(a) Holistic care for Tony Mandala would involve gathering comprehensive information about his alcohol use, physical and mental health, social support system, and addressing any underlying trauma or life events
(b) Alcohol withdrawal can be dangerous for Mr. Mandala due to the potential for severe symptoms such as delirium tremens (DTs), seizures, and cardiovascular complications.
(c) Once safely detoxified, treatment alternatives may include AA, CBT, medication, individual counseling, and community referrals to support his journey towards sobriety.
(a) To plan holistic care for Tony Mandala, the following information would be essential during the initial assessment:
Detailed history of his alcohol consumption, including the amount, frequency, and duration of his heavy drinking.
Any previous attempts to quit and the strategies used.
His motivation and readiness to change.
Physical health status, including any existing medical conditions.
Psychological and emotional well-being, including any symptoms of anxiety, depression, or other mental health concerns.
Social support system and the level of support available to him.
Employment and financial situation, as these factors may impact his ability to access certain treatment options.
Any history of trauma or significant life events that may have contributed to his alcohol use.
(b) Alcohol withdrawal can be dangerous for Mr. Mandala due to the potential for severe symptoms such as delirium tremens (DTs), seizures, and cardiovascular complications. Medical interventions commonly employed in alcohol withdrawal include:
Monitoring vital signs and providing supportive care to ensure stability.
Administering benzodiazepines to reduce withdrawal symptoms and prevent seizures.
Intravenous fluids to correct dehydration and electrolyte imbalances.
Thiamine supplementation to prevent Wernicke-Korsakoff syndrome.
Assessing and managing any co-existing medical conditions or complications that may arise.
(c) Once Tony is safely detoxified, there are several treatment alternatives that could be considered:
Alcoholics Anonymous (AA): AA is a mutual support group where individuals with alcohol use disorder share their experiences, provide support, and follow a 12-step program. It can be explained to Tony as a non-judgmental community where he can connect with others who have faced similar challenges, learn from their experiences, and work on maintaining sobriety.
Cognitive-Behavioral Therapy (CBT): CBT can help Tony identify and change the negative thought patterns and behaviors associated with his alcohol use. It can teach him coping strategies, stress management techniques, and skills to prevent relapse.
Medications: Certain medications, such as Acamprosate, naltrexone, or disulfiram, may be prescribed to help Tony maintain sobriety by reducing cravings or making alcohol consumption unpleasant.
Individual counseling: One-on-one counseling sessions can provide a safe space for Tony to explore the underlying reasons for his alcohol use and develop personalized strategies for recovery.
Community referrals: Referrals to local support groups, outpatient treatment programs, or specialized addiction treatment centers in the area can provide Tony with additional resources and ongoing support.
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Explain the role of evidence in determining best clinical
practice. (>150 words)
Discuss TWO differences noted with the RN Role vs. the UAP/CNA
role. Describe the EBP, clinical judgement, or cri
Role of evidence in determining best clinical practice: Evidence guides optimal care decisions.
Differences between RN and UAP/CNA roles: RNs have broader responsibilities, exercise independent clinical judgment, while UAPs/CNAs provide basic care under RN supervision.
Evidence plays a vital role in determining best clinical practice by providing a solid basis for decision-making in healthcare. Firstly, evidence-based practice (EBP) integrates the best available research evidence with clinical expertise and patient values.
It ensures that healthcare decisions are informed by rigorous scientific research and tailored to individual patient needs and preferences.
EBP promotes the use of systematic reviews, randomized controlled trials, and other high-quality evidence sources to identify interventions and treatments that have been proven effective and safe.
Secondly, evidence guides clinical judgment by providing healthcare professionals with a framework for critical thinking and decision-making.
Clinical judgment involves synthesizing available evidence, considering the patient's unique circumstances, and drawing on personal experience and expertise to determine the most appropriate course of action.
By evaluating and applying the best available evidence, healthcare providers can make informed decisions that optimize patient outcomes while considering individual patient preferences and values.
In summary, evidence serves as a cornerstone for determining best clinical practice by integrating research findings, clinical expertise, and patient values.
Now, let's discuss two differences between the Registered Nurse (RN) role and the Unlicensed Assistive Personnel (UAP)/Certified Nursing Assistant (CNA) role.
Scope of Practice: RNs have a broader scope of practice compared to UAPs/CNAs.
RNs are licensed healthcare professionals who are responsible for assessing patients, making nursing diagnoses, developing and implementing care plans, administering medications, performing complex procedures, and evaluating patient outcomes.
They have a higher level of education and training, enabling them to take on more complex and autonomous responsibilities in patient care.
On the other hand, UAPs/CNAs work under the supervision of RNs and assist with basic patient care tasks, such as bathing, feeding, taking vital signs, and maintaining a clean environment.
Clinical Judgment and Decision-Making: RNs exercise more advanced clinical judgment and decision-making skills compared to UAPs/CNAs. RNs are trained to analyze complex situations, interpret patient data, and apply critical thinking to make independent decisions about patient care.
They integrate evidence-based practice, clinical guidelines, and their own expertise to determine appropriate interventions and responses. UAPs/CNAs, while providing valuable support in patient care, work under the direction and supervision of RNs.
They follow specific care instructions and protocols provided by the RN, without the same level of autonomy in clinical decision-making.
These differences in scope of practice and decision-making highlight the contrasting levels of education, training, and responsibility between the RN role and the UAP/CNA role in healthcare settings.
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A physician has prescribed valproic acid (Depakote) for a child with a seizure disorder. What must the client be observed for? a. Abnormal liver enzymes Weight gain b. c. Night blindness d. Abnormal blood glucose levels
The client must be observed for a. Abnormal liver enzymes and b. Weight gain are the correct options.
Valproic acid (Depakote) is an anticonvulsant medication used to treat different kinds of seizures, bipolar disorder, and migraine headaches. Seizure disorders are caused by unusual electrical activity in the brain, which can lead to seizures, convulsions, or other abnormal movements. Here are some things that the client should be observed for after being prescribed valproic acid (Depakote):
Abnormal liver enzymes: Valproic acid can cause liver damage, so clients should have their liver enzymes checked regularly to make sure they are not abnormally elevated.
Weight gain: Valproic acid has been associated with weight gain, which can increase the risk of other health problems, such as diabetes or heart disease.
