Clinical Audits and Process Improvement in HospitalsLallu Joseph
How to conduct a clinical audit, differences between research and clinical audit, medical audit, History of audit, benefits of audit, standard, criteria, benchmarks, compare performance, examples of clinical audit, audit cycle, types of audit, NABH, JCI, QAPI, PDCA, Hospital accreditation,
oint Commission International Accreditation Standards for Hospitals, 6th Edition, provides the basis for accreditation of hospitals throughout the world. Joint Commission International (JCI) standards define the performance expectations, structures, and functions that must be in place for a hospital to be accredited by JCI. The standards are divided into two main sections: 1) patient-centered care and 2) health care organization management.
Clinical Audits and Process Improvement in HospitalsLallu Joseph
How to conduct a clinical audit, differences between research and clinical audit, medical audit, History of audit, benefits of audit, standard, criteria, benchmarks, compare performance, examples of clinical audit, audit cycle, types of audit, NABH, JCI, QAPI, PDCA, Hospital accreditation,
oint Commission International Accreditation Standards for Hospitals, 6th Edition, provides the basis for accreditation of hospitals throughout the world. Joint Commission International (JCI) standards define the performance expectations, structures, and functions that must be in place for a hospital to be accredited by JCI. The standards are divided into two main sections: 1) patient-centered care and 2) health care organization management.
1. A nurse responds to the cardiac monitor alarm of a patient an.docxmonicafrancis71118
1. A nurse responds to the cardiac monitor alarm of a patient and observes that the patient has atrial flutter. The patient is sitting up in the bed and is responsive. Which of the following actions should the nurse take first?
a. Institute carotid sinus massage
b. Assess the patient for dyspnea
c. Initiate CPR
d. Place the patient Trendelenburg position
2. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea. A nurse should take which of the following action first?
a. Administer antiemetic medication
b. Determine the patency of the patient’s NG tube
c. Instruct the patient to take deep breaths
d. Asses the patient’s pain level
3. A nurse from medical-surgical unit is asked to work on the orthopedic unit. The medical-surgical nurse has no orthopedic nursing experience. Which client should be assigned to the medical-surgical nurse?
a. a client with a cast for a fractured femur and who has numbness and discoloration of the toes
b. a client with balanced skeletal traction and who needs assistance with morning care
c. a client who had an above-the-knee amputation yesterday and has a temperature of 101.4F degrees
d. a client who had a total hip replacement 2 days ago and needs blood glucose
4. A nurse is caring for four clients and is preparing to do her initial rounds. Which client should the nurse assess first?
a. A patient with diabetes being discharged today
b. A patient with a trach with lots of secretions
c. A patient scheduled for PT this morning
d. A patient with a pressure ulcer that needs a dressing change
5. A nurse enters a room and finds a client lying on the floor. Which action should the nurse perform first?
a. Call for help
b. Determine if the patient is responsive
c. Assist the patient back to bed
d. Ask the patient what happened
6. The nurse plans care for a client in the post-anesthesia care unit. Which assessment should the nurse make first?
a. Respiratory status
b. Level of consciousness
c. Level of pain
d. Reflexes and movement of extremities
7. A nurse in the clinic is reviewing the diet of a 28-year old female who reports several months of intermittent abdominal pain, abdominal bloating, and flatulence. Which is a priority for the nurse to counsel the client to avoid in her diet?
a. Fiber
b. Yogurt
c. Broccoli
d. Simple carbs
8. A nurse in a long term facility is planning care for an elderly client with confusion. Which action should the nurse take first?
a. Sit the patient in the activity chair
b. Apply a vest restraint
c. Apply wrist restraints in the bed
d. Have a staff member sit with the patient for the entire shift
9. The nurse is providing care in the emergency department to the client with chest pain. Which action is most important for the nurse to do first?
a. Start an IV
b. Administer oxygen
c. Administer morphine
d. Start a lidocaine IV drip
10. A nurse arrives on the scene of a multi-motor vehicle accident. The nurse determines that.
The research design refers to the overall strategy that you choose to integrate the different components of the study in a coherent and logical way, thereby, ensuring you will effectively address the research problem; it constitutes the blueprint for the collection, measurement, and analysis of data.
Urgent-start peritoneal dialysis is generally reserved for patients who have no plan for dialysis modality, but are considered good candidates for peritoneal dialysis.
THE PURPOSE of the following sections is to give a brief description of many of the major drug classes that are important to nursing pharmacology; for drug class, we ‘ll discuss one prototype drug and examine it for information about warnings, indications, administration, and more; nurses, however, should seek out detailed information about individual drugs, as the prototype cannot be assumed to provide comprehensive information on other drugs in the same class; underline=preferred administration route
Define
Define related concepts nursing care of patients with musculoskeletal disorders.
