Category: Nursing

Hypogonadism

Draft … My original question in PICOT format was: In men, ages 45-65, with low testosterone levels, how does using intramuscular testosterone alone compare to using intramuscular testosterone in combination with subcutaneous human chorionic gonadotropin (hCG) in increasing serum testosterone levels after a 6-month treatment period. However, since creating it last week, I have decided to redefine it to: In men, ages 45-55 who present with symptoms of hypogonadism, how does using intramuscular testosterone alone compare to using intramuscular testosterone in combination with subcutaneous hCG in reducing reported symptoms after a 6-month treatment period.

Symptoms associated with hypogonadism are fatigue, loss of muscle mass, increased body fat, depression, decreased libido, and loss of night time erections. Granted, these symptoms alone may not result in a diagnosis of hypogonadism as comorbidities, such as obesity, hypertension and diabetes, must be considered (Lawrence, Stewart, & Larson, 2017).

Background questions are looking to answer general knowledge questions that often can be located in textbooks. They typically have a root question of who, what, when, where, how and why followed by the outcome of the intervention or area of interest (Colorado State University, n.d.). Foreground questions, as defined by Lawrence, Stewart, & Larson (2017), are “those that can be answered from scientific evidence about diagnosing, treatment, oe assisting patients in understanding their prognosis” (p.27).

Background questions would likely deal with the type of symptoms the patient initally reported that encouraged them to seek medical attention. Examples would be what causes fatigue and loss of energy in the aging man? What are the symptoms of low testosterone? What causes low testosterone? The symptoms associate with hypogonadism are easily located in textbooks and on the internet. The foreground questions pose the more clinical questions. An example may be, what other diagnoses may cause similar symptoms as hypogonadism? What does hCG do in the role of treating low testosterone?

Much of the evidence located initially was related to infertility in younger men. As I varied my key words for the searches, my results began to increase. The additional results were more specific to testosterone replacement in various ages and several were specific to older men. There are even fewer results that discuss the use of hCG with testosterone. The most specific article was “A Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Recombinant Human Chorionic Gonadotropin on Muscle Strength and Physical Function and Activity in Older men with Partial Age-Related Androgen Deficiency”, but it was from 2002 and did not use testosterone in combination with the hCG (Liu, Wishart, & Handelsman, 2002). I feel confident that with time and varying the key words in the searches that I will generate more appropriate results…

How management role interacts with colleagues and employees

In two or three paragraphs, assess how each management role interacts with colleagues and employees: Nursing, social services and patient care director.

Community health assessments

Needs Assessment

Community health assessments are used by health planners to identify, and prioritize health problems within a given community. To prioritize health programs and their development, a needs assessment is used. There are four types of needs that should be considered in a needs assessment. Although there is no single way to conduct a needs assessment, the basic steps to conducting a needs assessment can be identified.

Using the South University Online Library or the Internet, research about needs assessments and the types of health needs in your community. Based on your research, create a 2- to 3-page Microsoft Word document that:

Describes the four types of needs and compares them. Explains the interaction of the four types and the role of each type of need in the community assessment process.

Selects one of the four needs and provides an example of how this need can be applied to a health issue in your community. Describes the potential pitfalls of focusing a needs assessment on a single need. Provides examples to support your assertions.

Identifies and describes the basic steps of conducting a needs assessment and also explains the importance of each.

Describes any additional steps that should be considered in the assessment process.

Support your responses with examples.

Cite any sources in APA format.

Maximum Points

Described the four types of needs and compares them. Explained the interaction of the four types and the role of each type of need in the community assessment process.

15

Selected one of the four needs and provides an example of how this need can be applied to a health issue in the community. Described the potential pitfalls of focusing a needs assessment on a single need. Provided examples to support assertions.

10

Identified and described the basic steps of conducting a needs assessment and also explained the importance of each.

10

Described any additional steps that should be considered in the assessment process.

10

Presented a structured document free of spelling and gram

Evolution and Adoption of Health Information Systems

For this assignment, you are asked to perform the following tasks:

1. Describe the evolution of healthcare information technology by identifying key technological advancements in each decade, beginning with the 1960s, that had a direct impact on healthcare administrative and clinical functions.

2. Which decade do you feel was most significantly related to advances in health information systems? Please discuss.

3. Based on your own personal views, which specific law or act had the most significant advances for health information systems. Please discuss.

4. Discuss what the American Health Information Management Association (AHIMA) is and its significance to health information technology.

Your response should be at least three pages in length.

You are required to utilize your textbook and peer-reviewed journal articles from the University Online Library to complete this assignment. Make sure that you support any claims with proper sources, and appropriately cite your sources in APA format.

