A Nurse Is Repositioning A Client Who Has Quadriplegia

9 However, advice about the optimum frequency and precise methods of repositioning for the range of people affected is highly inconsistent. Level 1, 365 Queen Street, Melbourne Vic 3000 Phone (03) 9602. What cares are performed to a client's body by the nurse aide after a client passes away? Definition Close the client's eyes, the body is carefully bathed using gloves, all tubing and dressings are removed as directed by the nurse and clean dressings are applied if indicated, denture are placed in the mouth according to policy, position the. I will present information about the NCP for Vomiting - 6 Nursing Diagnosis and Interventions. The Clinical Practice of Neurological and Neurosurgical Nursing, 4th ed. Dry and hard feces. Common areas at risk for friction are the shoulders, back, buttocks, elbows, and heels. She has been the lead counsel in jury trials involving brain damage, quadriplegia, misdiagnosis and death. DNA evidence that matches the baby has been linked to 36-year-old Nathan Sutherland, a licensed nurse who cared for the woman. Table of Contents Table of Contents 1 Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice Chapter 02: Community-Based Nursing Practice Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing Process Chapter 04: Health Education and Promotion Chapter 05: Adult Health and Nutritional Assessment Chapter 06: Individual and Family Homeostasis, Stress, and Adaptation. Paralysis can be classified in two ways: paraplegia and quadriplegia. Studies have shown that patients who develop pressure ulcers have an increased rate of mortality. The interactive transcript could not be loaded. This action demonstrates the nurses understanding of what phenomenon? A) Research has shown that critically ill patients perceive turning as a painful procedure. Pro-viding a safer and more comfortable work environment has also resulted in additional benefits for some facilities,. NURSING CARE PLAN Acute Pain continued NURSING INTERVENTIONS/SELECTED ACTIVITIES* RATIONALE Outcomes partially met. Arrive at the interview a few minutes early. The Nurse Link has been truly disruptive and a leveler to say the least. Our focus is specialized home care for individuals with various needs. ,this is a sample nursing care plan for patients with cerebral infarction (stroke). Critical incident The aim of this reflection is to describe my personal experience in wound care and its management. Which of the following findings should the nurse report to the provider? Rhonchi on inspiration. Provide a safe environment for the client. Painful defecation. He represented me and I was blessed to have him as my attorney he goes above and beyond making sure you are treated fair. A client has a chest tube in place following a left lower lobectomy done after a stab wound to the chest. 275 East Main Street – 6 W-D. The nurse is repositioning the client who has returned to the nursing unit following internal fixation of a fractured right hip. Weinstein has a successful track record litigating personal injury, medical malpractice and birth injury matters obtaining multi-million dollar settlements and verdicts on behalf of her clients. You may become paralyzed (PER-e-liz-ed) if you were in a car or sports accident that broke your neck. The client has verbalized feelings of helplessness by using the term “ invalid. The Roy Adaptation Model has provided a framework for nursing practice, education, and research for more than 20 years. Try to prevent a fall. between nursing staff-induced repositionings is largely unknown, but these movement s might have implications for the repositioning intervention. A nurse is caring for a client who is scheduled for cardiac surgery and tells the nurse, "I don't think I'm going to have the surgery. Etiology And Pathophysiology Types of Traumatic Brain Injury Concussion – transient interruption in brain activity; no constructural. Pillow to keep the right leg adducted during turning c. for the nurse to evaluate the effectiveness of teaching sessions. Our mission is to empower, unite, and advance every nurse, student, and educator. Our members, staff, and writers represent more than 60 professional nursing specialties. His intracranial pressure (ICP) shows an upward trend. Our members, staff, and writers represent more than 60 professional nursing specialties. ) the cause is unknown, and there is no cure. At one point, while the obstetrician was attempting to reposition the second twin, the fetal heart rate dropped to 43 BPM. ambulation of client with tubes/equipment glucometer isolation procedures postmortem care repositioning using lift (draw) sheet repositioning frail client: supine repositioning frail client: sidelying assisting movement up in bed neurological: level 1 level 2 level 3 # of times glascoma scale. Saftey measures should be taken if there is an indication that the person is experiencing an aura before the onset of a seizure, (e. Left shoulder protracted. Table of Contents Table of Contents 1 Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice Chapter 02: Community-Based Nursing Practice Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing Process Chapter 04: Health Education and Promotion Chapter 05: Adult Health and Nutritional Assessment Chapter 06: Individual and Family Homeostasis, Stress, and Adaptation. nates client care and develops and implements a care plan that is individualized to each client and family. NASA Astrophysics Data System (ADS) Showstack, Randy. Most victims are aged 16 to 30; more than 80% are males. A nurse has admitted a client to the ER with complaints of chest pain over the previous 2 hours. The nurse is repositioning the client who has returned to the nursing unit following internal fixation of a fractured right hip. No ultrasound equipment was present in the delivery room, so the nurse monitored the fetal heart rate with a hand held device. 4 Safe Lifting and Movement of Nursing Home Residents This document is in the public domain and may be freely copied or reprinted. To help you with your search, browse the 31 reviews below for nursing homes in Peoria. 5 Respond to and report situations of risk to registered nurse. Which of the following instructions should the nurse give the AP? Allow the weights to hang freely. Nursing Interventions for Ineffective Airway Clearance Nursing Priority NO. i was infected with herpes simplex virus 2 in 2013, i went to many hospitals for cure but there was no solution, so i was thinking on how i can get a solution out so that my body can be okay. Recently, Nurse H. A client has a chest tube in place following a left lower lobectomy done after a stab wound to the chest. DNA evidence that matches the baby has been linked to 36-year-old Nathan Sutherland, a licensed nurse who cared for the woman. and treatment has been an increasingly important issue with doctor and nursing staff , hospital management and medical insurance organizations. A nurse caring for a client who has a pneumothorax notes continuous bubbling in the water seal chamber of the client's closed-chest drainage system. Private Duty Nursing: 60 Percent bof our Skilled nursing service is private duty nursing. The nurse has a lot of client needs to accomplish and the nursing assistant is able to assist. Scott Distasio is a Board Certified Civil Trial Lawyer in the state of Florida and is qualified to take on any type of personal injury case. She has played a significant role in several cases against hospitals and healthcare providers, resulting in life-changing awards for families. The standard of care requires that nurses check a patient's PEG tube for proper placement, signs of residual, and infection. • The practice of turning and repositioning has been used by nursing staff for several years based on an assumption this alleviates skin pressure especially on bony prominences. The nurse should expect to find an elevation of which of following values? 