Recognize
Recognize different types of musculoskeletal disorders.
Identify
Identify the clinical manifestations of musculoskeletal disorders.
Recognize
Recognize the medical management of musculoskeletal disorders.
Recognize
Recognize the nursing management
patients with musculoskeletal disorders.
MANAGEMENT OF PATIENTS WITH ENDOCRINE DISORDERSTHYROID DISORDERS (Hyperthyro...Jamilah AlQahtani
MANAGEMENT OF PATIENTS WITH ENDOCRINE DISORDERSTHYROID DISORDERS (Hyperthyroidism &Hypothyroidism)
Learning Objective
On completion of this lecture, the students will be able to:
Compare hypothyroidism and hyperthyroidism: their causes, clinical manifestations, management, and nursing interventions.
Diabetes insipidus and syndrome of inappropriate antidiuretic hormoneJamilah AlQahtani
MANAGEMENT OF PATIENTS WITH ENDOCRINE DISORDERSDiabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone
Learning Objective
On completion of this lecture, the students will be able to:
Compare diabetes insipidus and SIADH: their causes, clinical manifestations, management, and nursing interventions.
Dm,MANAGEMENT OF PATIENTS WITH ENDOCRINE DISORDERSDiabetes MellitusJamilah AlQahtani
MANAGEMENT OF PATIENTS WITH ENDOCRINE DISORDERSDiabetes Mellitus
Learning Objectives
On completion of this lecture, the students will be able to:
Differentiate between type 1 and type 2 diabetes
Describe etiologic factors associated with diabetes
Identify the diagnostic and clinical significance of blood glucose test results
Describe the relationships among diet, exercise, and medication for people with diabetes.
Describe the acute and chronic complications of diabetes
Management of Patients withLower Respiratory Disorders Pulmonary Tuberculosis (TB)
At the end of the lecture, the student will be able to
Describe the patho-physiology of the disease.
Discuss the major risk factors and clinical manifestations of the disease.
Use the nursing process as a framework for patient care.
Discuss medical , surgical and nursing management of the disease.
Pneumonia ,Management of Patients withLower Respiratory Disorders PNEUMONIA Jamilah AlQahtani
Management of Patients withLower Respiratory Disorders PNEUMONIA At the end of the lecture, the student will be able to
Describe the patho-physiology of the disease.
Discuss the major risk factors and clinical manifestations of the disease.
Use the nursing process as a framework for patient care.
Discuss medical , surgical and nursing management of the disease.
Management of Patients withLower Respiratory Disorders ASTHMA At the end of the lecture, the student will be able to
Describe the patho-physiology of the disease.
Discuss the major risk factors and clinical manifestations of the disease.
Use the nursing process as a framework for patient care.
Discuss medical , surgical and nursing management of the disease.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Adult nursing II
Section # 1 Urology disorders
Circle the right answer in the following MCQs:
1. The client with urolithiasis has a history of chronic urinary tract infections.
The nurse plans teaching the client to avoid which of the following?
1. Long-term use of antibiotics.
2. Wearing synthetic underwear and pantyhose.
3. High--phosphate foods, such as dairy products.
4. Foods that make the urine more acidic, such as cranberries.
3. Adult nursing II
2. The client who has a history of gout also is
diagnosed with urolithiasis and the stones are
determined to be of uric acid type. The nurse gives the
client instructions in which foods to limit, including:
1. Milk
2. Liver
3. Apples
4. Carrots
4. Adult nursing II
3. The client arrives at the emergency department with
complaints of low abdominal pain and hematuria. The client is
afebrile. The nurse next assesses the client to determine a
history of:
1. Pyelonephritits
2. Glomerulonephritis
3. Trauma to the bladder or abdomen
4. Renal cancer in the client's family
5. Adult nursing II
4. The nurse is reviewing the client's record and notes that the
physician has documented that the client has a renal disorder. On
review of the lab results, the nurse most likely would expect to
note which of the following?
1. Decreased hemoglobin level.
2. Elevated BUN
3. Decreased red blood cell count.
4. Decreased white blood cell count.
6. Adult nursing II
5. A client diagnosed with polycystic kidney disease has been
taught about the treatment plan for this disease. The nurse
determines that the client needs additional teaching if the client
states that the treatment plan includes:
1. Genetic counseling.
2. Sodium restriction.
3. Increased water intake.
4. Antihypertensive medications.
7. Adult nursing II
6. The nurse is caring for the client who has undergone renal
angiography using the left femoral artery for access. The nurse
determines that the client is experiencing a complication of the
procedure if which of the following is observed?