Public Health Problem

Understanding the health problem. A problem statement is one of the most crucial parts of your concept paper. This is the first section your audience will read, and it will set the tone for your proposed program. A well-written problem statement should include the nature of the problem, who the problem affects, the current impact of the problem, and future consequences of the problem, if left unaddressed.

Continuing with the Microsoft Word report you created in W1 Assignment 3, add 2–4 pages to the report covering the following:

Explain the public health problem your program will address using factual information.

Define the public health problem.

Describe the adverse effects of the problem on public health and well-being.

Provide detailed and specific data on the problem and the community in which the project will be implemented.

Explain the anticipated improvements in health outcomes upon successful implementation of the program.

Support your responses with examples.

Cite any sources in APA format.

Submission Details

Name your report SU_PHE4070_W2_A2_LastName_FirstInitial.doc.

Submit your report to the W2 Assignment 2 Dropbox by Week 2, Day 6.

Assignment 2 Grading Criteria

Maximum Points

Explained the public health problem to be addressed using factual information.

15

Described the adverse effects of the problem on public health and well-being.

10

Identified specific data on the problem and provided the details on the data and the community in which the project will be implemented.

10

Identified and explained the anticipated improvements in health outcomes upon successful implementation of the program.

10

Used correct spelling, grammar, and professional vocabulary. Cited all sources using APA format.

5

Total:

50

dysuria, urinary frequency and urgency

LN is a twenty-six-year-old married woman who presents at the clinic with symptoms of dysuria, urinary frequency and urgency. Further history yields two days of these symptoms but no fever, chills, or flank pain. She describes a burning discomfort during and immediately following urination and feeling the need to void every half hour. There is no vaginal discharge, itching, or odor. She is not using birth control at this time. She requests “a urine culture and some sulfa pills.” When asked to explain, she says she has had many “bladder infections” over the past three years and “sulfa pills usually work.” She was evaluated approximately five years ago with an IV pyelography and cystogram, and “nothing was wrong.” All her vital signs are normal. Answer the following questions:

What additional information would you like to collect?

What is your working diagnosis?

What are the contributing factors to this potential diagnosis?

What treatment would you implement and why?

What type of follow-up would you recommend?

Standardized Healthcare Data Set

1. Describe what a standardized healthcare data set is.

2. Compare and contrast at least three data sets used in electronic health records.

a. What are the data sets used for?

b. Where are the data sets stored/housed?

c. Are the standards governing the data sets used as part of the Department of Health and Human Services meaningful use regulations?

3. Analyse and compare administrative based data and clinical based data.

Your Standardized Healthcare Data Set response must be at least three pages in length, double spaced. You are required to use at least one outside source. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying APA citations.

Affordable Care Act (ACA)

Healthcare Policy: What You Need to Know About the Affordable Care Act

Pin It

Please go to www.whitehouse.gov/blog/2016/03/23/look-six-years-affordable-care-act (Links to an external site.)Links to an external site. to read the latest about the Affordable Care Act from the White House.

Respond to the questions below.

What are some benefits of the healthcare reform that has been prompted by the Affordable Care Act (ACA)?

Why is it important to be aware of changes in healthcare policy?

Why do you believe we spend more on healthcare than any other country but have the worst outcomes?

Medical Coding

Unit outcomes addressed in this Medical Coding Assignment:

• Apply diagnostic and procedure codes according to current guidelines using common classification systems, taxonomies, nomenclatures and terminologies

• Identify the documentation needs that relate to quality coding practices

• Discuss the role of coding with the key features of an electronic health record (EHR) system and clinical document standards.

• Discuss the importance and relevance of Computer-Assisted Coding along with coding problems that may arise.

ORDER A CUSTOM WRITTEN PAPER

Course outcome(s) practiced in this unit:

HI253-5: Appraise a health record for deficiencies needed for quality coding (Bloom’s Level 4)

AHIMA’s Professional Coding Approved Program (PCAP) Mapping:

Domain I. Data Content, Structure & Standards (Information Governance)

● Subdomain I.A Classification Systems

● 1. Apply diagnosis/procedure codes according to current guidelines (Bloom’s Level 3)

○ Classification Systems

■ ICD (ICD-9-CM, ICD-10, ICD-10-CM/PCS)

○ Taxonomies

■ Clinical Care Classification (CCC)

○ Nomenclatures

■ CPT, DSM, RxNorm

○ Terminologies

■ LOINC, SNOMED CT

Medical Coding Instructions:

Part 1: Coding Scenario Worksheet (coding practice): Complete the coding scenarios worksheet indicated in Part 1 below by indicating the appropriate codes.

Part 2:Nuance Quantim Physician Query Activity: Please access the AHIMA’s Virtual Laboratories (VLabs) at http://academy.ahima.org/ website. Within the Virtual Lab (My Learning), go to the Virtual Lab applications and open the Nuance Quantim Encoder application and complete the Nuance Quantim #6 Activity on Physician Query activity with a passing score of 100% and appropriately identify the documentation needs that relate to quality coding practices. Answer the provided questions and submit a screen shot of your completed Physician Query activity in the Part 2 section of the Assignment Worksheet.