Night blindness: Night blindness is not a known side effect of valproic acid.
Abnormal blood glucose levels: Valproic acid can cause hypoglycemia or hyperglycemia, which can lead to a variety of symptoms, such as shakiness, confusion, sweating, or fainting.
Therefore, the client should have their blood glucose levels monitored regularly to make sure they are within a normal range.
Therefore, a. Abnormal liver enzymes and b. Weight gain are the correct options.
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ontario is gradually moving to an ehealrh blueprint.Why is this important? Also give an example of how ehealth data could help a patient.Do you think it is a good idea that we are moving towards a paperless system? Why or why not?
Ontario is gradually moving to an eHealth blueprint for improved healthcare delivery and efficiency.
Moving to an eHealth blueprint is essential for healthcare delivery in Ontario for various reasons. The eHealth blueprint will bring about improved healthcare delivery and efficiency, including the availability of electronic medical records, ePrescriptions, telemedicine, and eConsultations. These technological advances will ensure seamless and timely access to medical records and information between health providers, making care delivery more efficient, accurate, and cost-effective.
An example of how eHealth data could help a patient is in the case of an emergency. In an emergency, a doctor can quickly access the patient's medical records, including allergies, medical history, and medications, and make informed decisions to save the patient's life. Yes, moving towards a paperless system is a good idea for several reasons. Firstly, electronic health records (EHR) are more secure and confidential than paper records, which can be easily misplaced or accessed by unauthorized persons. Secondly, EHRs reduce errors and redundancy in healthcare by providing timely and accurate access to patient data.
Lastly, EHRs save time and reduce healthcare costs by streamlining administrative tasks, reducing the need for physical storage and retrieval of paper records, and eliminating the need for printing and mailing of medical records.
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\rachel walters is diagnosed with a urinary tract infection. reginald bennett is admitted to the emergency room for an anaphylactic reaction to peanuts. nathan hoang presents with a burn on his left arm. krista diaz is diagnosed with sports-induced asthma.
Rachel Walters has been diagnosed with a urinary tract infection. Reginald Bennett is admitted to the emergency room for an anaphylactic reaction to peanuts. Nathan Hoang presents with a burn on his left arm. Krista Diaz is diagnosed with sports-induced asthma.IncidencesRachel Walters is diagnosed with a urinary tract infection:
Urinary tract infections are caused by microbes, including bacteria, that enter the body through the urethra and begin to multiply in the bladder. The most common symptoms of a UTI are painful urination and a strong need to urinate, even when the bladder is empty.
Reginald Bennett is admitted to the emergency room for an anaphylactic reaction to peanuts: An anaphylactic reaction is a severe allergic reaction to peanuts. The reaction can occur within seconds or minutes of exposure to peanuts and can cause breathing difficulties, loss of consciousness, and even death in severe cases.
Nathan Hoang presents with a burn on his left arm: Burns occur when the skin is exposed to high temperatures, chemicals, electricity, or radiation. The extent of the burn is determined by the depth of the injury, and it can range from first-degree burns, which only affect the skin's outer layer, to third-degree burns, which penetrate deeper into the skin.
Krista Diaz is diagnosed with sports-induced asthma: Asthma is a chronic condition that affects the airways in the lungs. Symptoms include wheezing, shortness of breath, chest tightness, and coughing. Exercise-induced asthma is a form of asthma that is triggered by physical activity, especially in cold and dry conditions.
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"Write a journal entry for clinical describing the
following:
Discuss at least one instance where sensitivity or a lack of
sensitivity to a patient's culture may have impacted patient care.
Today's clinical experience was a learning lesson for me. I had a patient who was from a different culture, and unfortunately, my lack of sensitivity towards her culture impacted her care negatively. The patient was from India, and due to my lack of knowledge and cultural sensitivity, I could not properly address her needs.
When I asked the patient about her preferences for food, I did not realize that she was a strict vegetarian and needed a specific diet. I was unaware of the importance of the Hindu religion and its belief in non-violence towards all living things, including animals. Therefore, when I brought the patient a meal containing meat, it was a cultural shock to her, and she was unable to eat it.
I apologized for the mistake and quickly arranged for a vegetarian meal to be served. However, I could tell that the patient was uncomfortable and anxious. She was very hesitant to answer any further questions and barely spoke to me. I realized that my lack of knowledge had affected the patient's trust in me and negatively impacted her care.
This experience has taught me the importance of being culturally sensitive in healthcare. As healthcare professionals, we must understand and appreciate the cultural diversity of our patients to provide them with the best possible care. We need to be aware of their cultural beliefs, values, and customs and incorporate them into our care plan to make our patients feel comfortable and respected.
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Which of the following symptoms are considered signs of a hip fracture? A. Tingling and coolness in affected leg. B. Tenderness in the region of the fracture site and internal rotation of the leg. C. External rotation and shortening of the extremity. D. Erythema of the leg and pain at the site of the fracture
Hip fractures are injuries that commonly occur in older people, particularly those who are frail. These fractures may occur with minimal trauma in the elderly. Therefore, the correct options are B
The following symptoms are considered signs of a hip fracture:
Option B. Tenderness in the region of the fracture site and internal rotation of the leg.
Option C. External rotation and shortening of the extremity.
Therefore, the correct options are B. Tenderness in the region of the fracture site and internal rotation of the leg and C. External rotation and shortening of the extremity.
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Because the physician suspects a delayed transfusion reaction causing in vivo RBC destruction, which tests would be most appropriate to order at this time?
The tests that would be most appropriate to order if the physician suspects a delayed transfusion reaction causing in vivo RBC destruction are the Direct antiglobulin test (DAT), Red blood cell antigen typing , a peripheral blood smear and Indirect antiglobulin test (IAT)
Direct antiglobulin test (DAT) would be the most appropriate test to order at this time because this test can determine if RBCs are coated with complement proteins or with an IgG antibody, which indicates that antibodies are binding to the patient's RBCs in vivo.
The indirect antiglobulin test (IAT) may be used to evaluate the serum for antibodies to donor RBCs.
Red blood cell antigen typing is the second most appropriate test to order at this time because it may identify alloantibodies produced in response to antigen exposure that is not present on the patient's RBCs.Reticulocyte count, hemoglobin, and hematocrit testing will be used to detect ongoing hemolysis if the diagnosis is established.
