...be at the estate at the time for a Father’s Day celebration), eagerly awaited the reading of Count Ralph’s will, since they all knew that they will would provide each blood relative with an equal share of his estate wealth. When the lawyer arrived, he noticed that a sum of money had been stolen from Count Ralph’s safe. The sum missing was equal to one person’s portion of the estate value. In addition, a small amount of fresh blood was found on the inside of the safe door, presumably belonging to the thief. As this news was being announced by the lawyer, the maid rushed into the room and revealed that she had walked into Count Ralph’s study and observed the thief quickly slipping out of the patio doors. She had not seen the face or been able to identify the thief, since he or she wore a mask and a bulky overcoat. She did see, however, that the thief had an attached ear lobe. Police Detective Morse was called to the Termond Estate. Upon his arrival, he immediately ordered blood typing tests on all in the house, and on the blood smear on the safe (found to be type A-). He also noted the ear lobe type of everyone. After studying the data, Morse called all of the relatives together and announced that he had discovered the identity of the thief. One of the children or grandchildren was not really a blood relative, and the theft of the money was to ensure a share in the inheritance. Using the data table on the next page, answer the following: 1. Draw this family’s pedigree...
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...specifically has a 24 bed unit and is a Level 1 pediatric trauma center. According to our website we see and treat nearly 41,000 children per year in the ED (“Cardinal Glennon”, 2015). It is truly a fascinating place to work and I learn something new every day that I am there. How Statistics are used at my Workplace: At Cardinal Glennon, there are various forms of statistics used. Like many other hospitals, the administration keeps track of numbers for all sorts of reasons. A few examples are as follows; the amount of infections that are related to central lines, how much profit was made each year, how many patients were seen in the ED each day, week, month and year, patient satisfaction scores, handwashing rates of co-workers, amount of blood cultures drawn each month and the amount that were determined contaminated. Those are just a few that matter to nursing but I am sure each individual department has their own forms of statistics they track. After these different sets of data are complied, some form of chart or graph is used to make an impact on the employees. This helps show the real data and make it easier for us to see just how much the numbers change each month. Of course an action plan is then formed to help us be able to “better” our numbers to reflect better or more cautious care. These charts and graphs can be an eye opener for the nurses a lot of times. As a bedside nurse, we are not always good at thinking of the numbers. Thankfully...
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...C4 THE SAMPLING, THE STORAGE AND TRANSPORT OF THE BIOLOGICAL MATERIAL ZMLIM 2015/2016 dr n. med. MONIKA ŁYSAKOWSKA IMPORTANT • The microbiology results begins with the patient and not at the door of the microbiology laboratory. • The proper collection and transport of specimens is critical • The communication between the microbiology laboratory and those collecting specimens may be necessary • All samples should be treated as if infectious materials SUCCESSFUL LABORATORY INVESTIGATIONS Advance planning Collection of adequate and appropriate specimens Sufficient documentation Biosafety and decontamination Correct packaging Rapid transport Choice of a laboratory that can accurately perform the tests Timely communication of results SUFFICIENT DOCUMENTATION CASE INVESTIGATION FORM Should include: Patient information • Age (or date of birth), sex, ID number/complete adress Clinical information • Date of onset of symptoms, clinical and immunization history, risk factors or contact history where relevant, anti-microbial drugs taken prior to specimen collection Laboratory information • Acute or convalescent specimen • Other specimens from the same patient SUFFICIENT DOCUMENTATION CASE INVESTIGATION FORM- LABORATORY Receiving laboratory records: date and time when specimen was received Name and initials of the person receiving specimen Record of specimen quality SUFFICIENT DOCUMENTATION LABELING SPECIMENS Patient’s name ...
