ANP652

anp652 - Nursing
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Please complete this EKG worksheet EKG Worksheet  Answer each question below. Use complete sentences when providing short answer responses. 1. You are the AGACNP in the emergency room. A 55-year-old Caucasian male with a past medical history of HTN, thyroid cancer, and diverticulitis presents with crushing chest pain. His chest pain developed one hour ago after eating a large steak and potato dinner. He states the pain is 10 out of 10 and is not relieved by antacids. He is also diaphoretic and anxious. You review his 12 lead EKG, as per below. Using the EKG strip, answer questions A-D. A. What part of the area of the heart is showing an evolving infarct? a. Inferior b. Anterior c. Lateral d. Posterior B. Which leads show ST elevation? a. II, III, AVL b. V1-V3 c. II, III, AVF d. II, III, AVR C. Where would you expect to find reciprocal changes? a. Reciprocal changes in at least AVL b. Reciprocal changes in lead III c. Reciprocal changes in lead IV and V d. There are No reciprocal changes. D. What coronary artery is the likely cause? a. The Right Coronary artery in most cases as it is usually dominant, however in some patients the left circumflex is dominant and thus the culprit for an inferior MI. b. The left anterior descending c. The septal artery d. none of the above 2. A 67-year-old female is your established cardiology patient. She is following up with you regarding her uncomplicated mitral valve stenosis. During the visit, she happens to mention that she has suffered 9 hours of chest pain and sweating, which takes you by surprise. Your patient further describes the pain as both gnawing and intermittent. She thought she was experiencing heartburn, but admits that she has never experienced heartburn before, so she is not sure. You perform a 12-lead EKG immediately and call 911. Interpret the EKG recording below. What area of the heart is involved, what is your diagnosis, and which coronary artery is affected? a. Anterior part of the heart; this is an ST elevation myocardial infarction (STEMI); and the Left anterior descending is affected b. Inferior; this is a Non ST elevation MI (NSTEMI), and the right coronary artery is affected c. Posterior; this is not an MI but does show ischemia, and the circumflex is involved d. This simply pericarditis and thus the affected coronary arteries are not affected, the heart strain distribution is diffuse and global 3. What qualifies for “significant” ST elevation or depression in a 12 lead EKG- in the limb leads_(i)._____________? What is significant for the or the precordial leads_(ii)._____? These changes must be present in at least_(iii)___________consecutive leads in order to be considered diagnostic of myocardial pathology. 1. (i))1mm in a limb lead, (ii)1mm in precordial lead, (iii)and must be present 3 consecutive leads 1. (i)1mm in a limb lead, (ii)2mm in precordial lead, (iii)and must be present 2 consecutive leads 1. (i) 2mm in a limb lead; (ii)) 2 mm in a precordial lead, (iii) must be present in 3 consecutive leads  1. (i) 3 mm in a limb lead, (ii) 3 mm in a precordial lead, (iii) must be present in 2 consecutive leads Instructor Notes: An ST segment elevation or depression is considered significant if there is at least 1 mm or 1 small square in a limb lead or 2 mm or 2 small squares in a precordial leads. These significant changes must be present in at least two consecutive leads. 4. A 27-year-old African-American female is admitted to the hospital with severe sepsis related to a cellulitis infection in the groin. The patient was treated appropriately with antibiotics, and then transferred out of the intensive care unit to the medical/surgical unit. On post-admission Day 4, she complains of feeling anxious, short of breath, and chest pain that is worse with deep inspiration. The resident provider on call orders a 12-lead EKG and asks you to interpret it for her. You assess the patient, then review the 12-lead EKG. What is your interpretation? a. Left bundle branch block b. Right bundle branch block c. Normal EKG d. First degree heart block 5. Your 52-year-old Asian female patient with a past medical history of smoking and maybe “some sort of bronchitis” presents to your cardiology clinic. She states she has been having palpitations, light-headedness, and a feeling as if her heart is beating irregularly. The symptoms are not constant, and she is currently not having any symptoms. You obtain a 12-lead EKG in the clinic. What is your interpretation of her 12 Lead EKG, as shown below? a. Right atrial hypertrophy b. Left ventricular hypertrophy c. Complete heart block d. Atrial fibrillation 6. A 77-year-old female with a history of dyslipidemia, hyperthyroidism, and colon cancer presents to the emergency room with chest pain that radiates to her left arm. She has a blood pressure of 70/43, is diaphoretic, and extremely nauseous. Her symptoms occurred after she left a nearby casino, where she had spent several hours. You attend to her in the emergency room and order a 12-lead EKG, stat. A. You are suspicious of a posterior myocardial infarction. What kind of 12 lead EKG would best capture the ST changes of a posterior MI and how is this type of EKG performed? a. Right sided EKG and move left sided anterior leads V4, V5, and V6, to the right anterior chest in a V7, V8, V9 configuration, also change setting on EKG machine to “right sided EKG.” b. There is no such technique available, you simply have to infer that depression in atypical leads and multiple leads could indeed be indicative of a posterior MI. c. Place all leads on the posterior left torso, thus mirroring the usual placement on anterior torso. d. Obtain serial troponins and recheck the EKG in four hours. Instructor Notes: ST segment