Additionally, a peripheral blood smear can reveal red blood cell morphology alterations consistent with autoimmune hemolytic anemia, such as spherocytes and polychromasia.
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Muscle relaxation requires
A. ATP to pump calcium back into the sarcoplasmic
reticulum
B. Acetylcholinesterase
C. ATP to allow actin/myosin dissociation
D. Both A and B
E. All of the above
Muscle relaxation requires both ATP to pump calcium back into the sarcoplasmic reticulum and acetylcholinesterase.
Muscle relaxation is the loosening or reduction of muscular tension. The muscle is made up of two types of proteins: actin and myosin, which work together in a complex called actomyosin, allowing the muscle to contract. The muscle tissue, also known as the active component of the musculoskeletal system, needs a vast amount of metabolic energy to carry out work.
The muscle relaxation is carried out in two steps: during the first phase, calcium ions are pumped into the sarcoplasmic reticulum, causing the actin/myosin complex to break down and in the second phase, the muscle returns to its resting position, and the body reabsorbs the calcium ions.
A sarcoplasmic reticulum is a specialized form of endoplasmic reticulum which acts as a calcium ion reservoir in muscle cells. The Calcium ions are released from the sarcoplasmic reticulum into the cytoplasm of the muscle fiber through a calcium channel called the ryanodine receptor, which spans the sarcoplasmic reticulum and transverse tubule. Calcium ions in muscle cells are necessary for muscle contractions to occur.
Muscle relaxation requires both ATP to pump calcium back into the sarcoplasmic reticulum and acetylcholinesterase. Therefore, the correct answer is option D.
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Disorientation, Delirium, and Dementia 233 31. Which of the following actions may increase a client's disorientation? A. Stating your name and showing your name tag B. Giving the client very detailed instructions prior to performing a procedure C. Calling the client by name each time you are in contact with him D. Encouraging the client to wear his glasses and hearing aid if needed
Delirium is a serious medical condition that typically occurs during acute medical illness. Clients that are disoriented are not able to make sense of the environment and are often confused. Disorientation may be caused by a number of things, including dementia and delirium.
Among the given options, which of the following actions may increase a client's disorientation? The answer is B. Giving the client very detailed instructions before carrying out a procedure. When a client is experiencing disorientation, they may not be able to comprehend and remember detailed instructions.
This could cause them to feel overwhelmed and anxious. This anxiety might cause them to act out in frustration, which can increase their disorientation. Detailed instructions should be avoided in this situation, instead of the instructions should be clear and concise to prevent the client from becoming confused or agitated. Hence, giving very detailed instructions may increase a client's disorientation.
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gentamicin 55mg IM q8hr.Available gentamicin 80 mg per 2ml.how many ml will the nurse administer for one dose.how many ml will the nurse administer for the day. 2,An Iv of 500ml NSS is to infuse at 60 ml/hr.How long will the infusion take?If the IV was started at 2000,when would the infusion be completed
Gentamicin 55mg IM q8hr. Available gentamicin 80 mg per 2 ml; how many ml will the nurse administer for one dose?
The available gentamicin is 80mg per 2 ml, thus the fraction of 80mg per 2 ml can be represented as 80/2. This can be reduced by dividing both the numerator and denominator by 2 to get 40mg per 1ml. Therefore, for a single dose of gentamicin 55mg, the nurse will administer 55/40 ml or approximately 1.375 ml of the medication. How many ml will the nurse administer for the day?
In a day, the nurse will administer gentamicin three times, meaning the total amount of gentamicin in a day will be 3 x 1.375 ml or 4.125 ml.2. An IV of 500 ml NSS is to infuse at 60 ml/hr. How long will the infusion take? To determine the length of time the infusion will take, we will use the following formula: Time = Volume ÷ Rate of Flow Time = 500 ml ÷ 60 ml/hr Time = 8.33 hours Therefore, the infusion will take approximately 8.33 hours.
How long will the infusion take if the IV was started at 2000, when would the infusion be completed?If the IV was started at 2000, then the infusion would be completed at:2000 hours + 8.33 hours = 0433 hours the next day.
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Paula wakes up in the middle of the night experiencing fever and chills. She calls telehealth for advice and is instructed to go to the hospital. Which health care delivery stage did she end up in? O Primary health care Secondary health care Emergency health care teritones O Tertiary health care 1 pts 1pts:
Paula ended up in the c) Emergency health care delivery stage as she wakes up in the middle of the night experiencing fever and chills and calls telehealth for advice and is instructed to go to the hospital. Hence, the correct answer is option c).
Health care delivery stages:
Health care delivery is the provision of medical care to individuals, groups, or communities by different healthcare providers like doctors, nurses, etc. Health care delivery stages can be classified into four: Primary health care, Secondary health care, Tertiary health care, and Emergency health care.
Primary Health Care (PHC):
This is the first point of contact between patients and the healthcare system. It is the initial level of medical care that provides preventive, promotive, curative, and rehabilitative health services. It includes services such as vaccination, health education, diagnosis, and treatment of common diseases and injuries.
PHC aims to improve the health status of individuals, families, and communities by addressing the underlying social determinants of health.
Secondary Health Care:
This type of healthcare is provided by medical specialists to diagnose and treat more complex medical conditions that cannot be managed at the primary healthcare level. Secondary healthcare requires referral from primary care providers and is often provided in hospitals or specialized clinics. It includes services such as x-rays, laboratory tests, surgeries, and treatment of chronic conditions like hypertension and diabetes.
Tertiary Health Care:
Tertiary healthcare refers to specialized medical care provided by hospitals or tertiary care centers. It includes highly specialized diagnostic and treatment services such as organ transplantation, cancer treatment, and neurosurgery. Patients are referred to tertiary care centers from secondary care centers or primary healthcare providers.
Emergency Health Care:
Emergency healthcare is medical care provided in an emergency situation. It is designed to provide immediate medical attention to people who have experienced sudden illness or injury. Emergency care can be provided in ambulances, emergency departments, or urgent care centers. It includes services such as cardiopulmonary resuscitation, stabilizing trauma victims, and administering emergency medications.