2…. Clients experience the inability to clean the body, acquire or obtain sources of water, set the temperature or the flow of the water bath, get toiletries, dehydrate the body, as well as entry. An older client has been lying in a supine position for the last 3 hours. The interactive transcript could not be loaded. Give him encouragement and praise when he assists with the transfer. Providing Instruction and Information to Client about Body Positions that Eliminate the Potential for Repetitive Stress Injuries. The nurse uses a: a. At Lanier Law Group, we employ a client-focused, results-oriented approach to each and every personal injury case we handle. Michigan LPN Jobs. Since 1990, Peach State Nursing Agency has provided Middle Georgia with dependable, compassionate skilled nursing and non-medical services. , cystic fibrosis, status post-heart-lung transplantation); those with excessive or abnormal mucus production (e. When applying cold to the client's injury, the nurse should: apply it immediately after the injury. Nursing homes that have implemented injury prevention efforts focusing on resident lifting and repositioning methods have achieved considerable success in reducing work-related injuries and associated workers' compensation costs. In addition to the fact that health care staff must be knowledgeable about and use good body mechanics and ergonomic principles, clients also need knowledge and skill in content areas including body position, proper bodily alignment and ways to prevent repetitive. Nurses' Role in Improving the Pain Management Culture By Diana Mahoney From Industry Edge August 2016. After mealsBefore mealsWhen the client has time When the nurse has time A physician orders chest physiotherapy for a client with pulmonary congestion. Bulechek (Eds. " Which of the following responses by the nurse is appropriate?. The nurse should first attempt nursing interventions, such as repositioning the client to avoid neck flexion, which increases venous return and lowers ICP. pressure area, venous obstruction, aspiration) within 6 hours of admission. She served as a nurse during the Crimean War, at which time she observed a correlation between the patients who died and their environmental conditions. A nurse has admitted a client to the ER with complaints of chest pain over the previous 2 hours. Provide assistance in activities of daily living. What actions does the nurse take? (have client put hands on. The frequency of repositioning was measured every 30 minutes and did not include any patient repositioning, which may have occurred in between the observation periods. Parkinson's disease is a slow, progressive disease that results in a crippling disability. Irrigate the eye w/ sterile saline is the priority nursing intervention when the client has a foreign body protruding from the eye. How should the nurse interpret this finding? 1. A nurse is positioning a quadriplegic client to a supported Fowler's position. Infuse dextrose 5% in water through the IV. SN educated patient and caregiver on the importance of always using assistive device with ambulation and transfers to avoid falls or injuries. 9 However, advice about the optimum frequency and precise methods of repositioning for the range of people affected is highly inconsistent. In which position should the nurse place this client to promote optimal circulation? Supine with the legs elevated ; In the Sims' position ; Left side-lying with the head flat. The nurse should assign the patient: a. , asthma, emphysema, pneumonia, dehydration, bronchiectasis, mechanical ventilation. 5 million hospitalized patients each year in the U. She is admitted to the hospital for treatment. The Gilbert Law Group, P. Based on the nurse's knowledge of the effects of immobility, which of the following describes the cardiovascular complications that can develop because of. Standard Text: Select all that apply. This is the way I do bowel care minus a shower ,and smell :-) For the first few years I was in bed for this process (Much Worse) Many Quads have no choice but to be in bed :-(. This morning the client has a B/P of 210/108 and a flushed face, and complains of nasal stuffiness and a headache. In 2007, Leland Dempsey secured an award of $43,000,000 for an injured child who was rendered a quadriplegic after receiving a measles, mumps, and rubella vaccination. Based on requests for the SPH training materials from numerous schools of nursing, within the next 5 years an estimated 60,000 additional students could be trained using the new materials. A nurse is reviewing the laboratory data of a client who has acute pancreatitis. Sylvie Hampton talks about patient repositioning "the nurses come and reposition them every 15 minutes. 38 caregiver for quadriplegic jobs available. What nursing interventions are necessary before this calculation is completed? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Level 1 services include one of the following: Ventilator weaning care, or. Nurses assess and determine the need for a client to be restrained or secluded and they also assess the appropriateness of the type of restraint/safety device that is used in context with the client's current condition and behaviors; they assess and reassess the client in a regular and ongoing basis to insure that the client is safe. The x type jaguar is now behind us and they put on hold at the library Child was recently informed a client of ours Than your coverage, or you could argue that the spouse 18 Mw3, black ops massacre, one handed player, deadp… the week has been on the way Shake up your vehicle and medical services provided during this time. How will the nurse plan to move this client? A. Looking for Home or Senior Care in Cottonwood, Arizona for someone you love? Eldercare. If the client has a pacemaker, you can perform an ECG with or without a magnet, according to the physician's orders. When repositioning the client, the nurse notices 200 cc of dark, red fluid flows into the collection chamber of the chest drain. The nurse uses a: a. Allow the client to have as many choices related to care as possible; A PACU nurse has received a semiconscious patient form the operating room and reviews the chart for orders related to positioning of the patient. Fowler’s position is useful for patients who have cardiac, respiratory, or neurological problems and is often optimal for patients who have nasogastric tube in place. Which nursing skill should be put into practice at the first contact with the client? a) Caring b) Comforting c) Assessment d) Counseling Explanation: On admission of the client to a health care facility, the nurse would be required to conduct an initial assessment. If nursing measures prove ineffective, notify the physician, who may prescribe mannitol, pentobarbital, or hyperventilation therapy. They come from all over the world to share, learn, and network. Rest the right leg on top of the left leg 2. Change the sheepskin liner when it is soiled and at least once each week. in Sarasota and Bradenton. Decreased cardiac output b / d the disturbance of blood flow to the heart muscle Rational Intervention • Check the ABC and if necessary release of the airway, and Massage Heart • Monitor pulse, RR, TD regularly • Check the state of the c. Our BrightStar Care team is available to help you and your family 24 hours a day, 7 days a week. 26,49 It should be noted that the use, indications, and length of treatment of these topical agents with potential harmful events in the microenvironment is. A nurse is completing a clients history and physical examination. Creatine kinase (CK) of 545 with MB of 4% c. When obtaining the health history from a client with retinal detachment the nurse expects the client to report:. 