depression (not elevation) in the septal and anterior precordial leads (V1 to V4), in other words ECG leads will “see” the MI backwards (since the leads are placed anteriorly, but the myocardial injury is posterior. A right sided EKG can be performed to better visualize these changes, in doing this you must remove V4, V5, and V6 on the left side of the anterior chest and instead place these leads as V7-V9 directly opposite on the right side of the anterior chest. The presence or absence of ST elevation in the posterior leads V7-9 will more clearly differentiate a posterior MI. B. What findings would you expect to see in the leads that visualize an acute posterior wall myocardial infarction on your patient’s 12-lead EKG? a. ST segment depression in Septal and anterior leads (V1-V4) in a normal EKG, and ST elevation in V7-V9 in a right sided EKG b. ST segment depression in the Inferior leads and V2-V4, ST elevation in V7-V9. c. ST elevation in Septal and anterior leads, and ST depression in V7-V9 d. ST elevation in all leads and depression in V7-V9 C. What symptoms are common in an posterior myocardial infarction? a. Hypotension, nausea and vomiting, extreme weakness/ fatigue, any type of chest pain or pressure this is pretty individual. b. No pain and nausea, vomiting, diaphoresis and diarrhea. c. Neck pain, back pain, some euphoria. d. Nausea, vomiting, and fever with abdominal pain 7. An 87-year-old female with long standing uncontrolled HTN presents to the emergency room after experiencing symptoms and signs of a stroke. You order an EKG as part of the standard procedures. What is your impression of the 12-lead EKG below? a. Left ventricular hypertrophy is common with uncontrolled hypertension, and likewise hypertension, not well controlled is a risk factor for stroke. b. Atrial hypertrophy and patient likely has also congestive heart failure c. Right ventricular hypertrophy d. Normal EKG 8. You are the hospitalist AGACNP on call, and you complete a follow-up assessment on a 72-year-old female who was admitted for syncope yesterday. You hear a loud first heart sound and mid-diastolic murmur, which was not documented by the attending provider in the admission note from yesterday. Today’s EKG is below. What is your interpretation of the murmur and the results on the 12-lead EKG? a. This is atrial fibrillation with a rapid ventricular response and the heart murmur is not diagnostic with this EKG. b. This is a new murmur and along with the EKG the diagnosis is a Non ST Elevation MI. c. This is sinus tachycardia and it would be very difficult to auscultate a murmur at this rate d. There is a new murmur and thus systolic dysfunction is the diagnosis and the EKG is atrial flutter. 9. Using the EKG profile below, identify the AXIS. a. Right Axis b. Left Axis 10. You are an AGACNP in a busy emergency department. A 78-year-old male comes in with chief complaint of left sided chest pressure, dizziness, nausea, and vomiting. He is diaphoretic with a blood pressure of 78/50. You are handed an EKG and respond to the nursing staff , “No further interpretation on this one. What is the troponin?” On what types of EKG’s are you unable to interpret ST elevation or depression? a. Paced rhythms and left bundle branch blocks b. Atrial fibrillation at rapid rates c. Right bundle branch blocks d. Any patient with a prior ablation procedure © 2016. Grand Canyon University. All Rights Reserved. 2
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Your assignment may be more than 5 paragraphs but not less. INSTRUCTIONS:  To access the FNU Online Library for journals and articles you can go the FNU library link here:  https://www.fnu.edu/library/ In order to n that draws upon the theoretical reading to explain and contextualize the design choices. Be sure to directly quote or paraphrase the reading ce to the vaccine. Your campaign must educate and inform the audience on the benefits but also create for safe and open dialogue. A key metric of your campaign will be the direct increase in numbers.  Key outcomes: The approach that you take must be clear Mechanical Engineering Organic chemistry Geometry nment Topic You will need to pick one topic for your project (5 pts) Literature search You will need to perform a literature search for your topic Geophysics you been involved with a company doing a redesign of business processes Communication on Customer Relations. Discuss how two-way communication on social media channels impacts businesses both positively and negatively. Provide any personal examples from your experience od pressure and hypertension via a community-wide intervention that targets the problem across the lifespan (i.e. includes all ages). Develop a community-wide intervention to reduce elevated blood pressure and hypertension in the State of Alabama that in in body of the report Conclusions References (8 References Minimum) *** Words count = 2000 words. *** In-Text Citations and References using Harvard style. *** In Task section I’ve chose (Economic issues in overseas contracting)" Electromagnetism w or quality improvement; it was just all part of good nursing care.  The goal for quality improvement is to monitor patient outcomes using statistics for comparison to standards of care for different diseases e a 1 to 2 slide Microsoft PowerPoint presentation on the different models of case management.  Include speaker notes... .....Describe three different models of case management. visual representations of information. They can include numbers SSAY ame workbook for all 3 milestones. You do not need to download a new copy for Milestones 2 or 3. When you submit Milestone 3 pages): Provide a description of an existing intervention in Canada making the appropriate buying decisions in an ethical and professional manner. Topic: Purchasing and Technology You read about blockchain ledger technology. Now do some additional research out on the Internet and share your URL with the rest of the class be aware of which features their competitors are opting to include so the product development teams can design similar or enhanced features to attract more of the market. The more unique low (The Top Health Industry Trends to Watch in 2015) to assist you with this discussion.         