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Patients with posterior column lesions may experience allodynia, which causes pain when applying pressure to various musculoskeletal locations. Or is it more likely that fibromyalgia is to blame for this? How do carbamazepine and gabapentin's clinical success rates compare? How may dissociative sensory loss be detected clinically? How much urograffin is advised to take before undergoing contrast-enhanced computed tomography? When a suspected intracerebral abscess or glial tumour is present, how far in advance should this be supplied before imaging?
Patients with posterior column lesions may experience allodynia, as can those with fibromyalgia. Carbamazepine and gabapentin are both useful drugs for reducing neuropathic pain.
Allodynia, a symptom in which pain occurs with ordinary pressure, is a neurological symptom that may appear in the setting of other medical conditions. Patients with posterior column lesions, for example, are likely to experience allodynia. Fibromyalgia, on the other hand, is a musculoskeletal disorder characterized by chronic widespread pain and tenderness. Patients with fibromyalgia may experience allodynia as well.
Carbamazepine and gabapentin are both effective medications for treating neuropathic pain, with gabapentin having a higher success rate. Pinprick and temperature sensation tests can be used to detect dissociative sensory loss, which is a lack of sensation in response to pinpricks and temperature changes. A patient should consume 1000 ml of urograffin or a comparable contrast agent before undergoing contrast-enhanced computed tomography. Prior to the imaging exam, intravenous dexamethasone, a corticosteroid drug, should be given if a suspected intracerebral abscess or glioma is present.
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A patient with severe BPH (benign prostatic hyperplasia) is at risk for hydronephrosis. True False indicative of: Si"
A patient with severe BPH (benign prostatic hyperplasia) is at risk for hydronephrosis - True
Hydronephrosis refers to a possibility in a patient with severe benign prostatic hyperplasia (BPH). The non-cancerous enlargement of prostate gland, which can restrict overall flow of urine, is what distinguishes BPH from other conditions. The urethra may get compressed when the prostate grows, preventing the flow of urine from the bladder.
The condition which is known as hydronephrosis, which results from a buildup of urine in the kidneys, can be brought on by this typical obstruction. If untreated, hydronephrosis can be a dangerous condition that calls for medical attention to clear the obstruction and avoid future problems.
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Which of the following is not a class of hormones? a) amines b) polypeptides c) steroids d) All of the above are classes of hormones.
Hormones are molecules produced by glands that are secreted directly into the bloodstream to regulate various physiological and behavioral activities in the body. There are three different types of hormones in the human body, which are: amines, polypeptides, and steroids. So, the answer is D) None of the above is not a class of hormones.
All three of the options given are classes of hormones, making option D the correct answer. Amines are derived from the amino acids tyrosine and tryptophan and include hormones like epinephrine, norepinephrine, and dopamine. Polypeptides are chains of amino acids, and examples include insulin and growth hormone. Steroids, on the other hand, are derived from cholesterol and include hormones like testosterone, estrogen, and cortisol. These three types of hormones are secreted in different ways and interact with different receptors in the body to elicit their effects.
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-Identify 1 health behavior modification you pursued.
-Using the Health Behavior Change Model, specify the steps you have
taken on how the behavior was modified. In a concept map form.
Health Behavior Change Model includes Precontemplation, Contemplation, Preparation, Action, Maintenance, Termination.
A general example of how the Health Behavior Change Model can be applied to modify a health behavior.
Health Behavior: Regular Exercise
Steps in Behavior Modification:
Precontemplation: Recognizing the need for regular exercise due to sedentary lifestyle and health concerns.
Contemplation: Evaluating the benefits and barriers of regular exercise, considering options for incorporating exercise into daily routine.
Preparation: Setting specific goals for exercise frequency, duration, and type. Gathering information on exercise programs and facilities.
Action: Initiating regular exercise by following a structured exercise plan, attending fitness classes, or engaging in physical activities.
Maintenance: Sustaining the exercise routine over time by establishing a schedule, overcoming challenges, and seeking support from friends or a fitness community.
Termination: Achieving a long-term behavior change where regular exercise becomes a habit and an integral part of a healthy lifestyle.
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Topic of the project is: Healthcare professional’s knowledge, attitude and beliefs about immunizations in adults.
This is the clinical scholarship project.
INTRODUCTION
Problem or Issue Background/Significance (minimum of 3 bullet points [max. 5] citing evidence from credible sources in APA to establish the significance of the problem or issue)
Purpose of the Project Overall AIM (Goal) (Should be SMART)
Outcome Measures (i.e., should include primary and secondary outcome measures of interest [data to be collected])
Study Question(s) PICO(T) format (e.g., Melnyk & Fineout-Overholt, 2019, Appendix A, pp. 706-7)
EBP Framework (Identify the EBP framework to guide the project and 1-3 sentences explaining why this was selected)
PROCEDURE
Key Stakeholders (i.e., who are the individuals with a vested interest in the project?)
Process Plan. (i.e., outline the plan for convening the team of stakeholders and developing the project with them)
Healthcare professional’s knowledge, attitude and beliefs about immunizations in adults.This Clinical scholarship project focuses on examining the knowledge, attitude, and beliefs of healthcare professionals regarding immunizations in adults. Healthcare professionals are important stakeholders in preventing vaccine-preventable diseases, and their perceptions of immunizations can significantly influence their vaccination recommendations to adult patients.
There is limited research on this topic, which highlights the need for this study. The study will help to understand the attitudes of healthcare professionals towards adult immunizations, identify barriers, and determine how to promote vaccine uptake in adults.Purpose of the ProjectThe purpose of the project is to examine the knowledge, attitude, and beliefs of healthcare professionals regarding immunizations in adults. This project aims to establish a baseline understanding of healthcare professionals' attitudes towards adult immunizations and identify any barriers that could impact vaccine uptake in adults.
The goal is to develop interventions that can be used to increase vaccine uptake rates in adults.Outcome MeasuresThe primary outcome measures for the project include the proportion of healthcare professionals who recommend vaccines to adult patients, the proportion of patients who receive vaccines, and the vaccine uptake rate in adults. The secondary outcome measures include the factors that influence healthcare professionals' recommendations and attitudes towards immunizations in adults.Study Question(s)The following is the PICO(T) format for the study questions:Population: Healthcare professionalsIntervention: Knowledge, attitude, and beliefs about adult immunizationsComparison: Healthcare professionals without knowledge, attitude, and beliefs about adult immunizationsOutcome: The proportion of healthcare professionals who recommend vaccines to adult patientsTimeframe: During the study periodEBP FrameworkThe project will be guided by the Johns Hopkins Nursing EBP Model. This model was selected because it provides a framework for evidence-based decision-making and focuses on integrating research evidence, clinical expertise, and patient values to improve patient outcomes. The model includes five steps:Ask, Acquire, Appraise, Apply, and Audit.
