Mr. L is a 58-year-old man who is recovering in the orthopedic unit of the hospital from a right total knee replacement of two days ago. Mr. L has type 1 diabetes and was diagnosed with the condition at 12 years of age. He has been managing his illness with blood glucose checks 4 times a day: before meals and once at bedtime. He currently takes Humulin-R on a sliding scale based on his glucose results. He weighs 315 lbs. and has developed osteoarthritis in both knees, requiring surgical replacement of the knee joint on the right side.
The nurse caring for Mr.L. enters his room at 8:15 AM for a morning assessment. She finds Mr. L lying in his bed awake, but his mental status is altered and there is a fruity odor to his breath. His vital signs are: HR 100bpm, RR 32/minute, BP 116/78 mm Hg. The nurse notes that his last blood glucose level was 156 mg/dl the previous night before bed and he received 2 units of insulin at that time, but he has not received his morning glucose check or any insulin yet today. A rapid bedside glucose check reveals a blood glucose level of 468 mg/dl. The nurse contacts the physician and upon further examination, Mr. L is diagnosed with diabetic ketoacidosis.
Describe how diabetic ketoacidosis could develop in a patient who has undergone surgery.
Mr. L has an elevated respiratory rate that is classified as Kussmaul respirations. Explain this type of respiratory pattern.
Mr. L complains of feeling very thirsty and that he can’t see very well because his vision is suddenly blurry. The nurse notes he has a large amount of clear urine in his catheter bag. She takes a sample of urine and it tests positive for ketone bodies.
How does the body release ketone bodies into the urine when DKA occurs.
Explain why Mr. L would have increased urinary output, blurred vision, and increased thirst.
The physician has given orders to administer 0.9% Sodium Chloride IV at 500 mL/hour for 1 hour, then 200mL/hour for the next 4 hours. The nurse is to start a drip of Regular insulin at 0>1mg/kg/hour. The physician has also added orders for lab work, including a metabolic profile and arterial blood gases. The metabolic panel results are: Na 135 mEq/L, K 3.2mEq/l, CL 95mmol/L, Ca 8.5mg/dl. The arterial blood gases results are as follows: ph 7.31, pCO2 20 mmHg, pO2 95 mmHg, HCO3 12 mmol/L
What is the rationale for the IV fluids to be given at this rate?
Explain why the patient’s potassium result is at the current level?
Based on the metabolic profile results, what is the next step that the nurse would most likely need to perform?
Explain why DKA would most likely produce these types of blood gas results.
An hour after the insulin was started, the nurse checks Mr. L.’s blood glucose levels and notes it has decreased to 208 mg/dl. He appears more comfortable and his vital signs are: HR 92 bpm, RR 22/ minute, BP 116/70mm Hg, O2 saturation 95% on 2L of oxygen.
What should the nurse do next?

Answers

Answer 1

The nurse should advice the patient to get admitted in the hospital one or two days prior to any operation so that he may be put under surveillance before the surgery.

For such patients, it is advised to wait a few days before their scheduled surgery. When possible, even urgent surgery should be postponed to give patients with diabetic crises time to stabilize. The physiologic stressor known as surgery can cause ketoacidosis. Insulin resistance increases as a result of the postoperative upregulation of regulatory hormones such glucagon, growth hormone, and cortisol.

Increased postoperative morbidity and mortality as well as an increased need for surgical operations are all related to diabetes. Perioperative ketoacidosis or hyperosmolar syndrome can arise from the stress response to surgery and the ensuing hyperglycemia, osmotic diuresis, and hypoinsulinemia.

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Related Questions

Gloria McGraw, a patient at Broadmoor Medical Clinic, underwent an arthroscopic surgical procedure of her right knee. Dr. Jones's fee for this procedure was $1400; however, the claim payment from her insurance carrier was reduced to $1100 because of UCR provisions. Ms. McGraw doesn't understand why this occurred and asks you to explain. What do you tell her?

