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CASE 1: EVIDENCE Ahmet Erat works as an internist at Beykoz Governmental Hospital. He has been

Question: CASE 1: EVIDENCE Ahmet Erat works as an internist at Beykoz Governmental Hospital. He has been following up his patient Mr. Metin who has idiopathic cardiomyopathy for nearly three years. After reading a news about his disease on a newspaper, Mr Metin was very excited and decided to visit Dr. Ahmet at the hospita l. The news was about a drug calledCASE 1: EVIDENCE Ahmet Erat works as an internist at Beykoz Governmental Hospital. He has been following up his patient Mr. Metin who has idiopathic cardiomyopathy for nearly three years. After reading a news about his disease on a newspaper, Mr Metin was very excited and decided to visit Dr. Ahmet at the hospita l. The news was about a drug called “ spironolactone ” which was found to be very efficient in a survey on cardiac insufficiency. Mr Metin believed that if he used this drug, he would be healthier and live longer. During the last 18 months his disease was st able and his symptoms were very mild and the disease stage was Class II(Left ventricular dysfunction)according to New York Heart Association Functional Classification. Mr. Metin is on enalapril ( 2X10 mg),metoprolol (2X50) and furosemide (1X20). His blood pressure was 110/70 mmHg and heart rate was 60 beats per minute. His creatinine level was 100 μmol/L and potassium level was 1.1 mmol/L. Dr. Ahmet knows that, enalapril suppresses aldosterone. He read that using these two drugs together is relatively contr aindicated because of hyperkalemia risk. Dr. Ahmet decides to search the articles to reach enough evidence. Where and how will Dr. Ahmet find these related articles? Will he believe the results of the articles? CASE 1: EVIDENCE AIM : At the end of this session, students will gain knowledge and skills in finding evidence and distinguishing the hierarchy of evidence based on the study types. Learning objectives: Students will be able to: 1. Gain knowledge about the philosophy of evidence – based medicine (EBM) ; 2. Gain knowledge on key steps of practicing EBM and explain the key elements on each step; 3. Identify the appropriate study type based on the types of clinical questions; 4. Identify the sources and level of evidence; 5. Gain knowledge on finding evidence and evaluation of the evidence; 6. Acquire skills about finding evidence using electronic databases and sources; 7. Explain the necessity of critical evaluation of the obtained articles; 8. Explain the reliability of the evidence based on study types Case 1

Reflection: Healthcare resources are limited and use of the resources should be based on

Question: Reflection: Healthcare resources are limited and use of the resources should be based on scientific evidence, not availability of resources. For example, there are criteria that help determine if persons who experience concussion should have a CT scan or not. Despite these criteria, many providers feel that they need to order the scans because of parental orplease answer all questions in a 1. , 2. , 3 format. THANK YOU !Show transcribed image text 100% (1 rating)As aparental choice i will insist the physician to write a ct scan for my child even the though there is no possibility of bleeding in the head As a…View the full answerTranscribed image text: Reflection: Healthcare resources are limited and use of the resources should be based on scientific evidence, not availability of resources. For example, there are criteria that help determine if persons who experience concussion should have a CT scan or not. Despite these criteria, many providers feel that they need to order the scans because of parental or patient demands that they want the scan to ensure that no bleeding is occurring in the head. For this exercise, put yourselves in the shoes of the parent. Your child has experienced a concussion and you are worried about their well being. You have insurance, so you know it will not cost you anything, so you are pressing the physician to order a CT scan. The physician informs you that in your child’s case, a CT is not indicated and that having the test actually increases your child’s exposure to radiation, so the physician does not want to order it. Which way will you argue; for getting the CT scan for your child or will you be ok with not getting it. State your reasoning from a parental, financial, and resource utilization standpoint (you must include all three views) and you may add your own views as well.

