Posts

What is the importance of administering the FFP prior to the PRBC’s

/in /by

Nursing homework help
Blood Transfusion Case Study
Name: _____________________________ Date: _____________________ Class: NUR 438
Brief Patient History
Mr. S is a 75-year-old man who has a long history of chronic atrial fibrillation treated with warfarin, CHF, ESRD, and DM II. Over the past week, Mr. S has experienced intermittent epigastric pain and black stools. He is now dizzy and weak.
Clinical Assessment
Mr. S is admitted to the intensive care unit from the emergency department. He recently began taking ciprofloxacin for a urinary tract infection. He also has been taking an aspirin each day because he heard it was good for you. Also, he recently began taking over-the-counter ibuprofen for his stomach pain and general aches.
Diagnostic Procedures
Mr. S’s admission laboratory work reveals a hemoglobin level of 7 g/dL and an international normalized ratio (INR) of 7. His baseline vital signs include the following: blood pressure of 80/60 mm Hg, heart rate of 150 beats/min (atrial fibrillation), respiratory rate of 30 breaths/min, SPO2 92%, and temperature of 37.3 degrees Celsius.
Medical Diagnosis
Diagnosis is acute gastrointestinal bleeding
Nursing Actions
You have started and finished the FFP, and are currently transfusing the allogenic PRBCs. Ten minutes after starting the PRBC transfusion, Mr. S begins to C/O back pain, chills, and SOB. After taking his oral temperature you note it is now 38.8 degrees Celsius. He appears anxious, and is pulling at his lines and tubes.


1. What is this patient’s mean arterial pressure (MAP)? Is his MAP adequate, and why? Please show your work for the math equation.

2. What signs and symptoms may Mr. S exhibit secondary to his low H&H laboratory values?

3. What is the importance of administering the FFP prior to the PRBC’s in Mr. S’s case?

4. What should the length of time be to transfuse Mr. S’s PRBC’s, and why?

5. Mr. S is O positive blood type. What blood types can he receive, and what blood types can receive his blood type?

6. What is the importance of Rh factor when considered which type of blood to administer to patients?

7. What does allogenic mean? What does autologous mean?

8. What do you think is occurring with Mr. S?

9. What should be your immediate actions/interventions?

10. What nursing diagnoses should you give for this patient?

11. What education can be provided to this patient upon discharge?

Describe the types of ACOs recognized by the Centers for Medicare and Medicaid Services

/in /by
 Nursing homework help
Urban and rural health care organizations throughout the industry are working together to coordinate care for Medicare patients. Accountable Care Organization (ACO) programs were established by the Centers for Medicare and Medicaid Services to help facilitate this cooperation.
Select a type of health care organization that would accept Medicare patients (e.g., family practice, hospital, urgent care, or nursing home).
Write a 700- to 1,050-word executive summary that discusses the purpose of joining an ACO and the funding available through one. Include the following:

  • Describe the organization you selected and the general services that would be offered to Medicare patients.
  • Describe the types of ACOs recognized by the Centers for Medicare and Medicaid Services.
  • Evaluate industry dynamics that would influence your organization’s decision to participate in an ACO.
  • Identify the steps needed to participate in an ACO.
  • Justify participation in an ACO for your organization.

Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).
Format your assignment according to APA guidelines

Discuss if there is any similarity in the health care beliefs and practices of the German and French Canadian heritage with the health care beliefs of your heritage

/in /by
 Nursing homework help
People of French Canadian Heritage.
People of German Heritage.
Read chapter 14 and 29 of the class textbook Transcultural Health Care. A Culturally Competent Approach (4th ed.)
Purnell, L.D.(and review the attached PowerPoint presentations.   Read Content chapter 29 in Davis Plus Online Website.  Once done answer the following questions;
1.  Describe the health care beliefs of the German and French Canadian heritages and mention the influence in the delivery of evidence-based health care.
2.  Discuss if there is any similarity in the health care beliefs and practices of the German and French Canadian heritage with the health care beliefs of your heritage.
3.  If you have to change your health care beliefs for any of one study this week, which one will you choose and why?
The assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used  with the appropriate references must be posted.
References must be no older than 5 years.  A minimum of 700 words is required.
PLEASE DO NOT PLAGIARIZE.

Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned personality disorder.

/in /by

Nursing homework help
Week 3: Personality Disorders
I cannot believe these people. Don’t they know who I am? I deserve better treatment than this. That hostess should have seated me immediately, but I had to wait for 10 minutes and then she put me at this table right by the kitchen. I see an empty table right in the middle where I should be. I am just going to get up and move there. I don’t care what the hostess says, rules don’t apply to me.
Ashley, age 25
Personality disorders represent perhaps the most challenging disorders that the psychiatric mental health nurse practitioner will have to address in their professional careers. Personality disorders can co-occur in every mental health disorder and, in some cases, can mask as disorder . Although difficult to treat, the PMHNP must be able to identify personality disorders and endeavor to work with the client to not only recognize the disorder, but to treat a disorder that clients often do not believe they have.
This week, you will explore the many personality disorders and use the DSM-5 criteria for diagnosing individuals with specific personality disorders. You will use the Decision Tree format to diagnose and treat a client with a personality disorder. You also will complete the Fitzgerald University Exit Comprehensive Exam to determine your readiness for the certification exam.
Photo Credit: kaisersosa67 / iStock / Getty Images Plus / Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)
Chapter 22, “Personality Disorders” (pp. 742–762)
Chapter 13, “Psychosomatic Medicine” (pp. 451–464)
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
Chapter 71, “Histrionic Personality Disorder”
Note: You will access this book from Walden Library databases.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
“Personality Disorders”
Note: You will access this book from Walden Library databases.
Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry: Interpersonal & Biological Processes, 76(1), 32–52. doi:10.1521/psyc.2013.76.1.32
Note: You will access this article from Walden Library databases.
Rees, C. S., & Pritchard, R. (2015). Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52(1), 45–55. doi:10.1037/a0035158
Kernberg, O. (n.d.). Psychoanalytic psychotherapy for personality disorders: An Interview with Otto Kernberg, MD. [Video file]. Mill Valley, CA: Psychotherapy.net
Note: This video is approximately 94 minutes of length. You will access this article from Walden Library databases.
Discussion: Treatment of Personality Disorders
Personality disorders occur in 10–20% of the population. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.
In this Discussion, you will explore personality disorders in greater detail and discuss treatment options using evidence-based research.
Learning Objectives
Students will:
Analyze diagnostic criteria for personality disorders
Analyze evidence-based psychotherapy and psychopharmacologic treatments for personality disorders
Analyze clinical features of clients with personality disorders
Align clinical features with DSM-5 criteria
Compare differential diagnostic features of personality disorders
Post:
Explain the diagnostic criteria for your assigned personality disorder. (Histrionic Personality Disorder)
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned personality disorder.

Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria.

Support your rationale with references to the Learning Resources or other academic resources.