Answers

The claims payment from her insurance carrier was reduced to $1100 because of UCR provisions. UCR decides what amount can be paid by the will be charged, it can be less or equal.

What is UCR?

The amount paid in a geographic area for a medical treatment based on what providers in the area typically charge for the same or similar medical service.

The UCR amount is occasionally used to calculate the permissible amount. Amount commonly charged for or covered for similar medically necessary, doctor-recommended, or treatment-required services and supplies.

Therefore, UCR decides what amount can be paid by the will be charged, it can be less or equal.

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What are the 3 types of cardiovascular?

Answers

Answer:

What are the different types of cardiovascular diseases? 1 coronary heart disease – disease of the blood vessels supplying the heart muscle; 2 cerebrovascular disease – disease of the blood vessels supplying the brain; 3 peripheral arterial disease – disease of blood vessels supplying the arms and legs

Explanation:

What are some examples of lifestyle choices?

Answers

Examples of lifestyle choices include diet and nutrition, physical activity, smoking and alcohol consumption, sleep, stress management, personal hygiene, social and community engagement, career and education, financial management, and technology use.

Some examples of lifestyle choices include:

Diet and nutrition: Choosing to eat a balanced and nutritious diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats.Physical activity: Choosing to engage in regular exercise such as going to the gym, playing sports, or going for a walk.Smoking and alcohol consumption: Deciding whether to smoke or drink alcohol and in what quantities.Sleep: Deciding how much sleep to get and how to maintain good sleep hygiene.Stress management: Deciding how to manage stress through activities such as meditation, yoga, or exercise.Personal hygiene: Deciding how often to shower, brush your teeth, and wash your hands.Social and community engagement: Deciding how much time to spend with friends and family and how much time to give back to the community through volunteering or community service.Career and education: Deciding what type of career or education to pursue and how much time to spend on continued learning and self-improvement.Financial management: Deciding how to manage money and plan for the future.Technology used: Deciding how much time to spend on technology and how to use it in a healthy and balanced way.

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What is Food and how does it help us burn calories

Answers

Answer:

Food is a source of energy for the body. It is made up of carbohydrates, fats, proteins, vitamins and minerals. When the body breaks down food, it releases energy in the form of calories. The body uses this energy to perform daily activities and to fuel the body's functions. Eating the right foods in the right amounts helps us to maintain a healthy weight and prevent obesity. Eating foods with high levels of calories can help us to burn these calories through activities such as exercise. Additionally, eating foods that are rich in fiber can help to make us feel fuller for longer, reducing the likelihood of overeating.

Which of the following is a severe burn in a 65-year-old patient? Select one: A. Superficial burn to 30% of the BSA B. Second-degree burn covering 10% of the BSA C. Full-thickness burn to 1% of the BSA D. Partial-thickness burn to 20% of the BSA

Answers

Superficial burn to 30% of the BSA is a severe burn in a 65 year old patient.

10% of people with significant burns are considered geriatric patients, who are often those over the age of 65. 1 Burns are more dangerous injuries in this age group than in the general population, and burns that cover more than 30% of the body surface area (TBSA) have a very high death rate.

This rise in morbidity and death is caused by co-morbid conditions. 2 Older persons are more susceptible to infection, have thinner skin, worse microcirculation, and are more likely to experience burn shock, inhalation damage, pulmonary pathology, septicaemia, and renal failure than younger ones.

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What are 3 benefits of cardiovascular fitness?

Answers

The benefits of Cardiovascular fitness are:

Increase in exercise toleranceReduction in body weightReduction in blood pressure

Cardiovascular fitness is indeed a health-related component of fitness that is achieved by regular physical exercise. Many physiological characteristics, including as heart rate, stroke volume, cardiac output, and maximum oxygen intake, influence a person's capacity to transport oxygen to working muscles.