1 it has a significant impact on patient well-being as well as the quality and outcome of nursing care 2, and is related to patients‟ family overall satisfaction with their care. Nebulizer and pulse oximeter 2. Feedback: The client needs assistance in performing activities of daily life. Repositioning can be difficult. Using person-centred approaches to improve access to comprehensive cardiac rehabilitation. Quadriplegia is caused by damage to your spinal cord. Provide assistance in activities of daily living. Hemiplegia refers to paralysis of one side of the body; therefore, the nurse should document that the client has left-sided hemiplegia. Paralysis can be either partial, periodic, complete, or incomplete. Studies of patient outcomes. What is "Turning" and Why is It Important to Prevention of Bed Sores? "Turning" is a very straightforward term in the nursing home care field: the term applies to the physical act of turning a patient's body to prevent the formation of bed sores. A 22-year-old client with quadriplegia is apprehensive and flushed, with a blood pressure of 210/100 and a heart rate of 50 bpm. Nystrom (2007) explained that the client’s feelings must be addressed to facilitate better health outcomes. Apply to Licensed Practical Nurse, Home Health Aide, Nursing Assistant and more!. She has been employed in the field of nursing for 30 years, and has recently retired. txt) or read online for free. His intracranial pressure (ICP) shows an upward trend. After my MRI, I could no longer tolerate hearing unanswered call bells, nor. , have the client lie down). A client with Guillain-Barré syndrome has been on a ventilator for three weeks, and can communicate only with eye blinks because of quadriplegia. His major complain was pain in the abdomen and left shoulder pain. plan to perform chest physiotherapy? A client who suffered a stroke has a nursing diagnosis of Ineffective airway clearance. A has nursing diagnoses of disturbed sleep pattern related to anxiety & unfamiliar surroundings. An older client has been lying in a supine position for the last 3 hours. Persons with impaired ciliary function (e. Mention of any company or product does not constitute endorsement by the National Institute for. B) Assessment. Scribd is the world's largest social reading and publishing site. Preventing unnecessary pressure on the lower limbs. Nursing intervention is needed even though the nurse understands that the client is not ill. Repositioning Description: Trapeze bar; hand blocks and push up bars attached to the bed frame When to Use: Reposition residents that have the ability to assist the caregiver during the activity, i. A client has a chest tube in place following a left lower lobectomy done after a stab wound to the chest. It gives me great pleasure to mentor and support the members of our clinical team and to teach others about being excellent hospice case managers. Client Cognition: Assess the client’s senses, state of mind, memory, communication medical. Department of Health and Human Services, will also seek. Correct: The nurse should provide an emesis basin at the bedside because the client who has meningitis may have nausea and vomiting. Our firm is dedicated to helping the residents of Tampa receive the compensation that they deserve. Attorney Marjorie Chalfant, R. Satellite instrument provides nighttime sensing capability. Restraints Nurses Responsibility PRESENTER: LATHIKA. *Quadriplegia-all four limbs. A client with a total hip replacement requires special equipment. Purchase Concept-Based Clinical Nursing Skills - 1st Edition. Injury levels C1 to C4 leads to quadriplegia with total loss of respiratory function. My name is Dolly Shelley. B) Apply a warm compress for 30 minutes. Mobilizing and repositioning bedbound and chair-bound patients is just part of the care to prevent the development of pressure injuries, and each patient will present different needs. Geriatric nursing assistants, also known as geriatric aides, work directly to supply care to elderly patients. Hemiplegia refers to paralysis of one side of the body; therefore, the nurse should document that the client has left-sided hemiplegia. Definition Also known as head injury. This study only examined predictors of the frequency of repositioning and not the causal factors that might relate to the patient, nurses and the organization. Home care is being considered for a young child who is ventilator-dependent. The client who has just undergone spinal surgery must be moved. Mechanical ventilation has become a common treatment, and nurses must be knowledgeable and confident when caring for ventilator patients. A nurse is positioning a quadriplegic client to a supported Fowler's position. Nursing homes and care facilities have a duty to their residents. drink extra fluids for the day B. Suction the nose to maintain airway patency d. The demyelination process on the myelin sheath disables the capability of the axons to receive electrical impulses thus the body could not perform or move the way it should be. Private Duty Nursing Position caring for 28-year-old male. Management – ideally focused on preventative measures. Admit the client to a room far away from the nurse's station 4. 3055 IN THE SENATE OF THE UNITED STATES July 8, 2019 Received July 9, 2019 Read the first time July 10, 2019 Read the second time and placed on the calendar AN ACT Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2020, and for other purposes. 3 per 10,000 workers, more than five times the average for all industries. this link since your browser does not support frames. General body weakness. Nursing is often a physically demanding and dangerous profession. For paraplegia, injury damage happens below the neck. Rating is available when the video has been rented. Which of the following nursing interventions should be done first? a. Chad is caring and wants the best for his clients. A Kennedy Terminal Ulcer or Kennedy ulcer is a specific type of bed sore (also referred to as pressure sore, pressure ulcer or decubitus ulcer) that is characterized by rapid onset and rapid tissue breakdown. and treatment has been an increasingly important issue with doctor and nursing staff , hospital management and medical insurance organizations. Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam. A nurse is delegating the task of repositioning a client who is in skeletal traction to an assistive personnel (AP). Encouraging patient participation in care is a growing trend in healthcare as it can increase adherence to treatment plans and improve outcomes. The licensed nurse may assign and/or delegate nursing care activities to other licensed nurses and unlicensed assistive personnel (UAP) based upon their own license. A client with a spinal cord injury at levels C5 to C6 has quadriplegia with gross arm movement and diaphragmatic breathing. Our goal is to help everyone stay independent and at home. Patient had BDP 3 months ago with dehydration. Nursing Interventions for Ineffective Airway Clearance Nursing Priority NO. #N#When preparing a client for an enema, the nurse should help him into the: left-lateral Sims' position. Kelly Sydnor 1,264,015 views. The client has ascending paralysis to the level of the waist. A Kennedy Terminal Ulcer or Kennedy ulcer is a specific type of bed sore (also referred to as pressure sore, pressure ulcer or decubitus ulcer) that is characterized by rapid onset and rapid tissue breakdown. However, some patients require additional and ongoing support to help them through their day. Department for Medicaid Services. Hemiplegia refers to paralysis of one side of the body; therefore, the nurse should document that the client has left-sided hemiplegia. Turning a patient is a good time to check the skin for redness and sores. Overall, the nursing community has become more accessible and collaborative and we're proud to help lead this shift. A school nurse has been working closely with a student who has cystic fibrosis. In each case, we develop a written plan that is tailored to the client. The drainage chamber is full. Give the client a simple explanation of how he is to assist. Thank you to Chad and his staff. 3 The maintenance of high nurse- patient‟s family commun- ication also depends on the nurse and patients‟ family. I have used this is our case study presentation (individual). Chapter 20: Family-Centered Home Care MULTIPLE CHOICE 1. Cushion the person's head. Maintain neck in neutral position by use of a hard collar, but change to two-piece collar for comfort and avoidance of complications (e. Our goal is to help everyone stay independent and at home. Our Business is People. Our members, staff, and writers represent more than 60 professional nursing specialties. You cough up blood. #N#The nurse is caring for a client with a right ankle sprain. The pneumothorax is resolving. Standards for student supervision and assessment. A trochanter roll to prevent abduction during turning 2. Our homecare services are an affordable alternative to care homes, delivered by our highly-trained professional team. Two nurses using a draw sheet. : McGraw-Hill, 1998; and Wirtz KM, Managing chronic spinal cord injury: issues in critical care, Critical Care Nurse 1996 16(4):24. This is the way I do bowel care minus a shower ,and smell :-) For the first few years I was in bed for this process (Much Worse) Many Quads have no choice but to be in bed :-(. Gait Belt A gait belt, sometimes called transfer belt, provides the DCW with secure points to hold. Limiting bladder catheterization to once every 12 hours. Trochanter roll to prevent external rotation while turning d. Change incontinence pad as soon as possible after client has voided or defecated. When he is brought in for care, the client experiences diaphoresis and headache. Coronavirus: RCN publishes resource for nurses. Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam. The nurse will plan care for this client based upon the understanding that the client has which of the following? A) Paralysis of the legs B) Weakness affecting one-half of the body C) Paralysis affecting one-half of the body D) Paralysis of the legs and arms. Our mission is to empower, unite, and advance every nurse, student, and educator. female dx: spinal cord injury with quadriplegia (MVA when client was 16), spasticity, neurogenic bowel and bladder. Chapter 20: Family-Centered Home Care MULTIPLE CHOICE 1. What is the principal indication for baclofen ? Muscle spasms with paraplegia or quadriplegia from spinal cord lesions. Low sodium is the diet for a client w/ Meniere's disease. This review has been conducted to clarify the role of repositioning in the management of patients with pressure ulcers. This pressure reduces blood supply to that area. Minimizing pressure on vulnerable body parts requires a combination of physically repositioning or turning patients at regular two-hour intervals — a labor-intensive but critically important process — and making sure they are resting on pressure-reducing surfaces. Maintain competence through ongoing learning and application of knowledge. Apply to Nursing Assistant, Licensed Practical Nurse, Caregiver and more!. Mention of any company or product does not constitute endorsement by the National Institute for. The call bell speaks for patients who can’t talk. Mention of any company or product does not constitute endorsement by the National Institute for. North American Nursing Diagnosis Association,2001,Philadelphia: NANDA; Nursing Interventions Classification (NIC) by J. Find similar vacancies, jobs in Abu Dhabi - United Arab Emirates. Encourage the person to help you if possible. A trochanter roll to prevent abduction during turning 2. The nursing home also reported that workers' compensation costs have declined from an average of almost $140,000 per year to less than $4,000 per year, reduced absenteeism and overtime have resulted in annual savings of approximately $55,000, and a reduction in costs associated with staff turnover has saved an additional $125,000 (1). On inspection of the client’s wound, the nurse notes that it appears infected and has a large amount of exudate. Position the client flat in bed b. Phoenix Police have announced that they’ve made an arrest in the Hacienda HealthCare case, in which a woman who had been in an incapacitated state for over 25 years gave birth in December. Give him encouragement and praise when he assists with the transfer. B) Gradual reduction in intelligence. Since 1990, Peach State Nursing Agency has provided Middle Georgia with dependable, compassionate skilled nursing and non-medical services. Encouraging patient participation in care is a growing trend in healthcare as it can increase adherence to treatment plans and improve outcomes. Changing a patient's position in bed every 2 hours helps keep blood flowing. You have questions or concerns about your condition or care. com has thousands of Elder Care workers looking for jobs. The DOJ, in partnership with the U. Mechanical ventilation has become a common treatment, and nurses must be knowledgeable and confident when caring for ventilator patients. Assess the client for mobility, gait, strength and motor skills; Perform skin assessment and implement measures to maintain skin integrity and prevent skin breakdown (e. Quadriplegia is caused by damage to your spinal cord. "Someone like Will (in the movie) would have strong reflex erections," he adds. NURSING 250 muscle saunders questions & Answers 1. In a March 3, 2020, speech by Attorney General Bill Barr, the Department of Justice (DOJ) announced a new nursing home enforcement initiative targeting “grossly-substandard” care of Medicare and Medicaid beneficiaries in nursing homes nationwide. Reading, Pa 19601 Page 1 of 1 Vital Signs 1 2 3 4 Safe Transfer Techniques 1 2 3 4. There are also federal and state regulations to prevent employing individuals convicted of abusing, neglecting, or mistreating individuals in a healthcare-related. Autonomic Dysreflexia A guide to acute nursing care prevention, and education Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. A convenience sample of 14 subjects diagnosed with spinal cord injury (12 male, 2 female; age range 23-62 years) was recruited to participate in this study (Table 1). Left shoulder protracted. A nurse is delegating the task of repositioning a client who is in skeletal traction to an assistive personnel (AP). Seizure Protocol Before a seizure occurs: 1. Which observation indicates that the spouses understood what has been taught ? The client has a history of seizures is scheduled for an. You have blood in your urine or bowel movement. Incisional healing d. Despite being a quadriplegic and needing to get around in a motorized wheelchair, the Halifax resident said she feels more independent than she has in years. The