...Nightingale Executive Summary Western Governor’s University Nightingale Executive Summary Nightingale Community Hospital is a 180 bed hospital that provides acute care and a range of services to their community. Nightingale has four core values that consist of safety, community, teamwork, and accountability. Communication is a key concept in achieving and defining those values. According to the National Patient Safety Goal Data in regards to communication for Nightingale Community Hospital there is not consistency and goals are not being met for the following: reporting critical results within 60 minutes as evidenced by documentation, verbal orders/read-backs, unacceptable abbreviations, and time out hospital wide. Critical Results Within 60 Minutes Nightingale Hospital has showed variations in compliance with reporting critical results within 60 minutes for the months of January through December. Compliance went from 63% in January to 80% in December. In between this time there have been significant variances. As noted there from the data there was only 56% and 57% compliance for the months of June and July. Reporting of Critical Results with 60 minutes should be at 100% compliance. Verbal Orders/Read-Backs The ED met 100% compliance with verbal order/read-back audits for the fiscal year to date. Ortho is at 62% compliance. The other departments at Nightingale Hospital are ranging from 91% to 99%. For JCAHO standards the departments should be at 100%. ...
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...Geriatrics Geriatrics Jennifer P. Dugan, Pharm.D., BCPS Clinical Assistant Professor University of Colorado Colorado, Denver Updates in Therapeutics: The Pharmacotherapy Preparatory Review and Recertification Course 31 Geriatrics Learning Objectives: The following case pertains to questions 2 and 3. J.T. is an 82-year-old community-dwelling woman with a history of stage III Parkinson disease, hypertension, and urinary incontinence (UI). She is receiving carbidopa/levodopa, pramipexole, selegiline, tolterodine, diazepam, metoprolol, and hydrochlorothiazide. When she comes to your pharmacy to get her prescriptions, she walks slowly with a cane, and she is stooped over. 1. Identify age-related pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend...
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...American Economic Journal: Microeconomics 3 (February 2011): 1–36 http://www.aeaweb.org/articles.php?doi=10.1257/mic.3.1.1 Strategic Entry Deterrence and the Behavior of Pharmaceutical Incumbents Prior to Patent Expiration† By Glenn Ellison and Sara Fisher Ellison* This paper develops a new approach to testing for strategic entry deterrence and applies it to the behavior of pharmaceutical incumbents before patent expiration. It examines a cross section of markets, determining whether behavior is nonmonotonic in market size. Under some conditions, investment levels will be monotone in market size if firms do not invest to deter entry. Strategic investments to deter entry, however, may result in nonmonotonic investment because they are unnecessary in small markets, and impossible in large ones. Consistent with an entry-deterrence motivation is the finding that incumbents in medium-sized markets advertise less prior to patent expiration. (JEL D92, G31, L11, L21, L65) T he insight that firms may make “strategic investments” to alter future competitive conditions is one of the most fundamental ideas in industrial organization. Jean Tirole’s (1988) chapter reviewing arguments about how excess capacity, capital structure, advertising, contractual practices, learning-by-doing, and other actions can be used to deter entry is easily the longest in the text.1 Strategic investment models are difficult to test directly, however, and the vast majority of this literature is theoretical...
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...Diarrhea / ORT DEFINITION | SIGNS/SYMPTOMS | Most commonly due to acute infectious diarrhea (gastroenteritis) from a variety of causative organismsAntibiotics are a common cause of acute diarrhea! | Acute inflammation of the lining of the stomach and intestines caused by viruses, bacteria or their toxins or parasitesPresents commonly with diarrhea, abdominal cramps, and vomiting.CommunicabilityOften fecal-oral route (especially viruses)Food poisoning (especially bacteria)Day care centers, crowded living conditions, poor sanitation and cleanliness | DIAGNOSTIC TESTS | MAIN TREATMENT | Stool gram stain and culture (if bloody stools)Stool for Ova & Parasites (if hx suggestive)CBC – assess for anemia/infectionUrinalysis and urine culture (r/o UTI)Electrolytes | Oral rehydration therapy (ORT) is one of the major worldwide health advances of the last decade:Safer, less painful, and less costly than IV rehydrationOral rehydration solution enhances and promotes reabsorption of H2O and NaReduces vomiting, diarrhea, and duration of illnessORT GuidelinesDiarrhea w/o dehydrationMild dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet...
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...Part II POLICIES AND PROCEDURES FOR THE PHYSICIANS’ INJECTABLE DRUG LIST GEORGIA DEPARTMENT OF COMMUNITY HEALTH DIVISION OF MEDICAL ASSISTANCE PLANS Published October 1, 2013 PREFACE The Physicians’ Injectable Drug List (PIDL) manual contains basic information regarding Georgia’s Fee for Service (FFS) Medicaid and PeachCare for Kids programs and should be used in conjunction with Policies and Procedures Manual for Medicaid and PeachCare for Kids Part I, Part II Policies and Procedures Manual for Physician Services, and other applicable program manuals. We urge you and your office staff to familiarize yourselves with the contents of this manual and refer to it when questions arise. Use of the manuals will assist in the elimination of misunderstandings concerning the coverage levels and billing procedures that can result in delays of claims processing or payments, inaccuracies and/or denials. The PIDL is reviewed and updated quarterly, it is re-priced annually. Drugs that are not re-priced by the manufacturer or are no longer manufactured, or obsolete may not be re-priced or changed— refer to the Schedule of Maximum Allowable Payments (Appendix A) in this manual. For quality purposes, the PIDL is periodically purged of drugs with no or low (fewer than 50 units of service annually) utilization over a three (3) year period; except for orphan drugs and certain chemotherapeutic agents. Requests for coverage of purged drugs will be considered on a case-bycase...