Part 3: Electronic Health Record and Coding Systems:

A. VistASimulation: Please access the AHIMA’s Virtual Laboratories (VLabs) at http://academy.ahima.org/ and follow the instructions under Part 3. Once completed, take a screen shot of the completion page and attach to the appropriate Part 3 section of the Assignment Worksheet. Remember to review the VLab instructional sheet in Doc Sharing if you trouble navigating.

B. EHR and Coding Resources Comparison Table: Answer the question indicated and support your answer by providing a table to include where the resource would be located and how best to access.

Part 4: Computer-Assisted Coding: Refer to the information from your Unit 10 Discussion Board and provide your answers/discussion in the Part 4 section of the Assignment Worksheet.

Requirements:

● Your assignment worksheet may contain citations and references, and if used, should utilize APA style, with no more than 10% quoting. Please use paraphrasing, in-text citation, and referencing.

● Correct spelling and grammar should be utilized throughout and if required, the answers provided in complete sentences.

● The word count should reflect the following:

○ Part 1 = Short answer 1-6 words; or applicable code.

○ Part 2 = Short answer 1-6 words and VLabs screenshot.

○ Part 3 = VLab screenshot; short answer 1-6 words and then 75-100 words for the entire table.

○ Part 4 = 75-100 words

○ Total = about 225-300 words with VLabs screenshot and completed coding worksheet.

Medical Coding ASSIGNMENT WORKSHEET

Part 1: Coding Scenarios Worksheet

Provide the correct code or short answer for the following questions and case scenarios:

1. A patient has a bundle of his recording and intra-atrial pacing done by Dr. Henry on 07/01/YY. When using CPT to code these procedures, the coder should:code each procedure separately

2. Mary Joseph is a patient at a local hospital. She underwent surgery and had severe postoperative complications that included respiratory arrest and acute blood loss. She received critical care services for 85 minutes. CPT codes 99291 and 99292 are reported. Code 99292 is considered a(n) Neonatal intensive care______________________code

3. Wyatt presents to Dr. Franks’ office complaining of swollen neck glands. Dr. Frank does not find any other physical findings but orders laboratory tests. His impression is localized cervical lymphadenopathy.

a. What is the main term utilized to code this case?

b. Assign the ICD-10-CM code:

4. Kelly presents with urinary frequency and nocturia. The doctor does not detect any abnormal findings but orders an IVP.

a. What are the patient’s signs and symptoms?

b. Assign the ICD-10-CM code:

5. Mary Jane had her tonsils taken out 2 days ago. She now presents with postoperative hemorrhage status post tonsillectomy. She requires control of her bleeding and was given Demerol 95 mg IM for pain.

What is the HCPCS code for Demerol?J2175

6. Joseph is a chemotherapy patient suffering from anemia secondary to treatment. He presents to his oncologist’s office for his routine B12 injection for vitamin B12 deficiency anemia due to the chemotherapy. Sytobex 1000 mg IM was provided.

What is the HCPCS code for the Sytobex? J3420

7. Anesthesia services are organized by what process in the CPT Coding Book? Body site

8. A patient on vacation out of state fractures her leg and sees a doctor who sets the fracture.

The out-of-state physician will report which modifier to the code?

9. Identify the main term from this statement used for CPT coding: “Sinus endoscopy with concha bullosa resection:concha bullosa

10. How many possible values are there for each character in an ICD-10-PCS code?

11. Which of the following is an invalid code? “06H033T” or “06H14DZ”?

Explain your answer:

12. Which of the following codes is an invalid code “3E0F37Z” or “3E0F03D”?

Explain your answer:

Part 2: Nuance Quantim Physician Query Activity and Documentation Practices

A. Provide brief answers to the following:

1. Provide the definition of principal diagnosis:

2. List the criteria that must be met in order to report a diagnosis or condition as secondary:

3. Explain the circumstances in which the present on admission (POA) indicator would be listed as “N”:

4. Which portion of the medical record contains documentation of the postoperative diagnosis?

5. Terms such as “hospital course” and “final diagnosis” are located in which inpatient report in the medical record?

6. When coding an inpatient medical record, the coder should review which document(s) to determine the reason a test was ordered?

7. The patient’s reason for the visit is often referred to as the chief complaint. What is the other term used to describe the chief complaint?

B. Nuance Quantim Physician Query #6 Activity:Submit screen shot of the completion page and attach here:

Part 3: Electronic Health Records and Coding Systems

A. VistASimulation: Please access the AHIMA’s Virtual Laboratories (VLabs) at http://academy.ahima.org/. Click on My Learning; Click on VLab Academy; Scroll to VistA; Click on the VistA Simulations. This is a PDF with links to the software simulations.