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...control passed and there was no contamination. Since we saw growth this is indicating that no contamination was present. Otherwise, if the agar was contaminated, we wouldn’t see any changes or growth on these agars. If you were to look at tables 1.2-1.5 you’ll see signs of growth on the surfaces of the agars. In table 1.2 you’ll see that S. epidermidis showed an olive metallic streak with colonies and coagulase positive on the blood agar. The olive metallic streak with colonies is indicating that the RBC’s are hemolyzed completely. This is known as beta-hemolysin or complete. Two days after our agar was put into the incubator at 37°C we added a drop of hydrogen peroxide to check for positive results. According to professor Harry Sdralis, “Catalase is an enzyme that breaks down hydrogen peroxide to oxygen and water.” After adding the drop of hydrogen peroxide, we waited to see if any bubbles were going to surface. If any bubbles were to form on the surface...
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...extraneous variables enables the researcher to identify relationships among the study variables accurately and examine the effects of one variable on another. One can say as an example for a new technique of how to obtain blood cultures with the decrease risk of contamination. The researcher will assign two groups of laboratory technicians for twenty four hours. One of the group will clean the top of the blood culture bottle with alcohol wipes just before attaching the bottle to the vacutainer. While the other group will not clean the top of the bottle...
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...Given the data and observation in Table 1 the identity of unknown E may be P.vulgaris because it scored a 31/38 in comparison with P.aeruginosa who had a 15/38 when both were compared to unknown E. This was based on using the Gram stain outcome and the blood agar outcomes to rule out the other species from being considered. Unknown E was a species that came from a plastic urinary catheter in a long-term healthcare facility. These conclusions are supported by literature as Enterobacteriaceae family members are mainly found in the gut flora. 6 Knowing this we can narrow the identity of the unknown to E.coli, K.pneumoniae and P.vulgaris. The result that unknown E could be P.vulgaris was observed in the beginning of the experiment, as its morphology and smell was similar. When the tests were done however, it did not match each other perfectly. This could be for multiple reasons, including the different growing conditions for unknown E and P.vulgaris, while the unknown E grew in a catheter the other was cultured in the lab. This would have had drastic implications on how unknown E would grow to behave as that colony might not be used to working in those conditions. It could have also had to do with the onsite contamination cultures...
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...Clinical Documentation System Excelsior College October 6, 2013 Clinical Documentation System Clinical information system (CIS) collects patient data in real time, stores healthcare data and information using secure access to the healthcare team. (McGonigle & Garver Mastrian, 2012, p. 554). The CIS that is used at Texas Health Dallas is CareConnect. CareConnect is used by all of the Texas Health Resources (THR) encompassing 25 hospitals, affiliated physician offices, and ancillary facilities. CareConnect allows physicians and management to access the system on their mobile devices and home computer for real time data. The shift for CIS is set for implementation throughout the United States by 2015. The clients served are those in the community that THR provides healthcare services to. The electronic health record is shared amongst the healthcare team and other affiliates. Data collection can be continuously updated, used for “statistical evaluation for purposes of quality improvement, outcome reporting, resource management, and public health surveillance.”(Yamada, 2008, p. 5). Data collection is generally initiated in the ER, and other times when the patient is at the physician's office or in the outpatient service line. To reference inpatient services, data collection begins in the ER. The patient's allergies, current medications, medical history, vital signs, immunizations, suicide screening and domestic violence screening are all obtained...
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...Prevention: Thoroughly cook meat, sanitation; avoid dirty drinking water, which is usually found in foreign countries) 2. A California farmer developed a low- grade fever, myalgia, and cough. A chest X- ray exam revealed an infiltrate in the lung. Microscopic examination of the sputum revealed round, budding cells. A sputum culture grew mycelia and arthroconidia. What organism is most likely the cause of the symptoms? What is causing the man’s disease? How is this disease transmitted? How might it be prevented? Answer: The disease is primarily a food born disease and it is circulated through fecal-oral route through contamination food and water, furthermore, the only way to prevent this, is by washing the hands thoroughly. Once ingested the eggs are absorbed in the lumen of the intestine and migrates preferentially to the brain and muscles 3. A teenaged male in California complained of remittent fever, chills, and headaches. A blood smear revealed ring- shaped cells in his red blood cells. He was successfully treated with primaquine and chloroquine. Answer: The patient lives near the San Luis Rey River and has no history of foreign travel, blood transfusion, or intravenous drug use. What is the disease? How was it acquired? Without additional information, an educated guess would be malaria acquired from mosquitoes infected by biting migrant workers from...