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Purpose
The purpose of this case study is to develop a pain management plan based on the assessment.
Case Study Description
J.P. is a 15-year-old African American adolescent who lives with his mother and father and was diagnosed with sickle cell disease 3 years ago. He is in the 10th grade. He is a honor roll student and is on the track team of his school. J.P. presents to the emergency department with deep muscle pain in both his legs, related to sickle cell crisis. Rates his pain at 8/10. He is 5 feet 6 inches and weighs 140 lb. On admission his vital signs are T: 37°C, P: 80 beats/min, R: 18 breaths/min, BP: 140/68 mmHg
Writing Prompts
What other assessments should be included for this patient?
Identify the various types of pain.
What type of pain does this patient describe?
What standards of assessing pain will be applied to this patient’s plan of care?
What teaching should the nurse consider from the problems list?
What interventions should be included in the plan of care for this patient?
1. Comprehensive pain assessment, musculoskeletal exam, and laboratory tests required.
2. Acute, chronic, neuropathic, nociceptive, somatic, and visceral pain types.
3. Patient describes deep muscle pain (acute pain).
4. Use pain scale, monitor vital signs, reassess pain regularly.
5. Teach pain management strategies, analgesics, and treatment adherence.
6. Administer analgesics, provide comfort measures, monitor complications, collaborate with team.
1. Additional assessments for this patient should include a comprehensive pain assessment, including location, intensity, quality, and duration of pain. Physical examination, including a thorough musculoskeletal assessment, and laboratory tests to evaluate for potential complications or infections related to sickle cell disease should also be conducted.
2. The various types of pain include acute pain, chronic pain, neuropathic pain, nociceptive pain, somatic pain, and visceral pain.
3. This patient describes deep muscle pain in both legs, which is likely a manifestation of acute pain related to sickle cell crisis.
4. The standards of assessing pain for this patient's plan of care should include utilizing a pain scale to assess pain intensity, monitoring vital signs, documenting pain characteristics and responses to interventions, and regularly reassessing pain to evaluate the effectiveness of pain management interventions.
5. The nurse should consider teaching the patient and their family about pain management strategies, including the use of prescribed analgesics, non-pharmacological interventions such as heat or cold therapy, relaxation techniques, and the importance of adhering to the treatment plan.
6. The plan of care for this patient should include administering prescribed analgesics, providing comfort measures such as heat or cold therapy, encouraging adequate hydration, promoting rest and mobility as tolerated, monitoring for complications, and collaborating with the healthcare team to address any underlying factors contributing to the pain crisis.
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The question is inappropriate; the correct question is:
The purpose of this case study is to develop a pain management plan based on the assessment.
Case Study Description
J.P. is a 15-year-old African American adolescent who lives with his mother and father and was diagnosed with sickle cell disease 3 years ago. He is in the 10th grade. He is a honor roll student and is on the track team of his school. J.P. presents to the emergency department with deep muscle pain in both his legs, related to sickle cell crisis. Rates his pain at 8/10. He is 5 feet 6 inches and weighs 140 lb. On admission his vital signs are T: 37°C, P: 80 beats/min, R: 18 breaths/min, BP: 140/68 mmHg
Writing Prompts:
1. What other assessments should be included for this patient?
2. Identify the various types of pain.
3. What type of pain does this patient describe?
4. What standards of assessing pain will be applied to this patient’s plan of care?
5. What teaching should the nurse consider from the problems list?
6. What interventions should be included in the plan of care for this patient?
Discuss the key elements of an assessment for a patient with a
diagnosed or suspected musculoskeletal disorder.
Assessment is a critical component of treating patients with musculoskeletal disorders. A musculoskeletal disorder is a condition that affects the joints, muscles, and bones. An assessment is necessary to identify the source of the problem and design a treatment plan.
A healthcare provider will use different types of assessment tools to make an accurate diagnosis of the condition. Here are some of the key elements of an assessment for a patient with a diagnosed or suspected musculoskeletal disorder:
1. History Taking: This involves a detailed history of the patient's complaint and previous medical history. The healthcare provider will ask questions about the patient's symptoms, duration, and severity. It is important to note the location of the pain, aggravating or relieving factors, and any radiation of the pain.
2. Physical Examination: This involves a thorough physical examination of the patient's joints, muscles, and bones. The healthcare provider will look for any deformities, swelling, tenderness, or changes in the range of motion. They may also perform specific tests to identify the source of the problem.
3. Diagnostic Tests: These tests include x-rays, MRI scans, and blood tests. These tests help to identify any fractures, dislocations, or soft tissue injuries.
4. Functional Assessment: This involves an assessment of the patient's ability to perform everyday tasks. The healthcare provider will evaluate the patient's strength, range of motion, and coordination.
5. Psychosocial Assessment: This involves assessing the patient's mental health and social support. Musculoskeletal disorders can have a significant impact on a person's mental health, and it is essential to address this aspect of the patient's care.
In conclusion, an assessment for a patient with a diagnosed or suspected musculoskeletal disorder involves a detailed history, physical examination, diagnostic tests, functional assessment, and psychosocial assessment. It is important to consider all of these elements to make an accurate diagnosis and design an effective treatment plan. The assessment must be comprehensive and involve the patient in the decision-making process. This will ensure that the patient receives the best possible care and improves their quality of life.
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Name the DSM-IV-TR indicators necessary for a diagnosis of PTSD? (at least five of condition/symptoms, with two in each category, include specific symptoms in children) This question has different parts: You must mention the five (5) conditions, 2 characteristics in each category. Also specific symptoms in children
The DSM-IV-TR indicators necessary for a diagnosis of PTSD include the following five conditions: (1) Exposure to a traumatic event, (2) Re-experiencing symptoms, (3) Avoidance symptoms, (4) Arousal and reactivity symptoms, and (5) Duration of symptoms for more than one month. Specific symptoms in children may include nightmares, separation anxiety, and reenacting traumatic events in play.