Click on “Coding an Office Visit”. Complete the simulation and take a screen shot of the completion page and attach it here:

B. EHR and Coding Resources Comparison Table: Answer the question indicated and support your answer by providing a table to include where the resource would be located and how best to access. Your information can be based on the three systems you have reviewed in Unit 9 and Unit 10 (Nuance Quantim, 3M Encloder, VistA) or other systems you have worked with or reviewed:

QUESTION: You are the coding supervisor at a major acute care hospital. What resources would you recommend to ensure that the most current ICD-10-CM/PCS codes are in use in your healthcare facility? Remember to address issues such as coding resources and computer systems.

Create a table outlining the features of health information systems and their advantages in coding. Support your information with examples. See example table below:

System Name Attribute (Medical Coding)

Part 4: Computer-Assisted Coding

Refer to the information from your Unit 10 Discussion Board and provide your answers/discussion here:

Can computer assisted coding (CAC) be helpful to outpatient coders? CAC is a supporting technology that has reached an exciting stage of development. It holds a great deal of promise for assisting in further automation of the coding process. Although the technology holds great promise, it also faces a huge challenge because of the complexity and variability of human speech. However, promising new CAC products are beginning to emerge in certain medical arenas, such as emergency medicine and radiology.

Do you believe that systems such as the CAC system will reduce the need for coders? Why or why not? What problems might result from CAC?¬¬¬¬¬¬¬¬¬¬

Submitting your Medical Coding work:

Submit your Medical Coding Assignment to the appropriate Dropbox. For instructions on submitting your work, view the Dropbox Guide located under Academic Tools at the top of your unit page.

To view your graded work, come back to the Dropbox or go to the Gradebook after your instructor has evaluated it. Make sure that you save a copy of your submitted work.

Unit 10 Assignment Grading Rubric = 170 points

Medical Coding Assignment Requirements Points possible Points earned by student

Part 1:Students successfully applies diagnostic and procedural codes according to current guidelines and quality practices and identifies the appropriate clinical documentation deficiencies. 0–34

Part 2:Student successfully identifies the documentation needs that relate to quality coding practices and has appraised various health records for documentation deficiencies. 0–51

Part 3:Student successfully discusses the role of coding and the key features of an electronic health record (EHR) and clinical documentation standards. 0–51

Part 4: Student successfully discusses the importance and relevance of Computer-Assisted Coding along with coding problems that may arise. 0–34

Total (Sum of all points)

Points deducted for spelling, grammar, and/or APA errors.

Adjusted total points

Scholar-Practitioner Project: Public Health Leadership Theory

Refine and develop your Public Health Leadership Theory based on leadership theories and a systems approach learned in this course. For this Assignment, your theory should reflect Instructor feedback, researched studies, introspection, innovation, and literature analysis.

The Assignment (9–12 pages):

Section 1 — Abstract and Introduction (1–2 pages)

Section 2 — Revised Literature Review and Problem Statement (5–7 pages):

Literature Review to include:

A synthesis of the literature of 15–20 peer reviewed, scholarly resources

A description of theoretical gaps in the research

Problem Statement to include:

An explanation of the specific problem that addresses identified gaps within the literature

An explanation of how your problem statement incorporates implications for positive social change.

Section 3 — Personal Public Health Leadership Theory (2–3 pages):

An articulation of your personal Public Health Leadership Theory

Section 4 — Revised Visual Representation of Your Public Health Leadership Theory (3–4 pages):

Your visual representation should include:

Your personal Public Health Leadership Theory to address the gaps identified in the literature

A visual representation of the theory (e.g. table, graph, matrix)

A explanation on how the theory addresses the literature gap identified in Week 5

A description of how your theory incorporates aspects of systems thinking

Section 5 — Empirical Evaluation Plan for a Public Health Leadership Theory (3–4 pages):

You will assess if the newly developed leadership theory addresses the problem you have been working on. What methodological steps will you use? How will you collect data? Suggestion – start with how theories in our text are evaluated. It does not have to be detailed, but it must include the methods, measures and analytic techniques.

If the assignments are done correctly, there should be an alignment from the topic of choice to the evaluation:

The topic is researched in the literature

The literature review points out a theoretical gap that needs to be addressed by leadership

The gap is turned into a problem statement

A leadership theory to address the problem proposed

The theory is depicted in a visual; and finally

An evaluation plan describes how the newly developed theory resolves the problem identified in the literature

To further help, examples (Two final projects – permission given to post) are located in the Doc Sharing area for this week

Section 6 — Public Health Leadership Theory Conclusion (1–2 pages)

Section 7 — References

An APA-formatted reference list of 15–20 peer-reviewed, scholarly journals