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...In blood transfusion practice, the ABO is the most important blood group system for blood group compatibility (Schwarz & Dorner, 2003). This is because A, B antigens are strongly immunogenic and upon stimulation elicit a strong antibody response and their alloantibody can cause destruction of transfused red cells (Enosolease & Bazuaye, 2008). The ABO blood group system is considered to be safe and cost effective in most transfusion except in case of multiple transfusions where extensive cross matching is required even for minor antigen to prevent alloimmunization (Hassan et al., 2004). ABO antigen is the integral part of cell membrane and has different biochemical composition despite similar basic antigen (Dean, 2005). B phenotype is most common...
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...Phlebotomy is the process of drawing blood for any type of testing, diagnosis, or analysis. Blood contains two parts which are cells and fluids such as plasma and serum. Plasma is a fluid that contains substances which may be glucose, protein, or water. Serum is the fluid that remain after the blood is allowed clotting in the tube. Blood can help control fluid balance, body acid balance, and body temperature. According to MedlinePlus, Blood test can help diagnose or analyze of a patient health. These blood test are mostly important because it can help evaluate the diagnosis or even the effectiveness of medications that are given. Phlebotomist uses the order of draw, which is a specific order of tubes that must be used when blood is being collected. This theory is to identify and have less confusion of certain additives in the tubes. The National order of draw is usually determined by Blood culture, Coagulation, Additive, and Non-Additive tubes....
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...bacterial identification down to the “species” level. These schemes are based on creating and matching biochemical profiles of the production of enzymes, acids and gases by isolated pure cultures of a given microorganism. Identification schemes and flow charts can be found in reference texts such as “Bergey’s Manual of Determinative Bacteriology” or “The Prokaryotes”. Each group of students will receive a TSA slant or broth containing a pure culture of an unknown bacterium belonging to the Family Enterobacteriaceae. It is the responsibility of the group to maintain stock cultures of the organism provided. Working stock cultures will be used to inoculate the various biochemical test media over the next several weeks and should be fresh and free from contaminants. A reserve stock culture should be made and after incubation and comparison with the original slant, kept with the original slant in the refrigerator. It is critically important that aseptic techniques are used during transfers and inoculations to prevent contamination of your cultures. If contamination is suspected, you will be able to fall back to your reserve stock. If you fail to maintain a reserve stock you will not be able to recover your organism if disaster strikes. The instructor will not provide a new culture for you to start with in the middle of the unknown exercises. It is your responsibility to: keep your organisms alive and fresh to run tests check with us if you question purity of your...
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...Microbiology Overview Interpretation of preliminary microbiology data Gram-positive cocci Aerobic In clusters ● Coagulase (+): Staphylococcus aureus ● Coagulase (-): Staphylococcus lugdunensis and other coagulasenegative staphylococci In pairs/chains ● Optochin sensitive: Streptococcus pneumoniae ● Alpha-hemolytic: Viridans group Streptococcus, Enterococcus ● Beta-hemolytic: ○ Group A Strep (Streptococcus pyogenes) ○ Group B Strep (Streptococcus agalactiae) ○ Group C, D, G Strep Anaerobic: Peptostreptococcus spp. and many others Gram-positive rods Aerobic ● Large: Bacillus spp ● Cocco-bacillus: Listeria monocytogenes, Lactobacillus spp ● Small, pleomorphic: Corynebacterium spp ● Branching filaments: Nocardia spp, Streptomyces spp Gram-negative cocci Aerobic ● Diplococcus: Neisseria meningitidis, N. gonorrhoeae, Moraxella catarrhalis ● Cocco-bacillus: Haemophilus influenzae, Acinetobacter Anaerobic: Veillonella spp. Gram-negative rods Aerobic Lactose fermenting (Lactose positive): ● Enterobacter spp, Escherichia coli, Klebsiella spp ● Citrobacter spp*, Serratia spp* Non lactose-fermenting (Lactose negative): ● Oxidase (-): Acinetobacter spp, Burkholderia spp, E. coli, Proteus spp, Salmonella spp, Shigella spp, Serratia spp*, Stenotrophomonas maltophilia ● Oxidase (+): P. aeruginosa, Aeromonas spp. Anaerobic ● Large: Clostridium spp Anaerobic: Bacteroides spp, Fusobacterium spp, Prevotella spp. ● Small, pleomorphic: P. acnes, Actinomyces spp *Serratia and Citrobacter spp...