Show Solution And The Answer Must Be In Kg/min


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Show solution and the answer must be in kg/min


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A refrigeration machine of 6 tons capacity working on Bell-Coleman cycle has an upper limit pressure of 5.2bar. The pressure and temperature at the start of the compression are 1 bar and 18*C, respectively. The cooledcompressed air enters the expander at 41°C. Assuming compression to be adiabatic with an inde… Show more… Show more

Using the fixed pill combinations of candesartan and hydrochlorothiazide as an example, explain some of

Accounting Assignment Help Question: Using the fixed pill combinations of candesartan and hydrochlorothiazide as an example, explain some of the overall advantages of fixed pill combinations of drugs. Briefly discuss the most important side effect of candesartan-hydrochlorothiazide combined pills. Using the fixed pill combinations of candesartan and hydrochlorothiazide as an example, explain some of the overall advantages of fixed pill combinations of drugs. Briefly discuss the most important side effect of candesartan-hydrochlorothiazide combined pills.
Candesartan and hydrochlorothiazide combination is used to treat high blood pressure. Fixed pill combinations of candesartan and hydrochlorothiazide (HCTZ) are highly effective in lowering blood pressure while providing impro…View the full answer

Welcome week 5 Mental Health What is Jill diagnosis and careplan 30mins ends 6:20pm

Question: Welcome week 5 Mental Health What is Jill diagnosis and careplan 30mins ends 6:20pm Jill, a 24 y/o Hispanic female arrives in the emergency room where her parents brought her for evaluation. They are worried because she is giving away all of her possessions and says she is planning to move to the South Pole so she can “save the world.” Her parents say that

Show transcribed image textJill is suffering from BIPOLAR DISORDER. RATIONALE :- This is because People like Jill suffering with bipolar disorder have experiences of severe sadness as well as moments of mania, which include feelings of extreme joy, excitement, or euphoria, a l…View the full answerTranscribed image text: Welcome week 5 Mental Health What is Jill diagnosis and careplan 30mins ends 6:20pm Jill, a 24 y/o Hispanic female arrives in the emergency room where her parents brought her for evaluation. They are worried because she is giving away all of her possessions and says she is planning to move to the South Pole so she can “save the world.” Her parents say that she has hardly been sleeping at all for the last 7 days, but she seems very energetic. They say she has appeared to be “in a frenzy” lately. When you interview Jill you notice that she speaks very rapidly and is laughing uncontrollably. It is hard to get her to be quiet long enough for you to ask questions. She seems agitated and has difficulty sitting still.

Briefly explain the renin-angiotensin aldosterone mechanism, placing the ‘…pril’ and ‘…sartan’ drugs into the context

Question: Briefly explain the renin-angiotensin aldosterone mechanism, placing the ‘…pril’ and ‘…sartan’ drugs into the context of that explanation include the actions of angiotensin II and the results of those actions.Briefly explain the renin-angiotensin aldosterone mechanism, placing the ‘…pril’ and ‘…sartan’ drugs into the context of that explanation include the actions of angiotensin II and the results of those actions.
RAAS Mechanism Angiotensin | | (Angiotensin converting enzyme (ACE)) | Angiotensin || Angiotensin || acts on: Blood vessel: causes constriction of blood vessel -> increase in total peripheral resistance -> increase in BP Aldosterone release: causes s…View the full answer


in An Education Setting, Consider The Culture Of The Classroom And How Get Essay Help


In an education setting, consider the culture of the classroom and how this may influence a student’s behaviour. Provide two (2) examples. These may be influences you have observed or have discussed with the teacher or education support worker. Do the examples have positive or negative impacts and how could they be encouraged or prevented?

Discussion Topic: Providing nutrition support through enteral tube feedings or total parenteral nutrition to the

