Is this how u really feel fam? i mean like joji is cool and all but who hurt u?
Duodenal ulcer is the diagnosis for a patient who experiences chronic intermittent pain in the epigastric area when the stomach is empty and in the middle of the night.
A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine. It occurs in the lower part of the esophagus. Few symptoms of duodenal ulcer are a dull or burning pain in the belly. The main cause of this ulcer is bacterial infection. The bacteria causes the lining of the stomach to become inflamed and an ulcer can form. Few medications such as ibuprofen may also cause ulcer.
The wound generally heals on its own but if the ulcer is deep it can cause serious pain or bleeding.
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Answer:
The best answer from the choices, to the question: The cause of the hyperventilation is described by which of the following statement:___, would be, B: A decrease in the bicarbonate concentration stimulates ventilation.
Explanation:
The acid-base balance in the human body, is a very restrictive one. Normal ranges in this base are: 7.35 to 7.45. Whenever the values go either below 7.35 or above 7.45, we are talking about a person going into acidosis or alkalosis. Both situations are pretty serious and they have to do with the balance between the amounts of bicarbonate, and CO2 in the form of carbonic acid, in the blood. The normal ratio of bicarbonate to carbonic acid, is usually 20:1. Chemoreceptors, especially central ones in the neck, measure constantly that the balance is kept and if this is not the case, then several mechanisms will be put into place to recover it. One such measure is respiratory, and the other is metabolic. In the case of this 17-year-old, he has a pneumonia, which means that from the start, one of his recovery mechanisms is impeded, which is the respiratory mechanism of balance. He is also having metabolic problems with his system of compensation because his body is already producing high levels of H+ ions and not enough bicarbonate. Hyperventilation in this person is attempting to expel as much CO2 as possible, to try and restore the balance. The first thing that is sensed by the receptors is the changing in the 20:1 ratio, the increase in pH due to too much carbonic acid, and thus the body initiates the use of CO2 expulsion by the lungs, while metabolic mechanisms come into play.
A Drug Trend report published in 2009 had predicted continued price increase among traditional branded and biotech drugs that lack generic competition. Now, further, CMS has reduced its Average Sales price (ASP) margin from 6 percent to 4 percent for non-pass-thorough. This has affected pharmacy reimbursement. However, there are certain other aspects of Pharmacy Billing that can affect reimbursement and thereby the Revenue Cycle Management (RCM) process if not well implemented.
1. Data Workflow:
Recognizing how the revenue cycle works in pharmacy is very essential. Procurement to Inventory, billing and reimbursement involves purchase of medications, their storage, and method of dispensing, how they are administered, way they are coded & billed, and finally reimbursed. If the drug is covered as a pharmacy benefit, or the payer needs that to be obtained via a specialty pharmacy as identified through patient-specific benefit verification, then here both the provider and the pharmacy are part of the reimbursement process. The physician writes a prescription and orders the drug. This is followed by the pharmacy that fills the order and issues the drug to the physician, CMHC, or hospital outpatient department. Here the pharmacy bills the insurance company for the drug. If any information is entered incorrectly into the pharmacy system in the initial phase of the cycle, errors can prove to be costly, impacting aspects of clinical and revenue cycle.
2. Procurement:
During this phase information is converted from purchased quantities and pricing to storage units of measure (UOM) and inventory costs. Manually entering the data is followed in most cases. UOM conversions, when data is uploaded from the wholesale distributor to the pharmacy system, are also checked and verified manually. Here too mistakes can lead to breakdown in the revenue cycle management (RCM) process.
3. The Charge master:
Critical & substantial revenue leakage can occur when separately reimbursable medications are either missing from or miscoded in the charge master. Conversion of pharmaceutical quantities is a must from purchased amounts to patient-administered amounts, and only then made billable. There is often a difference between dosage amounts required for patient use as from that purchased. Besides inventory, the clinician and pharmacist should convert dosage, strength, and delivery mechanism for each drug. Drug data must be correctly converted from the quantities residing in clinical systems into the payer-billable quantities appropriate for the financial system or charge master. The UOMs must be reconciled to avoid any under- or over-payments. More than often, missing or incorrect data in the charge master can result in negative financial consequences – denied claims, partial reimbursement, and compliance risks.
4. Linkages between Purchases & Billing:
Most hospitals have separate processes to order drugs, administer them, and process reimbursement. Without linkage between pharmacy expenditures for medications (i.e., spend data) and the charge master, ensuring proper charge capture and optimal reimbursement is a challenge. Besides hospitals should have automated tools to identify charge capture errors precisely, so as to pinpoint when and where their occurrence to decreasing revenue loss.