1. Urine output, 50 mL/hr
2. Blood pressure, 110/74 mm Hg
3. Pallor and coolness of the left leg.
4. Absence of hematoma in the left groin.
8. Adult nursing II
7. The nurse has taught the client with polycistic kidney disease
about management of the disorder and prevention and
recognition of complications. The nurse determines that the client
understands the instructions if the client states that there is no
reason to be concerned about:
1. Burning on urination.
2. A temperature of 100.6F
3. New-onset shortness of breath.
4. A blood pressure of 105/68 mmHg
9. Adult nursing II
8. A client is undergoing diagnostic tests to rule out a diagnosis of
renal disease. The lab results indicate a ratio of BUN to creatinine
of 15:1. The nurse determines that this result indicates:
1. A fluid volume deficit
2. Liver failure
3. A fluid volume excess
4. A normal ratio
10. Adult nursing II
9. A client is schedule for a excretory urogram. Which
of the following would the nurse expect to be
prescribed as a component of preparation for this test?
1. NPO status after midnight.
2. Administration of a sedative before the test.
3. Administration of intravenous fluids.
4. Bowel preparation to remove fecal contents
11. Adult nursing II
10. A client is complaining of severe flank and abdominal pain. A
flat plate of the abdomen shows urolithiasis. Which of the
following interventions is important?
1-Strain all urine
2-Limit fluid intake
3-Enforce strict bed rest
4-Encourage a high calcium diet
12. Adult nursing II
Section #2 ophthalmologic disorders
1. A male client has just had a cataract operation without a
lens implant. In discharge teaching, the nurse will instruct the
client’s wife to:
a. Feed him soft foods for several days to prevent facial movement
b. Keep the eye dressing on for one week
c. Have her husband remain in bed for 3 days
d. Allow him to walk upstairs only with assistance
13. Adult nursing II
2. After the nurse instills atropine drops into both eyes for a client
undergoing ophthalmic examination, which of the following instructions
would be given to the client?
a. “Be careful because the blink reflex is paralyzed.”
b. “Avoid wearing your regular glasses when driving.”
c. “Be aware that the pupils may be unusually small.”
d. “Wear dark glasses in bright light because the pupils are dilated.”
14. Adult nursing II
3. Which of the following symptoms would occur in a client with a
detached retina?
a. Flashing lights and floaters
b. Homonymous hemianopia
c. Loss of central vision
d. Ptosis
15. Adult nursing II
4. The client arrives in the emergency room after sustaining a chemical
eye injury from a splash of battery acid. The initial nursing action is to:
a. Begin visual acuity testing
b. Irrigate the eye with sterile normal saline
c. Swab the eye with antibiotic ointment
d. Cover the eye with a pressure patch.
16. Adult nursing II
5. Which of the following procedures or assessments must the
nurse perform when preparing a client for eye surgery?
a. Clipping the client’s eyelashes
b. Verifying the affected eye has been patched 24 hours before
surgery
c. Verifying the client has been NPO since midnight, or at least 8
hours before surgery.
d. Obtaining informed consent with the client’s signature and
placing the forms on the chart.
17. Adult nursing II
6. The nurse is performing an admission assessment on a client
with a diagnosis of detached retina. Which of the following is
associated with this eye disorder?
a. Pain in the affected eye
b. Total loss of vision
c. A sense of a curtain falling across the field of vision
d. A yellow discoloration of the sclera.
18. Adult nursing II
7. The nurse is caring for a client with a diagnosis of Corneal ulcer.
Which assessment sign would indicate that bleeding has occurred as a
result of the Corneal ulcer?
a. Complaints of a burst of black spots or floaters
b. White spot on cornea
c. Total loss of vision
d. A reddened conjunctiva
19. Adult nursing II
8. When developing a teaching session on Corneal ulcer for the
community, which of the following statements would the nurse
stress?
a. To avoid the following: wearing contact lenses, wearing
makeup, taking other medications and touching own eye
unnecessarily.
b. Yearly screening for people ages 20-40 years is recommended.
c. Glaucoma can be painless and vision may be lost before the
person is aware of a problem.
d. Need to avoid activities that increase intraocular pressure such
as straining with coughing, bowel movements, or lifting
20. Adult nursing II
9. When developing a teaching session on glaucoma for the community,
which of the following statements would the nurse stress?
a. Glaucoma is easily corrected with eyeglasses
b. White and Asian individuals are at the highest risk for glaucoma.
c. Yearly screening for people ages 20-40 years is recommended.
d. Glaucoma can be painless and vision may be lost before the person is
aware of a problem.
21. Adult nursing II
10. Which of the following procedures or assessments must the nurse
perform when preparing a client for eye surgery?
a. Clipping the client’s eyelashes
b. Verifying the affected eye has been patched 24 hours before surgery
c. Verifying the client has been NPO since midnight, or at least 8 hours
before surgery.
d. Obtaining informed consent with the client’s signature and placing
the forms on the chart.