Scenario
T.C. is a 30-year-old woman who 3 weeks ago underwent a vaginal hysterectomy and right salpingooophorectomy for abdominal pain and endometriosis. Postoperatively she experienced an intraabdominal hemorrhage, and her hematocrit (Hct) dropped from 40.5% to 21%. She was transfused with 3 units of packed RBCs (PRBCs). After discharge she continued to have abdominal pain, chills, and fever and was subsequently readmitted twice: once for treatment of postoperative infection and the second time for evacuation of a pelvic hematoma. Despite treatment, T.C. continued to have abdominal pain, chills, fever, and nausea and vomiting (N/V).
T.C. has now been admitted to your unit after an exploratory laparotomy. Vital signs (VS) are 130/70,
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2. Formulate a plan, given the resources mentioned previously.
The plan I would need in place would first to address her respiratory status and maintain a patent airway. I would also want to have the patient demonstrate how to splint while deep breathing or coughing. I would ask the Cna to help with position changes every 2 hours or more if needed for comfort for the patient. I would need to do a full assessment at this point if the patient is more stable. By having the patient deep breath will also help her return to consciousness, (Ahmed, Latif and Khan, 2013). I would want to keep her comfortable and in as little pain as possible. I would also want to try to educate her as to when to push for pain medications from her PCA pump. If there were any family I would want to try to get them involved with the education as well. The use of an incentive spirometer should be included in the teaching too. I would keep monitoring the incision site and watching for signs that the patient is in pain. While I was working on patient education with this patient, I would ask the CAN to do vitals on the 2 postop patients every 15 minutes for the first hour, reporting abnormal vital signs to myself or the other R.N. I would also ask the other R.N. if she/ he would do the discharge for that patient, while I remain with this patient and make sure she is going to stay stable.
Misplacing items happens to every individual throughout their lives. For Melissa, she happened to misplace her keys. In order to find her keys, Melissa must know something about them. It is in my view that Melissa does not know anything about her keys because she lacks knowledge that they are missing as well as how to find them.
S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.
8. After surgery, R.T. is admitted to the surgical intensive care unit (SICU) with a large
I tend to agree with you, when employees refuse to adhered to new processes and system it can produce negative results for the company. For example, we have a Caliper line that inadvertently sent a defective part to one of our biggest customers. Fortunately, the customer did not issue an alert because of the mistake. Therefore, we implemented an additional process that the operator must perform before placing the part in the dunnage. However, one particular employee continued to send defective parts out because they refused to follow the new procedures. Consequently, the next time, over 150 parts arrived at the customer with the same defect as before. Unfortunately, our BIQS Level was reduced from Level 3 to Level 1, which means that we cannot
I review few of the vouchers and what I see is that the providers did the drug test to the patients b/c they are prescribing pain medications or some of the patients coming for F/u on their pain medications refills. I review and study the attachment and I'm not 100% sure if we can use any of these codes for support the CPT code 80300.
Each site slated for secure indoor wireless had a site survey done. The site survey method was top-down with the roof as the starting point. As with most site surveys the locations for equipment was identified and the cabling pathways were determined. In addition, a wireless survey was performed to identify possible sources of interference and find best install sites for AP’s. This was performed using wireless analysis tools to get the best installation places.
The expression of lanes 3,4,6,7,8 and 9 were expected but the expression of lane 5 was not expected. The reason lanes 3,4,6,7,8 were expected is that lanes 4,5,7,8 contain genomic DNA, which should contain multiple genes including the genes for Heat shock resistants. Also the genomic DNA in lane 4 and 8 under went heat shock condition, which led to the expression and amplification of Heat shock resistant proteins. This is also the case for lane 6, which contains heatshock cDNA. Since it contains cDNA that underwent heat shock condtion, that means the gene is being express and amplified in order to resist those heated condotions.
CD4 is a glycoprotein found on the surface of immune cells such as T helper cells, monocytes, macrophages, and dendritic cells. HIV infects cells of the immune system called T lymphocytes (T cells) and macrophages. HIV has an envelope and contains two copies of single-stranded RNA as the genome. Within the viral capsid are important viral enzymes called reverse transcriptase, integrase, and protease. The HIV virus has a spike protein that is called gp120, and the host cell receptor is CD4+. HIV belongs to a class of viruses called retroviruses. Retroviruses are RNA viruses, and to replicate or reproduce, they must make a DNA copy of their RNA through transcription and translation. It is the DNA genes that allow the
Unit 2 was driving eastbound in the left lane of 167th St. between Orchard Ridge Ave. and Anthony Ave. in Hazel Crest, IL. Unit 2's approximate speed was 35 miles per hour. A large puddle of water had formed from a very recent rain. It covered the right lane and part of the left lane. The driver of Unit 2 noticed the puddle and proceeded to slow down to a speed of approximately 20 miles per hour. The driver of Unit 2 then noticed Unit 1 coming from behind in the right lane at a high rate of speed. Unit 1 tried to avoid the puddle without slowing down and impacted Unit 2. Unit 1 was pushed back into the right lane. Unit 2 was pushed off of the left side of the road onto the slightly raised median. The front and left side of Unit 1 was severly
Can you please give me the cost of a case of booties for installers to wear on their feet when installing Exede services? Eventually we will need to order about 55 cases.
The country that I am going to describe for the assignment is the United States (USA). The USA is the third largest country in the world with a population of 320 million. The USA culture is shaped by immigrants from all countries of the world. The USA does not have an official language, but business and political matters are mainly conducted in English. The non-English languages spoken in the USA are Spanish, German, French, Chinese and Hebrew. The majority of Americans considered themselves as Christians; however, a considerable number of people claim to have no religious affiliation. For Americans, it is a norm to tip when dining out or when receiving a service.
I’m working on ITP form’s mapping requirement and need some confirmation from your side that how we supposed to address ITP form if more than one borrowers are available in the loan application.
Patient focused practice would be key to ensure the nursing staff in charge of her care at this stage are able to clearly explain any procedures and to administer pain relief. Frequent reassessment of the patient will identify early signs of confusion and delirium. Avoidance of the use of overly technical medical language and treating the patient as an individual can help to calm anxiety about the
Mr. Kramer and Mrs. Ghidotti gave a brief overview of the application process and the reasons for crafting the application with Mr. Chris Withrow to include a line item pricing structure based on the recommendations of NCDPI during the application submission process.
After surgery, she was transferred to the PICU. Today, she was just transferred from the PICU to Explorer-West. She is continuing to show improvement; however, she is being administered Keppra for prophylaxis of seizures. She has a dressing over her surgical wound that is currently dry and intact. The wound closure itself is closed with steri-strips. She’s currently at a GCS of 14. She is able to answer questions with soft words, nods, and shakes her head. However, she can become disorganized and agitated at times, which results in her pulling on her lines and tubes; therefore, a restraint was ordered. In addition, she has a decrease in motor ability. Her ROM, strength, and tone are all weak bilaterally in her lower extremities. She is able to ambulate with assistance only along with the use of the cervical orthosis prescribed by the physical therapist. She is currently on room air with an oxygen saturation of 100%. Her current vitals are as follows: temperature 36.9 ̊C; pulse 97; RR 23; and BP