To diagnose PTSD according to DSM-IV-TR, several conditions must be met. Firstly, the individual must have been exposed to a traumatic event. Re-experiencing symptoms refer to recurrent and distressing memories or nightmares about the traumatic event. Avoidance symptoms involve efforts to avoid triggers associated with the trauma. Arousal and reactivity symptoms include hypervigilance, irritability, and difficulty sleeping. The symptoms must persist for more than one month to meet the duration criteria. In children, specific symptoms can manifest differently, such as nightmares related to the traumatic event, increased clinginess or separation anxiety, and reenacting the traumatic event in play or drawings.
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A nurse in a long-term facility is caring for an older adult client who has Alzheimer's the client states that they want to go home and visit their parent,who is deceased which of the following techniques is an example of the nurse using validation therapy?
Repeating and summarizing what the client is saying and acknowledging their feelings is an example of the nurse using validation therapy.
Validation therapy is a technique that's based on the notion that a person with dementia experiences reality differently from the rest of us. It's used to build trust, rapport, and communication with the individual. By acknowledging the feelings and validating the person's perceptions, the nurse will be able to build a relationship with the client that's grounded in trust and understanding. In this scenario, the client states that they want to visit their deceased parent.
The nurse, by repeating and summarizing what the client is saying and acknowledging their feelings, would be using validation therapy. For example, the nurse could say something like, "I understand that you really want to visit your parent, who is no longer with us. It must be difficult for you to not be able to visit them." In this way, the nurse is acknowledging the client's feelings and validating their perception of reality, which will help them feel heard and understood.
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Which of the following is NOT a primary criterion for assessing causation? a) Temporal relationship b) Coherence c) Biological plausibility d) Strength of association e) Prevalence
The criterion that is NOT a primary criterion for assessing causation is e) Prevalence.
When assessing causation, several criteria are commonly used to evaluate the relationship between an exposure or factor and an outcome. These criteria help determine if there is a causal link between the two. The primary criteria for assessing causation include:
a) Temporal relationship: This criterion examines whether the exposure precedes the outcome in time, establishing a temporal sequence.
b) Coherence: Coherence refers to the consistency between the observed association and existing knowledge or understanding of the biological mechanisms involved.
c) Biological plausibility: This criterion assesses whether there is a plausible biological explanation for the observed association based on existing scientific evidence and understanding.
d) Strength of association: The strength of association refers to the magnitude of the observed relationship between the exposure and outcome. A stronger association increases the likelihood of a causal relationship.
These primary criteria help establish the presence or absence of causation in epidemiological investigations. However, prevalence, which refers to the proportion of individuals in a population with a particular condition at a specific time, is not a direct criterion for assessing causation. While prevalence can provide important information about the burden of a condition, it does not directly assess the causality between an exposure and an outcome.
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The nurse is seeing a client who has been prescribed saquinavir for treatment of HIV/AIDS. What would be important to teach the client about this drug? A. Take it immediately upon waking up in the morning. B. Take it 2 hours prior to meals. C. Take the drug on an empty stomach. D. Take the medication with food.
Take the medication with food. When it comes to the medication saquinavir used for the treatment of HIV/AIDS, it is crucial to instruct the client to take it with food.
It is based on the specific drug mentioned, saquinavir, which is used for the treatment of HIV/AIDS. Saquinavir is known to have better absorption and effectiveness when taken with a meal or snack. It is important to explain to the client that taking saquinavir on an empty stomach may result in reduced absorption and potentially compromise the intended therapeutic effects. By instructing the client to take the medication with food, healthcare providers can ensure that the drug is properly absorbed and utilized by the body, optimizing its effectiveness in managing HIV/AIDS. This guidance promotes adherence to the prescribed regimen and enhances the overall treatment outcomes for the client.
In conclusion, taking saquinavir with a meal or snack improves its absorption and enhances its effectiveness. By emphasizing the importance of taking the medication with food, healthcare providers can ensure optimal therapeutic outcomes for the client. Adherence to this instruction promotes the proper absorption and utilization of the drug, ultimately contributing to the successful management of HIV/AIDS.
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Submit a 1- to 2-page reflection answering the following questions:
How have you contributed to our scholarly community throughout the 6 weeks of this course? Provide examples from your participation in our course activities to support your perspectives.
How will you continue to use the skills from this course as you move forward in your academic journey? Provide specific ideas based upon the work you have completed in the course.
I have contributed to the scholarly community during the course of the six weeks of this course by taking part in conversations, offering my opinions, and giving feedback to my colleagues.
I actively engaged in the course's discussions and contributed my own views in an effort to benefit the scholarly community. I posted discussion comments and provided criticism on the contributions made by my peers, which sparked fruitful discussions and an exchange of ideas. I also finished tasks and turned them in on time, showing my dedication to learning and developing my skills.
I intend to keep applying the abilities I've learned in this course in my future academic endeavors. For instance, I'll use my critical thinking abilities to analyze and assess the various claims and pieces of evidence made in my coursework. Additionally, I'll keep honing my writing abilities by applying efficient communication strategies like coherence, clarity, and concision to my academic writing. In order to do thorough research and create arguments that are supported by solid evidence for my academic work, I will apply the research techniques I acquired in this course.
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docter order 40 meq Iv of potassium chloride, available is 5 meq/hr
the supply is 40 meq per 100 ml how many ml of potassium chloride
per hour with the nurse give
The doctor orders 40 meq of IV potassium chloride, but the available amount is 5 meq/hr, with the supply of 40 meq per 100 ml. The nurse will give 0.8 ml of potassium chloride per hour.
Solution: We need to use the formula of intravenous infusion to solve the problem.
IV infusion (ml/hr) = Total volume of IV fluid (ml) × Drip rate (gtts/min) / Time of infusion (min)1000 ml = 1 liter.
We need to use this to convert ml into liters as well.
Therefore,IV infusion (in liters/hr) = Total volume of IV fluid (in liters) × Drip rate (gtts/min) / 60 (min)
First, we need to find out the drip rate. Drip rate = Ordered dose / Hourly volume
Drip rate = 40 meq / 5 meq/hr
Drip rate = 8 gtts/min
Then, we need to find out the total volume of IV fluid.