standard of care requires that nurses check a patient's PEG tube for proper placement, signs of residual, and infection. Marjorie has spent over twenty-five years in courtrooms representing injured victims and their families. The nurse should first attempt nursing interventions, such as repositioning the client to avoid neck flexion, which increases venous return and lowers ICP. This site includes tools, web applications, articles, links, and libraries to assist both caregivers and students in the careplanning process. A nurse is delegating the task of repositioning a client who is in skeletal traction to an assistive personnel (AP). Jones has been suspended without pay, and Sgt. The nurse refers to the written plan of care, noting that the client has a drainage device exceeds 100 mL for the day. which of the following actions should the nurse take to prevent client musculoskeletal injury? internally rotate the hips by using the trochanter roll. Disclaimer. The recent proposal by the Centers for Medicare & Medicaid Services (CMS) to remove HCAHPS pain management questions from the hospital payment scoring calculation is designed to alleviate concerns that linking reimbursement to patients’ perceptions of how well their pain management needs. While receiving a report, the nurse learns that a client has paraplegia. Caregiver Connection has been Portland, Oregon's top choice for independent in-home caregivers since 1998. Repositioning is only one way of minimising the risk of pressure ulcers. A nurse has given a client with chronic obstructive pulmonary disease a nursing diagnosis of Activity Intolerance. Download Nurse stock photos. THE WORD MOBILITY is associated with physical movement, including both simple gross motor movements and more complex fine motor movements, along with associated coordination of those movements. Print Book & E-Book. Maintains accurate and timely clinical documentation. to a private room so she will not infect other patients and health care workers. However, some patients require additional and ongoing support to help them through their day. The nurse responds to this assessment rapidly because of the potential for it to indicate which disorder?. My first room mate when I moved to San Francisco had been in a car accident in New Jersey. D) Underachievement in school. urinary retention). The client has been deteriorating in health because of a lack of activity. de Castro, A. Immediate treatment is hospital admission following the spinal cord injury and later, neurorehabilitation during recovery to enable the affected individual to live an optimal and near-normal life despite limitations. The RCN is the world's largest nursing union and professional body. Caring for adults with impa This article has an associated Continuing Education component. Creatine kinase (CK) of 545 with MB of 4% c. Release the tension of the ropes. Find a study method that works best. 3055 IN THE SENATE OF THE UNITED STATES July 8, 2019 Received July 9, 2019 Read the first time July 10, 2019 Read the second time and placed on the calendar AN ACT Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2020, and for other purposes. Clients experience the inability to clean the body, acquire or obtain sources of water, set the temperature or the flow of the water bath, get toiletries, dehydrate the body, as well as entry. ThePoint - Chapter 1 A nurse is assigned the care of a client who has been admitted to the health care facility with high fever. Exam Mode– Questions and choices are randomly arranged, time limit of 1min per question,answers and grade will be revealed after finishing the exam. A client with a spinal cord injury at levels C5 to C6 has quadriplegia with gross arm movement and diaphragmatic breathing. Private duty nursing is the care of clients by nurses, who may be licensed as RNs or LPNs/LVNs. Client requires eight (8) or more hours of direct skilled nursing care per day AND the client’s medical needs cannot be met at a lower level of care due to clinical complexity. Adaptation, the goal of the model, serves as an effective guide for planning care for the client with quadriplegia. Assess for bladder distention to determine if there is urinary retention. Looking for Home or Senior Care in Cottonwood, Arizona for someone you love? Eldercare. Integration of informatics in nursing is going beyond data processing functions such as payroll, to an important role in patient care by: interpreting ECG, entering orders, reporting results, and preventing drug interactions (by cross referencing drug compatibilities and warning the. K 2ND YR MSC N BMCON 4. , residents with upper body strength and use of extremities, who are cooperative and can follow instructions. 141 116th CONGRESS 1st Session H. • Self-care activities (ADLs, exercises, bowel and bladder. Our members, staff, and writers represent more than 60 professional nursing specialties. Greet people with a smile and make eye contact during the conversation. The head-tilt, chin-lift maneuver requires neck hyperextension, which can worsen the cervical spine injury. Patients with spinal cord injury should be referred at the earliest opportunity to a specialist spinal injury unit. Affordable and search from millions of royalty free images, photos and vectors. Read more here. A nurse is caring for a client with a spinal cord injury during the immediate post injury period. Bathing / hygiene. When a seizure occurs, the main goal is to protect the person from injury. O Remove the weights when rewrapping bandages. The nurse’s assessment then reveals the client has a hematoma in the venipuncture area. Quadriplegic stands, walks, and hugs big bro, grandparents, ICU nurse for first time in 5 1/2 ye - Duration: 6:29. The client has lost the ability to move the right arm but is able to walk independently. 3633 Contact Us. Assess for bladder distention to determine if there is urinary retention. After eight minutes and no success at turning the fetus, the obstetrician called for a C-section. Although she has worked with Jordan before, Shannon still feels uneasy delegating tasks to him and wishes more. This is a nursing care plan and diagnosis for Tracheostomy or Tracheotomy. The role of the nurse in the care of the hip replacement patient is to educate, provide safe and competent care, and help coordinate the care provided by the multidisciplinary team. The nurse uses a: a. com - don't miss out! 2 Live in Caregivers needed for split shifts for a sweet elderly woman in the Fayetteville AR area. Turning a patient is a good time to check the skin for redness and sores. The nurse should first assess the client's vital signs to determine if the client's blood pressure is elevated. Bed sores, or decubitus ulcers, represent one of the three most common nursing home-acquired injuries. If nursing measures prove ineffective, notify the physician, who may prescribe mannitol, pentobarbital, or hyperventilation therapy. How should the nurse interpret this finding? 1. Wound Care Teaching 2289. Which of the following nursing interventions should be done first? 1. The client has traveled out of the country in the last 6 months. Mobilizing and repositioning bedbound and chair-bound patients is just part of the care to prevent the development of pressure injuries, and each patient will present different needs. 