Understanding the link between cardiorespiratory fitness as well as other types of conditioning necessitates an examination of the changes that occur with increasing aerobic or anaerobic capacity. As aerobic/anaerobic capacity grows, general metabolism rises, muscle metabolism rises, hemoglobin rises, bloodstream buffers raise, venous return rises, stroke volume rises, and the blood bed becomes more adaptable to varied demands. Each of these cardiovascular fitness/cardiorespiratory conditioning outcomes will have a direct favorable influence on muscular endurance and an indirect positive effect on strength and flexibility.

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29-30 ESSAY: Answer each question briefly with two or more sentences in in the space available below.

29.) What will you do to establish a hazard free working environment and prevent oneself from any untoward incident during baking.
Answer:

30.) How does it when when what is practicing hygiene in termsof physical,social and emotional aspect?
Answer:
Pls this is 60% part of my grade
I put 20points here
BRAINLIES-
5RATES-

Answers

Answer:

29) being safe and not touching anything hot

30) It is bad for your kidneys

The best way to treat an underweight person is to advise him or her to
A) eat high-fat foods such as cream, cheeses, ice cream, and ground beef.
B) stop exercising.
C) eat calorie-dense foods higher in vegetable fat like nuts and seeds.
D) eat high-calorie foods at the beginning of a meal.

Answers

The best way to treat an underweight person is to advise them to eat foods that are high in calories and high in plant fats, such as nuts and seeds.

What does calorie-dense foods mean?

If a food is calorie-dense, it usually means it has a lot of energy and few nutrients. This means it is a DRIVEN food. Consider these foods on the WHO A list. Calorie-dense foods are foods that contain a large number of calories relative to their weight. Some examples of high-calorie foods include whole dairy products, fatty beef, oils, nuts, and seeds.

Why are some foods so high in calories?

High-calorie foods are foods that contain a high number of calories relative to their weight. This is usually due to high amounts of saturated fat, sodium, added sugars and other simple carbohydrates.

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Discuss what humans can taste and what they smell and how this forms food flavor.

Answers

Explanation:

Humans can taste sour,sweet,bitter,salty and savoury flavours.Humans cannot taste vitamins as they are essential for the body.There is something in the nose called an olfactory receptor, also called smell receptor has proteins capable of binding odour molecules that plays a central role in the sense of smell in most vertebrates,arthropods and fish.

Nursing students are reviewing the structure and function of the ears in preparation for class the next day. The students demonstrate understanding of the information when they describe which of the following as a middle ear structure?
1- Auricle
2- Membranous labyrinth
3- Ossicles
4- Organ of Corti

Answers

Nursing students are reviewing the structure and function of the ears, the students demonstrate understanding of the information when they describe the following as a middle ear structure 3) Ossicles.

What are the functions of ossicles?

The ossicles are tiny bones and the smallest in the human body. The ossicles amplify the sound. The tiny stapes bone attaches to oval window that connects the middle ear to inner ear.

The ossicles are tiny bones in the middle ear, that form chain connecting the ear drum (Tympanic membrane, TM) and inner ear. When airborne sound vibrates the TM, ossicles perform an "impedance match" allowing sound energy to be transferred into fluid filled inner ear.

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Messages are impulses are carried from one part of the body to another by​

Answers

Answer: A special cell called a neuron

Hypertension is NOT a type of cardiovascular disease. Please select the best answer from the choices provided.T/F

Answers

False. Hypertension, or high blood pressure, is a condition that occurs when the force of the blood against artery walls increases and becomes too high for the heart to pump efficiently.

It can cause a wide range of health problems, such as heart disease and stroke, but it is not a type of cardiovascular disease. Hypertension is a risk factor for cardiovascular diseases, such as coronary artery disease, congestive heart failure, and cerebrovascular disease, but it is not an actual disease in and of itself.

Hypertension can be managed through lifestyle changes, such as eating a healthy diet, exercising regularly, and quitting smoking, as well as through the use of medications. It is important to monitor and treat hypertension to reduce the risk of developing more serious health problems.