Question: Discussion Topic: Providing nutrition support through enteral tube feedings or total parenteral nutrition to the terminally ill person is an ethical issue that confronts many health care professionals who work with end-of-life patients. For this Unit Topic, you are to Discuss the ethical issues involved with providing this advanced nutrition. You do not needDiscussion Topic: Providing nutrition support through enteral tube feedings or total parenteral nutrition to the terminally ill person is an ethical issue that confronts many health care professionals who work with end-of-life patients. For this Unit Topic, you are to Discuss the ethical issues involved with providing this advanced nutrition. You do not need to state whether you agree or disagree with providing advanced nutrition support to the terminally ill person. To write an end-of-life order the attending physician will discuss the issues related to resuscitation, IV hydration, enteral tube feedings, or parenteral feedings with patients, family members, and significant others. As a health care professional, you must be objective in answering any questions asked by these individuals regardless of your own personal beliefs. Your role is to provide unbiased, factual, accurate information about end-of-life decisions so that the patient and their loved ones can make an informed decision.
Enteral tube feeding is the one in which used for the patient that they cannot able to swallow or take the food orally.so here the scenario is discussed about the client is on terminal s…View the full answer

Providers should not adapt advice to both the situation and the patient. O True

Question: Providers should not adapt advice to both the situation and the patient. O True O False Question 10 5 pts If the patient is an individual who rarely appreciates advice, it may be better to cushion the advice with a story. O True FalseShow transcribed image textThe answer to first question is False As a provider of healthcare the medical advice given to the patient should always be adapted to the present situation and patient at hand. As every patient and every situation i…View the full answerTranscribed image text: Providers should not adapt advice to both the situation and the patient. O True O False Question 10 5 pts If the patient is an individual who rarely appreciates advice, it may be better to cushion the advice with a story. O True False

Dr. Martine will provide only the delivery service and tubal ligation. The patient’s hometown

