscious and is not breathing. her husband arrives and hands you what appears to be a valid do not resuscitate order and asks that you discontinue your efforts to save her. what should you do next
You should immediately stop all resuscitation efforts and contact the patient's physician to confirm the validity of the DNR order. If the order is valid, you should follow the instructions on the order and provide comfort care to the patient and her family.
A nurse is teaching a new mother about what to expect for bowel elimination in her newborn. Because the mother is breastfeeding, what should the nurse tell her about the newborn's stools
The nurse informed her that the newborn's faeces must be yellow-gold, loose, & stringy to pasty.
The neonatal phase is explained as an infant's first four weeks of life in this world. Many complicated physiologic changes occur during this period, and the newborn reacts with many stimuli. During this time, care should be constant and effective.
Growth characteristics and behaviors' are evaluated at birth. In the case of a normal spontaneous vaginal birth or a Cesarean section without difficulties, the examination is postponed until one hour after skin-to-skin contact with the mother is established, and nursing is initiated if suitable and requested. In the first twenty-four hours of life, a paediatrician or nurse practitioner checks the infant. A team having knowledge of the equipment, training, & resources is now in charge of assessing and attending to any neonatal resuscitation attempts required at the time of birth.
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A nurse manager is experiencing considerable conflict among staff members because of weekend staffing coverage. During a called staff meeting, the nurse manager asks the disgruntled staff to meet as a group and determine the best staffing practices. In doing this, the nurse manager is using the concept of collaboration to:
The nurse manager is utilizing collaboration to focus the energies of staff members on a win-win strategy.
Collaboration is the process of working together to achieve a common goal. By asking the staff to meet as a group and work together to determine the best staffing practices, the nurse manager is encouraging them to work together to come up with a solution that will benefit everyone. This encourages staff members to communicate and share ideas in order to find the best solution. It also helps to create a sense of teamwork and unity within the staff.
By doing this, the nurse manager is ensuring that all staff members have the opportunity to have their voices heard, and that all ideas are taken into consideration. Ultimately, this collaborative approach ensures that all staff members are working together towards a common goal, and that the outcome will be one that is favorable for everyone.
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