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Answer: False

Explanation:

How can you use technology to help you be more active?

Answers

Heart rate monitors, accelerometers, and pedometers have all been employed as motivating aids for many years. Global positioning systems (GPS), geographic information systems (GIS), interactive video games, and persuasive technology are some of the more recent technologies and strategies being utilised to encourage physical exercise.

What physical technology examples can you give?

Any tangible tool used by a person to complete a task is considered physical technology. This can apply to electrical devices like computers and electronic equipment.

Computers may be used to compose documents or view images in addition to accessing cyber tools.

Fitness trackers and smartwatches are examples of wearable technology that are growing in popularity since they provide a handy method to monitor your fitness progress.

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Is BMI the best measure of obesity?

Answers

No, BMI is not the best measure of obesity.

BMI continues to be the most generally used, broadly recognised, and practical measure of obesity in both children and adults, especially for monitoring. A person's body mass index is computed using their weight and height. The BMI is calculated by dividing the body mass by the square of the body height and is given in kilograms per square metre.

The BMI can be calculated using a table or graphic that shows BMI as a function of mass and height, with contour lines or colors for different BMI categories, and that may use alternative units of measurement.

The BMI is commonly used to determine how far an individual's body weight deviates from what is typical for a person's height. The National Institutes of Health revised US standards in line with World Health Organization criteria in 1998, decreasing the normal/overweight cut-off from 27.8 (men) and 27.3 (women) BMI to 25. This had the consequence of redefining nearly 25 million formerly healthy Americans as overweight.

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How can you improve your flexibility as a student?

Answers

To improve your flexibility as a student, alter your routine, practice creative thinking, transfer your learning, and seek out new experiences.

Learning to transfer what you ’ve learned in one environment into a new environment can be a great exercise in cognitive inflexibility, because it forces you to form new connections between preliminarily unconnected networks of knowledge and suppose more creatively.

Each time you experience something out of the ordinary or learn commodity new, the brain creates new synaptic connections. New and intriguing gests have also been shown to spark the release of dopamine, which not only increases provocation but also enhances memory and literacy.

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What is BMI for age and what are its uses?

Answers

BMI-for-age is a continuous metric that may be used to test children and teenagers aged 2 to 20 years for obesity, overweight, healthy weight, or underweight.

A person's body mass index is computed using their weight and height. The BMI is calculated by dividing the body mass by the square of the body height and is given in kilograms per square metre (kg/m2).

The BMI can be calculated using a table or graphic that shows BMI as a function of mass and height, with contour lines or colors for different BMI categories, and that may use alternative units of measurement (converted to metric units for the calculation).

The BMI is commonly used to determine how far an individual's body weight deviates from what is typical for a person's height. The National Institutes of Health revised US standards in line with World Health Organization criteria in 1998, decreasing the normal/overweight cut-off from 27.8 (men) and 27.3 (women) BMI to 25. This had the consequence of redefining nearly 25 million formerly healthy Americans as overweight.

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What are allergies?.....

Answers

Answer: Symptoms that include sneezing, runny nose, red, watering eyes, vomiting, diarrhea, rashes, and itching.

how to can you prevent allergies? stay away from what you allergies don't get to closer to whatever u have the allergie to  

brainliest pls

Answer:

Alergias.

Explanation:

Las alergias son reacciones que el sistema inmunológico ante ciertas sustancias para las cuales el organismo no sabe cómo tratar. Dichas reacciones pueden llegar a ser severas e incluso mortales.

What are the top 5 common diseases that we can acquire if your lifestyle is not health?

Answers

1. Obesity
2. Heart disease,including coronary artery disease and heart attack.
3. High cholesterol
4. Stroke
5. Metabolic syndrome

What is mental health and emotional health?

Answers

The ability to deal with it and manage emotions is referred to as emotional health.  The capacity to think clearly or make sound judgements is defined as mental health.

