Caring for patients with suspected or confirmed monkeypox requires early recognition through screening adapted to local settings, prompt isolation and rapid implementation of appropriate IPC measures (standard and transmission-based precautions, including the addition of respirator use for health workers caring for patients with suspected/confirmed monkeypox, and an emphasis on safe handling of linen and management of the environment), physical examination of patient, testing to confirm diagnosis, symptomatic management of patients with mild or uncomplicated monkeypox and monitoring for and treatment of complications and life-threatening conditions such as progression of skin lesions, secondary bacterial infection of skin lesions, ocular lesions, and rarely, severe dehydration, severe pneumonia or sepsis. Patients with less severe monkeypox who isolate at home require careful assessment of the ability to safely isolate and maintain required IPC precautions in their home to prevent transmission to other household and community members.
physical examination and health assessment 7th edition pdf 98
ANS:BWithaging,anincreaseinsystolicbloodpressureoccurs.Nosignificantchangeindiastolicpressureandnochangeintherestingheartrateoccurwithaging.Cardiacoutputatrestisdoesnotchangedwithaging.DIF:CognitiveLevel:Analyzing(Analysis)MSC:ClientNeeds:HealthPromotionandMaintenance12.A45-year-oldmanisintheclinicforaroutinephysicalexamination.Duringtherecordingofhishealthhistory,thepatientstatesthathehasbeenhavingdifficultysleeping.Illbesleepinggreat,andthenIwakeupandfeellikeIcantgetmybreath.Thenursesbestresponsetothiswouldbe: a. Whenwasyourlastelectrocardiogram? b. Itsprobablybecauseitsbeensohotatnight. c. Doyouhaveanyhistoryofproblemswithyourheart? d. Haveyouhadarecentsinusinfectionorupperrespiratoryinfection?
Normally,theexaminermayormaynotseeanapicalimpulse;whenvisible,itoccupiesthefourthorfifthintercostalspaceatorinsidethemidclavicularline.Aheaveorliftisasustainedforcefulthrustingoftheventricleduringsystole.Itoccurswithventricularhypertrophyasaresultofincreasedworkload.Arightventricularheaveisseenatthesternalborder;aleftventricularheaveisseenattheapex.DIF:CognitiveLevel:Applying(Application)MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare18.Duringanassessmentofahealthyadult,wherewouldthenurseexpecttopalpatetheapicalimpulse? a. Thirdleftintercostalspaceatthemidclavicularline b. Fourthleftintercostalspaceatthesternalborder c. Fourthleftintercostalspaceattheanterioraxillaryline d. Fifthleftintercostalspaceatthemidclavicularline
Somemurmursarecommoninhealthychildrenoradolescentsandaretermed innocent or functional .Theinnocentmurmurisheardatthesecondorthirdleftintercostalspaceanddisappearswithsitting,andtheyoungpersonhasnoassociatedsignsofcardiacdysfunction.DIF:CognitiveLevel:Applying(Application)MSC:ClientNeeds:HealthPromotionandMaintenance25.Whileauscultatingheartsoundsona7-year-oldchildforaroutinephysicalexamination,thenursehearsanS 3 ,asoftmurmurattheleftmidsternalborder,andavenoushumwhenthechildisstanding.Whatwouldbeacorrectinterpretationofthesefindings? a. S 3 isindicativeofheartdiseaseinchildren.
ANS:BAphysiologicS 3 iscommoninchildren.Avenoushum,causedbyturbulenceofbloodflowinthejugularvenoussystem,iscommoninhealthychildrenandhasnopathologicsignificance.Heartmurmursthatareinnocent(orfunctional)inoriginareverycommonthroughchildhood.DIF:CognitiveLevel:Analyzing(Analysis)MSC:ClientNeeds:HealthPromotionandMaintenance26.Duringtheprecordialassessmentonanpatientwhois8monthspregnant,thenursepalpatestheapicalimpulseatthefourthleftintercostalspacelateraltothemidclavicularline.Thisfindingwouldindicate: a. Rightventricularhypertrophy. b. Increasedvolumeandsizeoftheheartasaresultofpregnancy. c. Displacementoftheheartfromelevationofthediaphragm. d. Increasedbloodflowthroughtheinternalmammaryartery.
5. For the batch review, 1% of the bill batches completed during the month will be reviewed. If 1% of the batches completed during a month exceeds 20 batches, then 20 batches will be reviewed. The batches should include work from all keyers and resolvers, if possible. This review will involve examination of the physical bill batches only, although further investigation may be made, when indicated. Examples of situations warranting further review include: the presence of bill with no date stamp; or the presence of a bill on an incorrect form. During the batch review, the reviewer should also make note of bills with extended service date ranges, procedure code modifiers, multiple units, high dollar amounts, and repetitions of the same procedure code for the same date of service on the same bill, for inclusion in the bill reviews.
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