Week 6-Leadership and Professional Identity-Scheduling and Staffing Scheduling and Staffing Competency Collaborate in healthcare delivery systems settings for improved patient outcomes.Scenario You are making a staffing assignment knowing that you are short-staffed. You have five registered nurses (RNs), two licensed practical nurses (LPNs), and two nursing assistants. Those nine employees need to provide a 12-hour shift of services to 30 clients with a high acuity required to a ratio of nurse to client at 1:3.Client acuity level Six acuity level 1 Eight acuity level 2 Nine acuity level 3 Seven acuity level 4
List of Medications
| Medication Name/
Frequency |
Indications | Actions | Contraindications | Side Effects | Nursing Implication |
| Apixaban (brand name- Eliquis) 5mg P.O. B.D.
|
§ Prevention of systemic embolism and stroke in non-valvular atrial fibrillation.
§ Treatment of pulmonary embolism. § Prevention of pulmonary embolism after knee or hip replacement surgery. § Treatment of deep venous thrombosis. § Prophylaxis of deep venous thrombosis after knee or hip replacement surgery. § Decreases the reoccurrence of pulmonary embolism and deep venous thrombosis (Agrawal et al., 2022).
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§ Inhibits factor Xa, leading to blockage of the propagation phase in the coagulation cascade.
§ Inhibits thrombokinase activity and clot-bound and free factor Xa, leading to indirect inhibition of platelet aggregation caused by thrombin (Agrawal et al., 2022).
Therapeutic effects: § Prophylaxis and treatment of thromboembolic events. |
§ Hypersensitivity
§ Active bleeding § Patients with mitral stenosis, mechanical and prosthetic heart valves. § Forty-eight hours before invasive procedures or elective surgery with a moderate or high risk of bleeding § Twenty-four hours before invasive procedures or elective surgery, with a low risk of bleeding (Agrawal et al., 2022)
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§ Hypersensitivity reaction (allergic edema, rashes)
§ Bleeding § Epistaxis § Rectal hemorrhage § Gingival hemorrhage § Postoperative hemorrhage § Nausea § Hematuria § Bruising § Hemoptysis § Increased levels of gamma-glutamyltransferase, aspartate aminotransferase, and serum transaminases (Agrawal et al., 2022).
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Assessment:
§ Administer oral-activated charcoal in case of an apixaban overdose. § Monitor the patient for pulmonary embolism and deep venous thrombosis during therapy with apixaban.
Implementation: § Discontinue apixaban 48 hours before invasive procedures or elective surgery with a moderate or high risk of bleeding. § Discontinue apixaban 24 hours before invasive procedures or elective surgery with a low risk of bleeding. § Warfarin should be replaced by apixaban when INR is less than 2. § Discontinue apixaban before initiating therapy with another anticoagulant, such as warfarin (Agrawal et al., 2022).
Patient/Family Teaching: § Advise patient to take apixaban as directed, even if feeling well. § Advise the patient to take a missed dose as soon as possible on the same day. § Educate the patient on signs of bleeding and other side effects. § Advise the patient to take a missed dose as soon as possible on the same day. § Advise the patient to resume taking medication twice daily after a missed dose. § Advise the patient against doubling the dose when there is a missed dose. § If the patient cannot swallow, advise the patient to crush the tablet and suspend it in water (Agrawal et al., 2022). § Advise the patient to take the medication with or without food. § Advise patients to disclose their medication history if they visit a different healthcare provider. § Advise the patient to look for signs of hypersensitivity, such as rashes. § Advise pati Order a similar paper |