Emotional health also includes the ability to form positive relationships. Mental also includes the capacity to deal with stress and control emotions. Mental and emotional health are distinct, they are inextricably linked. People's emotions might run wild if they do not receive mental health therapy. Concentrating solely on emotional wellness generates mental confusion, making it difficult to perform regularly. Both mental and emotional therapies play important roles in assisting patients throughout rehabilitation.

Depression, anxiety, stress, and sorrow may all be treated with therapies and tactics such cognitive behavioral therapy, relaxation, mindfulness, and 'talk' therapy. If you notice that you are not operating normally and that something is bothering you, right now is the time to find out more about what's going on and maybe get treatment.

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All of the following are suggested health promotion practices for American Indians and Alaskan Natives except:

Answers

All of the following are suggested health promotion practices for American Indians and Alaskan Natives except Elders should be afforded no more respect than others.

According to the World Health Organization's Ottawa Charter for Health Promotion from 1986, health promotion is the "process of allowing individuals to increase control over, and enhance their health."

Health promotion is the process of empowering individuals to gain more control over their health and enhance it. It shifts away from an emphasis on human behaviour and toward a broad variety of social and environmental interventions. Premature deaths are reduced by health promotion. Health promotion, by focusing on prevention, minimises the expenses (both financial and human) that people, businesses, families, insurance companies, medical institutions, communities, states, and nations would incur for medical care.

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Length of program or degree for police officer?

Answers

Answer:Sign up at the police academy

Explanation:

Answer:

It usually takes about 13 to 19 weeks on average but can last up to six months. Note that it is possible to complete the Police Academy prior to applying for a police officer.

Explanation:

Hope this helps! :)

Jamie is talking to her dad about the homelessness issue in their city. Her dad tells her
there wouldn't be a problem if these people would just get jobs. Jamie disagrees with her
dad's statement. How might Jamie respond in a way that informs her dad about who
makes up the homeless population and why people become homeless? What are three
action steps Jamie and her family might take to make a difference in her city's homeless
population?

Answers

Answer:Jamie might respond by saying, "Dad, many of the homeless population are veterans, people with disabilities, and those who have experienced job loss due to the economy. It's not as simple as just getting a job. Many of these people need additional support and resources to get back on their feet."

Explanation:

Average salary for cosmetology in ns

Answers

In Halifax, Nova Scotia, a hair stylist can expect to make $33,421. Salary estimates are based on 12 salaries provided by anonymous Hairstylist employees in Halifax.

Does the market for cosmetologists exist?

Barbers, hairdressers, and cosmetologists' total employment is expected to increase by 11% between 2021 and 2031, which is substantially faster than the average for all occupations.

What wage should hairstylists receive?

In London, a hairdresser makes an average salary of £30,456. This represents a 17.6% increase over the national average hairdresser wage. The typical pay for hairdressers in London is 29% lower than the city's typical wage.

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Although most medical practices now submit claims electronically, it's important for health insurance professionals to know how to complete paper claims and understand what goes in each block, why that information is necessary, and where the information comes from. Why is this important?

Answers

A trustworthy environment is developed, and patient privacy is maintained, which increases the likelihood that the patient will seek treatment and will be as open and honest as possible during a medical visit.

What health insurance professionals must understand?

Computers are also used in the medical industry to manage financial records. In order to prevent unauthorized access to medical records and financial information, it is crucial to maintain the highest level of security.

Also see Relationship between Physician and Patient. Additionally, it might make the patient more inclined to seek treatment.

Therefore, to receive the greatest reimbursement that the medical record permits in the shortest amount of time.

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What are the impacts of nicotine and tobacco on the human body?

Answers

Answer:

maintain stability of the human body system

Rest periods and coffee breaks may be required by all of the following except: a.a municipal legislation. b.a state legislation. c.the FLSA.