3The nurse notices that a depressed client taking amitriptyline (Elavil) for 2 weeks has become very outgoing, cheerful, and talkative. A client has a chest tube in place following a left lower lobectomy done after a stab wound to the chest. We specialize in a variety of personal injuries including those that are a result of car accidents, truck accidents, motorcycle accidents, brain injuries, nursing home abuse, nursing home neglect and more. It is the difference between life and death for some patients, and it is the source of relief to a vulnerable person that a nurse is coming to help. It takes at least 2 people to safely move a patient up in bed. The E-Z Call Quadriplegic Nurse Call Switch is a great piece of assistive equipment for any home or hospital setting where an individual has limited movement of their limbs. Some of these risk factors include age, the client's current nutritional status, the client's state of overall health, the client's state of mental health and the medications that the client has been taking. Julie Hampton has worked as a professional freelance writer since 1999 for various newspapers and websites including "The Florida Sun" and "Pensacola News Journal. The nurse who has had the chickenpox has immunity to the illness and will not transmit chickenpox to the client. The "R" section in your note doesn't sound like a client response -- it sounds like more nursing actions. Since 1990, Peach State Nursing Agency has provided Middle Georgia with dependable, compassionate skilled nursing and non-medical services. Our homecare services are an affordable alternative to care homes, delivered by our highly-trained professional team. pdf), Text File (. Motor vehicle accidents are the most common etiology of injury. This term does not include conditions due to brachial plexus lesions or. Quad comes from the Latin for four and plegia comes from the Greek for the inability to move. There has been considerable ongoing debate in the literature regarding optimal staffing ratios in long term care facilities. Now it's time for nurses to have reliable, comprehensive support. 2011, Coleman et al. Clinical articles. “HEY!I THINK HE JUST MOVED! ADD ONE MORE!” 3. 8 Use emergency codes correctly. This client has a spinal cord injury of the sacral region of the spinal cord and will have bladder and bowel dysfunction, as well as loss of sensation and muscle control below the injury. Each shift accurately document the turning and repositioning that you have done, using the back of the form for any notes of significance for that shift. At all levels, there is usually some loss of function in the bowel and bladder. Purpose: To review the nurses' role in care of infants with hydrocephalus, care after VP shunt placement, prevention of complications, and parental preparation for. Instructed patient check the wound for increased redness, swelling, or a bad odor. Our members, staff, and writers represent more than 60 professional nursing specialties. Description At the care home I had to nurse many client’s who had developed. For an Individual, how Much Does it Cost to Treat Bed Sores? The cost of treatment for bedsores largely depends on the wound itself. The nurse would suspect which of the following. Select all the patients below that are at risk for a pressure injury: A. Adult and Pediatric Nursing Services In The Home As allowed by state law, Interim HealthCare offers in-home nursing care provided by Registered Nurses (RNs), Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs). Defining Characteristics: 1. Presence of two parents in the home c. If nursing measures prove ineffective, notify the physician, who may prescribe mannitol, pentobarbital, or hyperventilation therapy. They come from all over the world to share, learn, and network. which of the following responses should the nurse make" "I see that you are angry. Notice if your patient has paraplegia or quadriplegia. Experts in-house plus independent experts. And, rememberif you have an issue with any task that is. Our focus is specialized home care for individuals with various needs. com - don't miss out! 2 Live in Caregivers needed for split shifts for a sweet elderly woman in the Fayetteville AR area. Etiology And Pathophysiology Types of Traumatic Brain Injury Concussion – transient interruption in brain activity; no constructural. Geriatric nursing assistants often work in long-term care facilities and nursing. Lay the person on the ground in a safe area. Client requires eight (8) or more hours of direct skilled nursing care per day AND the client’s medical needs cannot be met at a lower level of care due to clinical complexity. 2 out of 5 stars. The nurse notes a circular wound 2 cm × 2 cm × 0. Nursing home care is often viewed as a sort of moral obligation, a duty to one’s elders. Client is alert oriented x3, self directing client is non-ambulatory is transferred via stand pivot; has power w/c client able to maneuver PWC independently; needs assist with manual w/c client purchased van. The nurse should first attempt nursing interventions, such as repositioning the client to avoid neck flexion, which increases venous return and lowers ICP. January 05, 2018 - In healthcare facilities, nurses can be found nearly everywhere—at patient screenings, in nursing stations, and, most importantly, with the patient in the exam room or at the bedside. which of the. A new job is posted every minute on Care. The call bell speaks for patients who can’t talk. A nurse is reviewing the laboratory data of a client who has acute pancreatitis. This article describes for med-surg nurses the initial crucial aspects of care for patients with severe TBIs, as well as continued care requirements for both. 2011, Coleman et al. 57 billion it has received since 2003 in the nursing homes. NCLEX Exam: Neurological Disorders 2 – Seizures (Sections 1) * An 18-year-old client is admitted with a closed head injury sustained in a MVA. A quadriplegic client is sliding down in bed. They can form when your skin and soft tissue press against a harder surface, such as a chair or bed, for a prolonged time. A nurse is completing a clients history and physical examination. If you want to search for other health articles, please search on this blog. Use of a wheelchair cushion to prevent skin breakdown. Persons with impaired ciliary function (e. Still, absent federal and state regulations for nursing homes, this care can fall short, leaving the ill and elderly vulnerable to neglect and abuse. Apply to In Home Caregiver, Nursing Assistant, Musician and more!. When he is brought in for care, the client experiences diaphoresis and headache. Left shoulder protracted. Barrier creams should be applied to the perineal area to prevent contamination of the skin with body waste products. Check it out!,. The nurse is a critical link in providing the continuity of care required for these patients throughout the perioperative phase. Delegation and assignment of nursing activities are important parts of the implementation component of practice for the licensed nurse (RN and LPN). One nurse lifting the client's leg while the client uses a trapeze. Adaptation, the goal of the model, serves as an effective guide for planning care for the client with quadriplegia. The Case Barnett Law Injury Law Team has helped clients recover tens of millions of dollars for injury, elder abuse and wrongful death claims. She has played a significant role in several cases against hospitals and healthcare providers, resulting in life-changing awards for families. Positioning the client b. , Philadelphia: Lippincott, 1997; Chin PA, et al. The role of the nurse in the care of the hip replacement patient is to educate, provide safe and competent care, and help coordinate the care provided by the multidisciplinary team. Motor vehicle accidents are the most common etiology of injury. The man is a resident of the Bronzeville Park Nursing and Living Center in Chicago, Illinois with diagnoses of quadriplegia, depression, gastric ulcer, and diabetes. Fall precautions Teaching 2311. A nurse is completing a clients history and physical examination. Client, quadriplegic Eatonton GA. How should the nurse interpret this finding? 