Total volume of IV fluid = Ordered dose / Available dose
Total volume of IV fluid = 40 meq / 40 meq / 100 ml
Total volume of IV fluid = 100 ml.
Then, we need to find out the IV infusion in liters per hour.
IV infusion (in liters/hr) = Total volume of IV fluid (in liters) × Drip rate (gtts/min) / 60 (min)IV infusion
= 100 ml / 1000 ml × 8 gtts/min / 60 (min)IV infusion
= 0.8 ml/min.
Therefore, the nurse will give 0.8 ml of potassium chloride per hour.
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A client with a syndrome of inappropriate antidiuretic hormone (SIADH) is lethargic, confused, and complaining of muscle spam. The serum sodium 110 mEg/L. which of the
following interventions should the nurse prioritize?
a) Initiate both seizure and fail precaution
b) Start the 3% sodium chloride 3% infusion
c) Fluid restriction of 800 ml per day
d) Administer furosemide intravenously
Syndrome of inappropriate antidiuretic hormone (SIADH) is a condition where there is excess secretion of antidiuretic hormone, leading to water retention and dilutional hyponatremia.
The normal serum sodium level is 135-145 mEq/L. Sodium is an important electrolyte and low levels of sodium in the body can cause a variety of symptoms. In the given scenario, the client has a low serum sodium level of 110 mEq/L which is considered a medical emergency as it can lead to seizures, coma and even death if not treated promptly. Therefore, the nurse should prioritize the following intervention:
Option B: Start the 3% sodium chloride 3% infusion. This is the correct intervention in the given scenario as the client has a critically low serum sodium level.
Option C: Fluid restriction of 800 ml per day is not the correct intervention as the client is already experiencing symptoms of low serum sodium level and further fluid restriction can worsen the condition. Fluid restriction is a management strategy for SIADH, but it is not the priority in the given scenario.
Option D: Administer furosemide intravenously is not the correct intervention as it can further decrease the serum sodium level and worsen the condition. Furosemide is a loop diuretic that promotes sodium and water excretion and can lead to further dehydration. It is contraindicated in the management of hyponatremia. Therefore, option B is the correct intervention to prioritize in the given scenario.
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A routine mammogram showed a large mass in the right breast of Mrs. H, age 42 years. A biopsy
confirmed the presence of a malignant tumor. Mrs. H was concerned because her mother and
an aunt had had breast cancer. No metastases were detected at this time. A mastectomy was
performed, and a number of axillary and mediastinal lymph nodes were removed. Pathologic
examination showed that several nodes from each area contained malignant cells. Given that
this case was considered to be stage III, it was recommended that Mrs. H have chemotherapy
and radiation treatment following surgery and later have her ovaries removed to reduce her
estrogen levels.
1. Discuss the differences between a malignant and benign tumor and how they may be used
in diagnosing the cancer. (See Characteristics of Malignant and Benign Tumors.)
2. Discuss what other signs and symptoms Mrs. H may expect to experience if the tumor
returns. (See Pathophysiology, Local Effects of Malignant Tumors, Systemic Effects of
Malignant Tumors.)
3. Other than the biopsy used in this case, discuss what other diagnostic tests could have been
used to diagnose the cancer. (See Diagnostic Tests.)
4. Discuss the reasons why the axillary lymph nodes were removed and it was recommended
that the patient continue with chemotherapy and radiation. (See Spread of Malignant
Tumors.)
5. Discuss the different treatments that the patient is going through, including advantages and
disadvantages of each type and overall prognosis. (See Treatment.)
Malignant tumors are cancerous growths that invade nearby tissues and can spread to other parts of the body, while benign tumors are non-cancerous and typically remain localized.
1. In diagnosing cancer, the presence of malignant characteristics, such as rapid growth, invasion of surrounding tissues, and the ability to metastasize, helps differentiate malignant tumors from benign ones.
2. If the tumor were to return, Mrs. H might experience various signs and symptoms. Locally, she may notice a recurrence of a breast mass, changes in breast shape or size, skin dimpling or puckering, nipple retraction, or discharge. Systemically, she could experience weight loss, fatigue, pain, or the development of metastases in distant organs. The specific signs and symptoms would depend on the location and extent of the tumor recurrence.
3. In addition to the biopsy, several diagnostic tests could have been used to diagnose the cancer. Imaging studies such as mammography, ultrasound, or magnetic resonance imaging (MRI) can provide detailed information about the tumor's size, location, and involvement of nearby structures. A breast MRI may be particularly useful in certain cases. Other tests, such as a blood test for tumor markers like CA 15-3 or CA 27-29, can provide additional information, although they are not definitive for diagnosing breast cancer.
4. The removal of axillary lymph nodes and the recommendation for chemotherapy and radiation treatment serve important purposes. The axillary lymph nodes were removed to determine if the cancer had spread beyond the breast. The presence of malignant cells in several nodes suggests regional lymph node involvement, which indicates an increased risk of distant metastasis. Chemotherapy and radiation therapy are recommended to target any remaining cancer cells after surgery, reducing the risk of recurrence and improving overall survival rates.
5. Mrs. H is undergoing a combination of chemotherapy, radiation treatment, and later, removal of her ovaries to reduce estrogen levels. Chemotherapy uses powerful drugs to kill cancer cells throughout the body, while radiation therapy focuses high-energy beams on specific areas to destroy cancer cells. The advantages of chemotherapy and radiation treatment include their ability to target and kill cancer cells, reducing the risk of recurrence and improving survival rates. However, these treatments can also have side effects such as fatigue, nausea, hair loss, and increased susceptibility to infections. Removing the ovaries reduces estrogen production, as estrogen can promote the growth of certain types of breast cancer. The overall prognosis will depend on several factors, including the stage of the cancer, the extent of lymph node involvement, and the response to treatment. Regular follow-up and monitoring will be crucial to detect any signs of recurrence and provide appropriate care.
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Mrs. Saunders is a 70-year-old retired secretary admitted to your unit from the emergency department with a diagnosis of stroke (cerebrovascular accident, or CVA). She has a history of hypertension and atherosclerosis, and she had a carotid endarterectomy 6 years ago. She is 40% over her ideal body weight and has a 20-pack-year smoking history. Her daughter says her mother has been having short episodes of confusion and memory loss for the past few weeks. This morning she found her mother slumped to the right in her recliner, unable to speak.
