For a client admitted with a cerebral contusion, the highest priority is neurologic deficit, and at risk of inflicting injury.
<h3>What is cerebral contusion?</h3>
Generally, Cerebral contusions are simply defined as patches of bleeding on the brain's surface,
In conclusion, the initial nursing diagnosis would be related to a neurologic deficit, and at risk of inflicting injury.
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Answer:
The correct answer is D.
Explanation:
Bordetella pertussis is a gram-negative coccobacillus that causes a disease called whooping cough.
The bacterium infests the patients by colonizing lung epithelial cells. To do so, it requires adhesins, called filamentous haemagglutinin, fimbriae and pertactin. Once the bacterium is attached to the lung epithelial cells, it produces a cytotoxin that prevents their cilia from moving.
Another virulent factor from B. pertussis is the pertussis toxin, which alters host immune system through the inhibition of phagocytes response to it.
The nurse should be prepared to monitor pulse and ventilation immediately for a patient receiving epinephrine infusion.
Epinephrine, often called adrenaline, is a very potent drug that may produce adverse side effects if taken in inappropriate amounts. It is used to treat cardiac arrest, hypotension, or severe allergies, known as anaphylaxis, caused by some insect's bite.
Some of its side effects include respiratory problems, dizziness, headache, weakness, nausea, pale skin, sweating, feeling nervous, anxious, or fearful.
Thus the nursing interventions should be performed as:
● Assess the patient's respiratory count, pulse, blood pressure, and urine output continuously
● Administer the dose carefully in appropriate amounts- usually, the dose does not exceed 1mg
● Report it to the doctors if any of the side effects do not vanish in 20 minutes after the infusion.
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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.
Giving the doctor a clear indication of the issue, enabling early therapy to begin, and being practical for the patient.
<h3>What do you mean by Clia-waived rapid test ?</h3>
According to the CLIA law, tests that the CDC or FDA deem to be sufficiently straightforward that there is minimal danger of error are waived.
- Pregnancy tests, faecal occult blood tests, some urine tests, and some tests for glucose and cholesterol are also exempt.
- The quick availability of results while the patient is available for immediate follow-up, the need for little training in simple tests, and the portability of many waived tests all contribute to the advantages of performing them.
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