1. Liver Abscess - 7 Nursing Diagnosis, Interventions and Evaluation is one of the nic health articles nursing frequently sought. The information revolution has changed the health care system to an unbelievable extent. For example, a lack of vitamin A may interfere with good wound healing, corticosteroids can interfere with wound healing, anticoagulant. Nurses assess and determine the need for a client to be restrained or secluded and they also assess the appropriateness of the type of restraint/safety device that is used in context with the client's current condition and behaviors; they assess and reassess the client in a regular and ongoing basis to insure that the client is safe and that their needs have been met when the use of restraints or seclusion cannot be avoided. Mechanical ventilation has become a common treatment, and nurses must be knowledgeable and confident when caring for ventilator patients. The nursing assessment priority for Jake from most urgent to least urgent is as follows. It's completely different working with someone who has quadriplegia and can't lift their limbs or move their body for you! Skill 15 Transfer A Client From A Bed Bariatric Repositioning. When repositioning the client, the nurse notices 200 cc of dark, red fluid flows into the collection chamber of the chest drain. People with spastic quadriplegia are prone to back and foot deformity especially. One nurse lifting the client's leg while the client uses a trapeze. While positioning, the nurse uses a pillow to support the arms and hands of the client. What is the nurse's priority? Assessing the fetal heart rate Estimating the amount of fluid Assessing the characteristics of the fluid Repositioning the client to a side-lying position O Confident Not sure. This can injure their shoulders. Pathophysiology of Hypertension by · October 29, 2008 Hypertension (high blood pressure) is a disease of vascular regulation resulting from malfunction of arterial pressure control mechanisms (central nervous system, rennin-angiotensinaldosterone system, extracellular fluid volume. Turn the person on his or her side. Amyotrophic lateral sclerosis (ALS), commonly called Lou Gehrig’s disease, is a rare progressive disease that attacks motor neurons, which control the movement of muscles through the anterior horns of the spinal cord and the motor nuclei of the lower. You have blood in your urine or bowel movement. At one point, while the obstetrician was attempting to reposition the second twin, the fetal heart rate dropped to 43 BPM. Quadriplegia (kwod-rih-PLEE-jah) is a type of spinal cord injury (SCI) that also may be called tetraplegia (tet-rah-PLEE-jah). Purchase Concept-Based Clinical Nursing Skills - 1st Edition. This action demonstrates the nurses understanding of what phenomenon? A) Research has shown that critically ill patients perceive turning as a painful procedure. What information should the teachingsession in. nates client care and develops and implements a care plan that is individualized to each client and family. Change the sheepskin liner when it is soiled and at least once each week. 122 Quadriplegic jobs available on Indeed. If nursing measures prove ineffective, notify the physician, who may prescribe mannitol, pentobarbital, or hyperventilation therapy. Unlike a neurogenic bowel, person with ALS have slowed bowel motility. You cough up blood. Take this quiz and see your capability to conquer the NCLEX!. 5 million hospitalized patients each year in the U. Patients who cannot reposition themselves require assistance. Pressure ulcers are a common problem in palliative care patients. Position arm of hoyer lift over patient. How will this help the client?. After mealsBefore mealsWhen the client has time When the nurse has time A physician orders chest physiotherapy for a client with pulmonary congestion. The nursing home also reported that workers' compensation costs have declined from an average of almost $140,000 per year to less than $4,000 per year, reduced absenteeism and overtime have resulted in annual savings of approximately $55,000, and a reduction in costs associated with staff turnover has saved an additional $125,000 (1). In each case, we develop a written plan that is tailored to the client. DNA evidence that matches the baby has been linked to 36-year-old Nathan Sutherland, a licensed nurse who cared for the woman. There are also federal and state regulations to prevent employing individuals convicted of abusing, neglecting, or mistreating individuals in a healthcare-related. Which of the following nursing interventions should be done first? 1. Repositioning in the wheelchair based on the patient's skin tolerance. restricting fluids would make secretions thicker and more tenacious, thereby hindering their removal. Our goal is to help everyone stay independent and at home. Nurses assess and determine the need for a client to be restrained or secluded and they also assess the appropriateness of the type of restraint/safety device that is used in context with the client's current condition and behaviors; they assess and reassess the client in a regular and ongoing basis to insure that the client is safe. The PoinTIS Spinal Cord Nursing site of the SCI Manual for Providers is based on information in Hickey JV. Nurses should watch out for dizziness or faintness during change of position. 3The nurse notices that a depressed client taking amitriptyline (Elavil) for 2 weeks has become very outgoing, cheerful, and talkative. Med-Surg III > Exam 3 - ATI Questions > Flashcards Flashcards in Exam 3 - ATI Questions Deck (53) 1 A nurse is caring for a client who has confusion and lethargy. Persons with impaired ciliary function (e. However, there is limited information on patients’ views of their perceived role in PIP. thank you've read the article example of nursing teaching plan. After mealsBefore mealsWhen the client has time When the nurse has time A physician orders chest physiotherapy for a client with pulmonary congestion. Repositioning the client every 2 hours-rationale: repositioning the client every 2 hours helps prevent secretions from pooling in dependent lung areas. Autonomic Dysreflexia A guide to acute nursing care prevention, and education Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. A nurse caring for a client who has a pneumothorax notes continuous bubbling in the water seal chamber of the client's closed-chest drainage system. Turning refers to repositioning a hospital patient or bedridden nursing home resident to relieve pressure on one area of the body. It is usually caused by spinal cord injury or a congenital condition that affects the neural (brain) elements of the spinal canal. Which of the following nursing interventions should be done first? 1. Proper positioning when ambulating or in a wheelchair, i. Which of the following would most likely demonstrate that the client is responding to this intervention? The client does not develop infection in the wound bed. Our results clearly demonstrate that bedridden, at-risk patients have substantial areas of skin that do not get relieved and remain at risk despite repositioning by experienced nurses. 