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...MEDICAL-SURGICAL NURSING NERVOUS SYSTEM Overview of structures and functions: Central Nervous System Brain Spinal Cord Cranial Nerves Spinal Nerves Sympathetic nervous system Parasympathetic nervous system AUTONOMIC NERVOUS SYSTEM Peripheral Nervous System Autonomic Nervous System Sympathetic Nervous System (ADRENERGIC) - Involved in fight or aggression response. - Release of Norepinephrine (cathecolamines) from adrenal glands and causes vasoconstriction. - Increase all bodily activity except GIT EFFECTS OF SNS - Dilation of pupils(mydriasis) in order to be aware. - Dry mouth (thickened saliva). - Increase BP and Heart Rate. - Bronchodilation, Increase RR - Constipation. - Urinary Retention. - Increase blood supply to brain, heart and skeletal muscles. - SNS I. Adrenergic Agents - Give Epinephrine. Signs and Symptoms: - SNS Contraindication: - Contraindicated to patients suffering from COPD (Broncholitis, Bronchoectasis, Emphysema, Asthma). II. Beta-adrenergic Blocking Agents - Also called Beta-blockers. - All ending with “lol” - Propranolol, Atenelol, Metoprolol. Effects of Beta-blockers B – roncho spasm E – licits a decrease in myocardial contraction. T – reats hypertension. A – V conduction slows down. Should be given to patients with Angina Pectoris, Myocardial Infarction, Hypertension. ANTI- HYPERTENSIVE AGENTS 1. Beta-blockers – “lol” 2. Ace Inhibitors – Angiotensin, “pril” (Captopril, Enalapril) 3. Calcium Antagonist – Nifedipine (Calcibloc)...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
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...00_078973706x_fm.qxd 1/14/08 2:42 PM Page i NCLEX-PN ® SECOND EDITION Wilda Rinehart Diann Sloan Clara Hurd 00_078973706x_fm.qxd 1/14/08 2:42 PM Page ii NCLEX-PN® Exam Cram, Second Edition Copyright © 2008 by Pearson Education All rights reserved. No part of this book shall be reproduced, stored in a retrieval system, or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. No patent liability is assumed with respect to the use of the information contained herein. Although every precaution has been taken in the preparation of this book, the publisher and author assume no responsibility for errors or omissions. Nor is any liability assumed for damages resulting from the use of the information contained herein. ISBN-13:978-0-7897-2706-9 ISBN-10: 0-7897-3706-x Library of Congress Cataloging-in-Publication Data Rinehart, Wilda. NCLEX-PN exam cram / Wilda Rinehart, Diann Sloan, Clara Hurd. -- 2nd ed. p. cm. ISBN 978-0-7897-3706-9 (pbk. w/cd) 1. Practical nursing--Examinations, questions, etc. 2. Nursing--Examinations, questions, etc. 3. National Council Licensure Examination for Practical/Vocational Nurses--Study guides. I. Sloan, Diann. II. Hurd, Clara. III. Title. RT62.R55 2008 610.73'076--dc22 2008000133 Printed in the United States of America First Printing: February 2008 Trademarks All terms mentioned in this book that are known to be trademarks or service marks have been appropriately...
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...This page intentionally left blank Te n t h E d i t i o n MODERN DATABASE MANAGEMENT Editorial Director: Sally Yagan Editor in Chief: Eric Svendsen Executive Editor: Bob Horan Editorial Project Manager: Kelly Loftus Editorial Assistant: Jason Calcano Director of Marketing: Patrice Lumumba Jones Marketing Manager: Anne Fahlgren Marketing Assistant: Melinda Jensen Senior Managing Editor: Judy Leale Project Manager: Becca Richter Senior Operations Supervisor: Arnold Vila Operations Specialist: Ilene Kahn Senior Art Director: Jayne Conte Cover Designer: Suzanne Behnke Cover Art: Fotolia © vuifah Manager, Visual Research: Karen Sanatar Permissions Project Manager: Shannon Barbe Media Project Manager, Editorial: Denise Vaughn Media Project Manager, Production: Lisa Rinaldi Supplements Editor: Kelly Loftus Full-Service Project Management: PreMediaGlobal Composition: PreMediaGlobal Printer/Binder: Edwards Brothers Cover Printer: Lehigh-Phoenix Color/Hagerstown Text Font: Palatino Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on appropriate page within text. Microsoft® and Windows® are registered trademarks of the Microsoft Corporation in the U.S.A. and other countries. Screen shots and icons reprinted with permission from the Microsoft Corporation. This book is not sponsored or endorsed by or affiliated with the Microsoft Corporation. Copyright © 2011, 2009, 2007, 2005, 2002...
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