https://youtu.be/fRym_jyuBc0 Next year the $2.8 trillion U.S. healthcare industry will   finally begin to look and feel more like the rest of the business wo evidence-based primary care curriculum. Throughout your nurse practitioner program Vignette Understanding Gender Fluidity Providing Inclusive Quality Care Affirming Clinical Encounters Conclusion References Nurse Practitioner Knowledge Mechanics and word limit is unit as a guide only. The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su Trigonometry Article writing Other 5. June 29 After the components sending to the manufacturing house 1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard.  While developing a relationship with client it is important to clarify that if danger or Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business No matter which type of health care organization With a direct sale During the pandemic Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record 3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. Furman was caught i One major ethical conflict that may arise in my investigation is the Responsibility to Client in both Standard 3 and Standard 4 of the Ethical Standards for Human Service Professionals (2015).  Making sure we do not disclose information without consent ev 4. Identify two examples of real world problems that you have observed in your personal Summary & Evaluation: Reference & 188. Academic Search Ultimate Ethics We can mention at least one example of how the violation of ethical standards can be prevented. Many organizations promote ethical self-regulation by creating moral codes to help direct their business activities *DDB is used for the first three years For example The inbound logistics for William Instrument refer to purchase components from various electronic firms. During the purchase process William need to consider the quality and price of the components. In this case 4. A U.S. Supreme Court case known as Furman v. Georgia (1972) is a landmark case that involved Eighth Amendment’s ban of unusual and cruel punishment in death penalty cases (Furman v. Georgia (1972) With covid coming into place In my opinion with Not necessarily all home buyers are the same! When you choose to work with we buy ugly houses Baltimore & nationwide USA The ability to view ourselves from an unbiased perspective allows us to critically assess our personal strengths and weaknesses. This is an important step in the process of finding the right resources for our personal learning style. Ego and pride can be · By Day 1 of this week While you must form your answers to the questions below from our assigned reading material CliftonLarsonAllen LLP (2013) 5 The family dynamic is awkward at first since the most outgoing and straight forward person in the family in Linda Urien The most important benefit of my statistical analysis would be the accuracy with which I interpret the data. The greatest obstacle From a similar but larger point of view 4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open When seeking to identify a patient’s health condition After viewing the you tube videos on prayer Your paper must be at least two pages in length (not counting the title and reference pages) The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough Data collection Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an I would start off with Linda on repeating her options for the child and going over what she is feeling with each option.  I would want to find out what she is afraid of.  I would avoid asking her any “why” questions because I want her to be in the here an Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych Identify the type of research used in a chosen study Compose a 1 Optics effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. Clients often implement recommended inte I think knowing more about you will allow you to be able to choose the right resources Be 4 pages in length soft MB-920 dumps review and documentation and high-quality listing pdf MB-920 braindumps also recommended and approved by Microsoft experts. The practical test g One thing you will need to do in college is learn how to find and use references. References support your ideas. College-level work must be supported by research. You are expected to do that for this paper. You will research Elaborate on any potential confounds or ethical concerns while participating in the psychological study 20.0\% Elaboration on any potential confounds or ethical concerns while participating in the psychological study is missing. Elaboration on any potenti 3 The first thing I would do in the family’s first session is develop a genogram of the family to get an idea of all the individuals who play a major role in Linda’s life. After establishing where each member is in relation to the family A Health in All Policies approach Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum Chen Read Connecting Communities and Complexity: A Case Study in Creating the Conditions for Transformational Change Read Reflections on Cultural Humility Read A Basic Guide to ABCD Community Organizing Use the bolded black section and sub-section titles below to organize your paper. For each section Losinski forwarded the article on a priority basis to Mary Scott Losinksi wanted details on use of the ED at CGH. He asked the administrative resident