3 The maintenance of high nurse- patient‟s family commun- ication also depends on the nurse and patients‟ family. Place the ankles in plantar flexion 4. Vital signs are BP 104/72, HR 116 and regular, and RR 42 with deep breaths. How will this help the client?. For accuracy of diagnosis and treatment, researchers have divided the condition into nine different forms; some individuals with CP have something referred to as mixed cerebral palsy. B) Apply a warm compress for 30 minutes. At its launch at UNC in 2005, the Quality Safety and Education for Nurses (QSEN) initiative sought to recast nursing education toward an ambitious goal: to prepare new nurses not only to provide excellent care to individuals and families, but to continuously improve the quality and safety of the health care systems in which they work. HHC has invested more than $450 million of the $1. He has congestive heart failure and is cared for at home by a home health aide 5 days a week, 3 hours a day, and his older sister who lives next door to him. The role of the nurse in the care of the hip replacement patient is to educate, provide safe and competent care, and help coordinate the care provided by the multidisciplinary team. In reviewing the client's respiratory status, the nurse can conduct an interview and a physical examination to maximize the data collected without having to add client respiratory distress. Knowledge on various aspects of caring for a child with a VP shunt will enable new and experienced nurses to better care for these infants and equip parents for ongoing care at home. The client has lost the ability to move the right arm but is able to walk independently. Pillow to keep the right leg abducted during turning b. C) Counseling. Prestige Nursing + Care provides homecare services nationwide for clients who need everyday help and support or who have more complex conditions. The nurse is repositioning the client who has returned to the nursing unit following internal fixation of a fractured right hip. Wound Care Teaching 2289. " She served in the U. * It can indicate a possible respiratory infection. 141 116th CONGRESS 1st Session H. These impacts have had a measurable effect on Quadriplegic Centre capacity. He had some very. Left shoulder protracted. A nurse is assessing a client who is quadriplegic secondary to a cervical fracture at vertebral level C5. Paralysis can be classified in two ways: paraplegia and quadriplegia. A nurse in the emergency department is assessing a client who was in a motor vehicle crash. A 49-YEAR-OLD quadriplegic who says his life is a "living hell" will find out whether he can starve himself to death as early as next Friday. Based on classical nursing theorist, Hildegard Peplau, and The Theory of Interpersonal Relations, the scenario displayed the importance of the client-nurse relationship. Army as a combat medic and nurse for over six years and recently worked as the Community Relations Director for a health center. Looking for Home or Senior Care in Cottonwood, Arizona for someone you love? Eldercare. Quadriplegia, also known as tetraplegia, is thusly named because it affects all four limbs, plus the torso (quad originates from the Latin word for four). Having a tumor or other diseases in your spinal canal also can cause quadriplegia. I need to take my pulse. Did you receive education on the Nurse Practice Act in your nursing program plan of study? Question 1: Which action best describes the term professional nursing? Care is based on legal expectations. Level of parents education b. Identify client populations at risk. O Remove the weights when rewrapping bandages. The attorneys at Distasio Law Firm have years of experience helping clients in their personal injury cases. What would warrant the nurse immediate intervention? 3. Our community brings together students, educators, and subject enthusiasts in an online study community. The client's parents are skilled stained-glass artists. A nurse is positioning a quadriplegic client to a supported Fowler's position. Critical incident The aim of this reflection is to describe my personal experience in wound care and its management. Private Duty Nursing: 60 Percent bof our Skilled nursing service is private duty nursing. The nurse uses a: Pillow to keep the right leg abducted during turning. Preventing unnecessary pressure on the lower limbs. Fowler’s position is useful for patients who have cardiac, respiratory, or neurological problems and is often optimal for patients who have nasogastric tube in place. Interviewers may ask. He represented me and I was blessed to have him as my attorney he goes above and beyond making sure you are treated fair. He helped me see that my rights were being violated and that I had a right to food even if it was after meal time. Understanding the principles and aims of intravenous fluid therapy. AACN Practice Alert: Oral care for patients at risk for ventilator-associated pneumonia; 2010. Position arm of hoyer lift over patient. Most people with tetraplegia have significant paralysis below the neck, and many are completely unable to move. Julie Hampton has worked as a professional freelance writer since 1999 for various newspapers and websites including "The Florida Sun" and "Pensacola News Journal. The nurse should first attempt nursing interventions, such as repositioning the client to avoid neck flexion, which increases venous return and lowers ICP. 62 Caregiver Quadriplegic jobs available on Indeed. Reading, Pa 19601 Page 1 of 1 Vital Signs 1 2 3 4 Safe Transfer Techniques 1 2 3 4. The nurse is caring for a patient brought to the emergency department after an automobile accident. Relaxation and sleep b. The Quadriplegic Centre supports co-ordination and integration of service delivery by working in partnership with acute care services and community care providers. With a large team of North Carolina personal injury lawyers and professional legal staff spread across multiple office locations throughout the state, we offer collaborative and powerful legal strategies for our clients. Nursing Home Abuse Lawyer in Charleston, WV. Increasing fluid intake will help the kidneys to flush excess waste and increase blood flow. These sores are caused by a lack of blood flow to an area of the skin resulting from prolonged pressure on one area of the body, which could be caused by neglect or negligent nursing care. Etiology And Pathophysiology Types of Traumatic Brain Injury Concussion – transient interruption in brain activity; no constructural. Quadriplegia, or tetraplegia, is paralysis of your arms, hands, trunk, legs, and pelvic organs. It includes nursing diagnosis for: Risk for ineffective airway clearance, risk for infection, and impaired verbal communication. Maintain neck in neutral position by use of a hard collar, but change to two-piece collar for comfort and avoidance of complications (e. ® defect cases. The nurse is admitting a client with Guillain-Barré syndrome to the nursing unit. It is usually caused by spinal cord injury or a congenital condition that affects the neural (brain) elements of the spinal canal. An Arizona nursing facility made headlines this week when a cognitively-impaired patient gave birth to a baby — sparking a sexual assault investigation. , (ATI) A nurse is caring for a hospitalized patient who has an activated partial thromboplastin time (aPTT) greater. Unlike a neurogenic bowel, person with ALS have slowed bowel motility. In both genders, motor vehicle accidents, falls, and gunshot wounds account. A client with a quadriplegia is placed on a tilt table daily. vital signs are as follows: HR 104, BP 88/42, RR 38, T 100. Prestige Nursing + Care has extensive experience in caring for and supporting clients of every age with complex and specialist needs. You have questions or concerns about your condition or care.