Answers

Except the FLSA, rest periods and coffee breaks may be required by all. The Fair Labor Standards Act is applicable to "employees who are engaged in interstate commerce or in the production of goods for commerce.

The right to a minimum wage and "time-and-a-half" overtime pay for hours worked above forty in a workweek is guaranteed by the Fair Labor Standards Act (FLSA), a piece of labor legislation in the United States. It also forbids the use of children in "oppressive child labor." Unless the employer can assert an exclusion from coverage, it applies to individuals involved in interstate commerce, working for businesses involved in commerce, or involved in the manufacturing of commodities for commerce. The Act was enacted by the 75th Congress and became law in 1938 under the administration of President Franklin D. Roosevelt.

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uman muscles have an efficiency of about __________. A. 9 to 17% B. 18 to 26% C. 27 to 35% D. 36 to 44% Please select the best answer from the choices provided. A B C D

Answers

Human muscles have an efficiency of about __ 18 to 26% ________. The correct  option is B

What is muscles?

Muscles are a specialized body part that produces movement or locomotion in animals, The muscle is comprised largely of muscle tissues. A muscle tissue is made up of muscle cells which in turn consist of several myofibrils.

Therefore muscles are attached to bones or internal organs and blood vessels are responsible for movement. Nearly all movement in the body is the result of muscle contraction.

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Health authorities recommend that adults consume _____ ounces of seafood per week. a. 8-12 b. 3-6 c. 14-21 d. 5-7 e. 2.5.

Answers

Adults should consume 8 to 12 ounces of seafood per week, according to health authorities.

The most popular marine life for human consumption as "seafood" is fish and shellfish. Clams, oysters, mussels, cephalopods like octopus and squid, crustaceans like shrimp, crabs, and lobster, and echinoderms like sea cucumbers and sea urchins are just a few of the mollusk species that go under the umbrella name "shellfish."

Around the world, seafood is a major source of (animal) protein, particularly in coastal cuisines. According to popular belief, pescetarians are semi-vegetarians who mostly consume seafood as their supply of meat.

There are some detrimental outcomes as well. Seafood allergy is more prevalent in areas where seafood is a big part of the diet. There are conditions that resemble seafood allergies that are caused by parasites or toxins present in seafood.

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Joan is a 39 y/o female who presents to the clinic with a chief complaint of: 3-day history of fever (101 F degrees), chills, n & v, and flank pain.

Answers

In a urine check, the NP notes that she has many leukocytes, hematuria, WBC casts, and mild proteinuria. Complications for Joan would include all the following except Shock.

Shock is a life-threatening disorder caused by an abrupt decrease in blood flow across the body. Trauma, heatstroke, blood loss, an allergic response, severe illness, poisoning, serious burns, or other reasons can all result in shock.

Renal failure, also known as end-stage kidney disease, is a medical condition in which the kidneys no longer filter waste materials from the blood properly, working at less than 15% of normal levels. Kidney failure is defined as either acute, which occurs quickly and may resolve, or chronic, which develops slowly and is typically permanent.

In healthcare settings, Gram-negative bacteria cause illnesses such as pneumonia, bloodstream infections, wound or surgical site infections, and meningitis.

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What is the formula for calculating the body mass index BMI of a person ?

Answers

Body mass index (BMI) is a person's weight in kilograms divided by the square of height in meters.

The body mass index of a person is calculated using their weight and height. The BMI is computed by dividing body mass by body height squared and is expressed in kilos per square metre.

BMI can be determined using a table or graphic that depicts BMI as a function of mass and height, with contour lines or colours for different BMI categories, and that may utilise multiple units of measurement. The BMI is widely used to measure how far a person's body weight deviates from what is expected for their height.

In 1998, the National Institutes of Health updated US standards to match World Health Organization guidelines, lowering the normal/overweight cut-off from 27.8 (men) and 27.3 (women)BMI to 25. As a result, roughly 25 million previously healthy Americans were reclassified as overweight.

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