Question: Dr. Martine will provide only the delivery service and tubal ligation. The patient’s hometown physician provided the antepartum care and will also provide the postpartum care LOCATION Inpatient Hospital PATIENT Melissa Hote ATTENDING PHYSICIAN: Andy Martner, MD SURGEON Andy Martin, MD PREOPERATIVE DIAGNOSES 1. Three prior canarsan section deliveries 2.help with abatracting and coding questionsShow transcribed image textTranscribed image text: Dr. Martine will provide only the delivery service and tubal ligation. The patient’s hometown physician provided the antepartum care and will also provide the postpartum care LOCATION Inpatient Hospital PATIENT Melissa Hote ATTENDING PHYSICIAN: Andy Martner, MD SURGEON Andy Martin, MD PREOPERATIVE DIAGNOSES 1. Three prior canarsan section deliveries 2. Voluntary sterilization. POSTOPERATIVE DIAGNOSIS: Same as Preoperative PROCEDURES PERFORMED ANESTHESIA Ge PREAMBLE The part is a 30-year-old woman gravida 4, para 3 at 36 weeks and 2 days gestation who presented initially to her hometown obstetrician in spontaneous labor. Because of her previous ces se she was bandemed bers. She was scheduled to have a repeat cesarsan section. She also has expressed a desire for permanent sterilization and has signed the papers for a tuba gation he was sure of her decision to proceed with the bal igation. When she presented she was contracting every 2 minutes with moderate intensity. The cervix was not yet dilating, but with the intensity of conas a was made to proceed with orsaran section for delivery PROCEDURE NOTE: The part was taken to the operating room and a spinal anesthetic was administered. The patent was then prepped and draped in the usual manner in supine position with left lateral AFoley cawan placed A Pareenatal skin incision was made superior to the pre-existing sa The tasca was then transversely incised. Peritoneal cavity was then carefully entered as the bladder high arty The bladder was then taken The placenta was the manually Good hemostasis was tubes were grasped uning Babcock portion of an tube by Got ham of the Saints was y from the front of the uterus and retected out of the way using the bladder retractor. A transverse incision was then made in the lower of at 1 me and 10 at 5 minutes and weight of 5 to 8 oz. The baby was suctioned on the table and immediately handed to the oved and appeared to be intad. At this point the uterus was exteriorized to allow for better visualization. The uterine incision was closed in a et At this point c antion was directed toward the fallopian tube Both ovaries and fallopian tubes were identified and appeared to be ps, and tral Panay kubeligation was caned out by tying off a loop of tube with plain suture and then excising the intervening red. At this poet the charus was replaced within the peritoneal cavity Pericolonic guters were swabbed free of Mood and The fascia was then dosed using running 0 Vioryl. Finally, skin was reapproximated using 4-0 Vicryl in a suboticular The patted the scedure wat and work to the recovery mom in good condition. There were no complications. The estimated trood loss wes 300 cc. The patient received Anca 1 gram V CPT Co ICD-10-CM Co od 600 PM 40 POSTOPERATIVE DIAGNOSIS Same as Preoperative. PROCEDURES PERFORMED 1. Repeat lower segment transverse cesarean section 2. Bilateral Pomeroy tuballigation ANESTHESIA: General PREAMBLE: The patient is a 30-year-old woman, gravida 4, para 3, at 36 weeks and 2 days gestation who presented initially to her hometown obstetrician in spontaneous labor. Because of her previous cesaran sections, she was transferred here. She was scheduled to have a repeat cesarean section She also has expressed a desire for permanent sterilization and has signed the papers for a tubal igation. She was sure of her decision to proceed with the tubal ligation. When she presented she was contracting every 2 minutes with moderate intensity. The cervix was not yet dilating, but with the intensi of contractions a decision was made to proceed with cesarean section for delivery PROCEDURE NOTE The patient was taken to the operating room and a spinal anesthetic was administered. The patient was then prepped and draped in the usual manner in supine position with left latera A Foley catheter was placed A Plannenstiel skin incision was made superior to the pre-existing scar. The fascia was then transversely incised Peritoneal cavity was then carefully entered as the bladder was pulled up quite high anteriorty The Madder was then taken away from the front of the uterus and reflected out of the way using the bladder retractor. A transverse incision was then made in the lower ulerine segment, and there was delivery of a livebom male infant with Appar of 8 at 1 minute and 10 at 5 minutes and weight of 5 b 8 or. The baby was suctioned on the table and immediately handed to the neonatal ensive cars team. The placenta was then manually removed and appeared to be intact. At this point the uterus was exteriorized to allow for better visualization. The uterine incision was closed in a single running tocked layer of 0 Chronic Good hemostasis was achieved. At this point attention was directed toward the fallopian tube. Both ovaries and fallopian tubes were identified and appeared to be completely normal. Falopian tubes were grasped using Babcock clamps, and bilateral Pomeroy tubal ligation was carried out by tying off a loop of tube with plain subure and then escising the intervening portion of fallopian tube bilaterally Good hemostasis of the falopian tubes was ensured. At this point the uterus was replaced within the peritoneal cavity. Pericolonic gutters were swabbed free of blood and clots. The uterine incision was once again inspected and confirmed to be hemostatic. The fascia was then closed using running 0 Vicryl. Finally, skin was reapproximated using 4-0 Vicryl in a subouticular manner. The patient tolerated this procedure well and went to the recovery room in good condition. There were no complications. The estimated blood loss was 300 cc The patient received Ancef 1 gram IV aher cord camping CPT Code(s) ICD-10-CM Code(s) Abstracting Questions 1 is the tubal figation reported separately? 2, la the history of previous C-section reported? 3. is a Zode required for the tubal ligation?

There is one heart available for donation with an equally good match for each

Question: There is one heart available for donation with an equally good match for each of the following potential recipients. Which one would you give the heart transplant and why? Single mother of 3 children, poor and minimally insured. In less than ideal health from inability to afford medications and proper nutrition. Married, father of 2 boys, well insured, inShow transcribed image text 100% (1 rating)The correct answer will be option A. Single mother of three children poor and minimally insured. In less than ideal health from inability to afford medication and proper nutrition. Ra…View the full answerTranscribed image text: There is one heart available for donation with an equally good match for each of the following potential recipients. Which one would you give the heart transplant and why? Single mother of 3 children, poor and minimally insured. In less than ideal health from inability to afford medications and proper nutrition. Married, father of 2 boys, well insured, in reasonable health except that he is a smoker. Has a good job and supportive wife. Single male, no children. For the previous 10 years has been an IV drug abuser, went through rehabilitation 3 months ago and is in otherwise good health with average health insurance despite being unemployed.

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