Explain the pathophysiology of a stroke. Which type of stroke is most likely the cause of Mrs. Saunders’s symptoms?
Mrs. Saunders is flaccid on her right side. What is the term used to describe this?
Which hemisphere of Mrs. Saunders’s brain is damaged?
List four risk factors for stroke evident in Mrs. Saunders’s history.
Mrs. Saunders appears to understand when you speak to her but is unable to speak intelligibly. She says "plate" when she means shower and "broccoli" when she means gown. What is the term for this?
Neurologic checks are ordered every 2 hours for 4 hours and then every 4 hours for 4 days. When you enter her room and call her name, she opens her eyes. She is able to squeeze your hand with her left hand. However, she is only able to make incomprehensible sounds. What is her score on the Glasgow Coma Scale?
List at least three early symptoms of increasing intracranial pressure for which you will be vigilant. (You may want to refer back to Chapter 48.)
List two medications that the health care provider may order. Why might they be used?
The pathophysiology of a stroke is the result of ischemia due to reduced blood supply to a part of the brain or hemorrhage. Mrs. Saunders is likely to have had an ischemic stroke.
A stroke is a brain injury caused by a disruption in the blood supply to the brain. Ischemic and hemorrhagic are the two types of strokes. A lack of blood supply caused by an obstruction in the brain’s arteries is the most common cause of ischemic strokes. Mrs. Saunders is most likely to have had an ischemic stroke. It can be caused by a blood clot that forms in the blood vessels that supply blood to the brain. Mrs. Saunders's history of hypertension and atherosclerosis, along with a smoking history, increase her risk of ischemic stroke.
Flaccidity is the term used to describe Mrs. Saunders's right-side paralysis, which is also referred to as hemiplegia. The left side of Mrs. Saunders's brain is most likely damaged, which controls the right side of the body. Four risk factors for stroke evident in Mrs. Saunders’s history are hypertension, atherosclerosis, obesity, and smoking. Dysphasia is the term for Mrs. Saunders's difficulty in speaking intelligibly. Glasgow Coma Scale score for Mrs. Saunders is 8.
Early symptoms of increasing intracranial pressure include headache, nausea, vomiting, lethargy, decreased LOC, and changes in respiratory patterns. The healthcare provider may order anticoagulant or antiplatelet medication to prevent further stroke. In the case of ischemic stroke, thrombolytic therapy may be considered to dissolve the clot.
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In general, screening should be undertaken for diseases with the following feature(s): a) Disease where screening incurs increased health risks. b) Disease for which the impact on health is low. c) Disease for which early treatment can have beneficial effects. d) Diseases with low prevalence in identifiable subgroups of the population
In general, screening should be undertaken for diseases with the following features: d) Disease for which early treatment can have beneficial effects.
Why is disease screening important?Disease for which early treatment can have beneficial effects. This is the most important factor to consider when deciding whether or not to screen for a disease. Early treatment can often lead to better outcomes for patients. For example, early detection and treatment of cancer can improve survival rates.
Diseases where screening incurs increased health risks, diseases for which the impact on health is low, and diseases with low prevalence in identifiable subgroups of the population should not be screened unless the benefits of screening outweigh the risks.
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describe all the feelings that you or other PSWs might
have in this situation. Explain how they might be helpful or
unhelpful in resolving the problem
Here are some of feelings : Empathy, Frustration, Compassion, Anxiety, Gratitude. By cultivating empathy, compassion, gratitude, avoiding feelings of frustration and anxiety, PSWs can work collaboratively with their clients to find solutions that meet their needs.
As a PSW, there are a number of feelings that can arise in different situations. Some of these feelings may be helpful, while others may be unhelpful, especially when trying to resolve a problem.
1. Empathy: PSWs may experience feelings of empathy towards their clients who are facing a difficult situation. This can be helpful in resolving the problem as it can help PSWs understand the client's perspective and work towards finding a solution that meets their needs.
2. Frustration: In some situations, PSWs may feel frustrated when clients refuse to follow their advice or when things don't go as planned. This can be unhelpful in resolving the problem as it can lead to feelings of anger and resentment towards the client, which can make it difficult to work collaboratively towards a solution.
3. Compassion: PSWs may also feel a sense of compassion towards clients who are struggling with health issues or other challenges. This can be helpful in resolving the problem as it can help PSWs remain patient and understanding, even in difficult situations.
4. Anxiety: PSWs may feel anxious when dealing with difficult clients or situations. This can be unhelpful in resolving the problem as it can lead to feelings of panic or overwhelm, which can make it difficult to think clearly and find a solution.
5. Gratitude: PSWs may feel grateful for the opportunity to make a positive impact on their clients' lives. This can be helpful in resolving the problem as it can help PSWs maintain a positive attitude and focus on finding solutions that will benefit the client.
As a PSW, it is important to be aware of the feelings that arise in different situations and how they can either be helpful or unhelpful in resolving the problem
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no copy paste new answer.. APA reference needed..
for presentation.. I want briefe discription to what to avoid
during breaking bad news in hospitals? 2 slides maximum
During breaking bad news in hospitals, it is essential to avoid the use of medical jargon, speak clearly and calmly, be empathetic, avoid discussing multiple issues at once, and provide support and further resources.
Breaking bad news is a challenging task for healthcare providers, as it can have a significant impact on patients and their families. Therefore, it is crucial to approach the situation carefully to minimize the emotional burden on the recipient. When breaking bad news, healthcare providers should avoid using medical jargon, which can be confusing and lead to misunderstandings. Instead, they should speak in plain language, using clear and concise statements to ensure that the recipient understands the situation fully.
Healthcare providers should also be empathetic and show concern for the recipient's emotions, as this can help build trust and rapport. Furthermore, they should avoid discussing multiple issues at once, as this can be overwhelming for the recipient. Lastly, healthcare providers should provide support and further resources to help the recipient cope with the situation and navigate the next steps. In conclusion, breaking bad news is a challenging task, and healthcare providers should approach it with care and empathy to minimize the emotional impact on the recipient.
APA reference:
No references are needed for this question, as it is a summary of general advice for healthcare providers and not a direct quote or paraphrase from a specific source.
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