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...perspective. Looking at communities through the eyes of a nurse creates an assessment all its’ own. Analyzing the events and conditions people live in tells a lot about the person. The nurse can reflect on the surroundings and develop an opinion regarding the patient. The difficulties the community can impose create negative outcomes and or can be productive for the patient; this is revealed in the assessment surrounding the patient. The historical area of the community does have down falls. The paint that was used in the era of older homes and apartments contain lead. Lead, a contaminate to children in the home, school or business is a concern for the community and the nurse. The lead would give the nursing diagnosis of, Risk for Contamination (Household Lead Exposure). Lead exposure in apartments, schools and playground equipment are primary sites for exposure. Nursing interventions would consist of ongoing screening program for lead levels of individuals, agency notification of levels, decrease the exposure to minimize the risk, relocate families to a safe environment, and educate the high-risk people about lead exposure (Polk & Green, 2007). OSHA has standards set in place to regulate the levels of lead exposure. They mandate that areas of lead paint must be removed and for a cleaner environment of the community. The city and state enforce the regulations in communities. Groups within the community organize individuals from the community to provide free help in removing...
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...History: What were people’s views on health? According to his picture, it identifies that throughout history people around the world thought if one with illness, physical, sensory or mental impairment were thought of as under the spell of witchcraft, possessed by demons or big sinners, being punished by god for wrong doing by themselves or their parents (Medical model vs social model, 2007). These ideas still remain some power, in different cultures. Before the development of medical science, quasi – religious views of health and illness were dominant, whereby illness was connected with sin, penance and evil spirits. This dominant view had conceived the body and soul as a sacred entity beyond the power of human intervention. The influence of scientific disconnect, linked diseased organs with symptoms observed before death. Pasteur’s germ theory, eventually endorsed a belief in the separation of body and soul. This view came to be known as mind/body dualism, referred to a Cartesian dualism after the philosopher Rene Descartes 1590-1650 which refers to a belief that the mind and body are separate entities, which ignores the psychological and subjective aspects of illness. Descartes suggest that although the mind and body interacted with one another with the say of “I think therefore I am”. He identifies that the brain was part of the physical body, whereas the mind existed in the spiritual realm. Therefore medicine could rightly practise on the body while religion could focus...
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...POLYMERASE CHAIN REACTION (PCR) PCR stands for the Polymerase Chain Reaction and was developed in 1987 by Kary Mullis (which won him a Nobel Prize) and associates. With this technique it is possible to make virtually unlimited copies of a single DNA molecule even though it is initially present in a mixture containing many different DNA molecules. It is used to amplify a specific DNA (target) sequence lying between known positions (flanks) on a double-stranded (ds) DNA molecule. The polymerase chain reaction can be used to amplify both double and single stranded DNA. In order to perform PCR, one must know at least a portion of the sequence of the target DNA molecule that has to be copied. Generally, PCR amplifies small DNA targets 100-1000 base pairs (bp) long. It is technically difficult to amplify targets >5000 bp long. A pair of single stranded oligonucleotide primers, which have DNA sequences complementary to the flanking regions of the target sequence, must be synthesized. The primers are complementary to either end of the target sequence but lie on opposite strands. The primers are usually 20-30 nucleotides long and bind to complementary flanking region at 3' end. Requirements: Thermal cycler (thermocycler) PCR amplification mix typically containing: Sample dsDNA with a target sequence Thermostable DNA polymerase Two oligonucleotide primers Deoxynucleotide triphosphates (dNTPs) Reaction buffer containing magnesium ions and other components Procedure: 1. The DNA molecule...
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