Nursing Conference Details

AONE 2014 Annual Meeting CME

Date: March 12-15, 2014
Location: Orlando, Florida 32789, United States
Email: aone@aha.org
URL: http://www.aone.org/conference2014/index.shtml

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Read Article Summaries From Top Medical Journals

1 American organization of nurse executives nurse leader survey: Compensation trends and satisfaction levels The Journal of Nursing Administration, May 13, 2014
2 Conceptualizing clinical nurse leader practice: An interpretive synthesis Journal of Nursing Management, February 9, 2015
3 Nurse leaders' perceptions of the ethical recruitment of study subjects in clinical research Journal of Nursing Management, August 14, 2014
4 Leadership style and patient safety: implications for nurse managers The Journal of Nursing Administration, July 14, 2015
5 Educational gaps and solutions for early-career nurse managers' education and participation in quality improvement The Journal of Nursing Administration, April 2, 2015

Related Quizzes From Smartest Doc

Question:

A disease-specific management strategy improves which outcome among patients hospitalized for chronic, nonvalvular AF?

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Question:

Recall that a gynecologist found a certified registered nurse anesthetist (CRNA) conscious but disoriented in the physicians’ lounge bathroom between surgical cases. The CRNA had appeared well and in his usual state of health during a surgical case 15 mins earlier. The 44-year-old was transported to the ER where these vital signs were measured: T, 40.1oC; BP, 78/40 mmHg; pulse, 140 bpm; and respiration, 30 per min. O2 saturation was 94% on room air; blood glucose, 96 mg/dL. He responded to commands, but was disoriented to place and time.

Physical examination was significant for diffuse petechiae, a rash on the palms of both hands and abdomen, splinter hemorrhages, and splenomegaly. There was a questionable pericardial rub without murmur. He could not provide a medical history, but a CRNA colleague believes he is divorced and lives alone. The colleague thinks he was in good health, but did notice that the patient left a number of tissues with spots of blood in the trash can of the physicians’ lounge bathroom approximately 2 weeks ago.

Fever, hypotension, tachycardia, and tachypnea suggested an infectious process. His state of confusion also may be linked to an infectious process, but it is possible that this is drug-related given his easy access to medications and the reported bloody tissues.

A CBC revealed a hemoglobin of 25 g/dL, an elevated WBC, a platelet count of 88,000, an elevated ESR, and RF was positive. Urinalysis revealed proteinuria and microscopic hematuria. The toxin screen was negative.

Given the strong suspicion of an infectious process, you ordered that 2 sets of blood cultures be performed 30 minutes apart.

The two sets of blood cultures grew Staphylococcus aureus. An echocardiogram revealed an oscillating intra-cardiac mass and vegetations involving the tricuspid valve.

The CRNA’s significant other, while visiting him in the ICU, mentioned to the attending physician that her partner had been abusing IV narcotics for approximately 18 months.

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Question:

A gynecologist finds a certified registered nurse anesthetist (CRNA) conscious but disoriented in the physicians’ lounge bathroom between surgical cases. The CRNA had appeared well and in his usual state of health during a surgical case 15 mins earlier. The 44-year-old is transported to the ER.

In the ER, the CRNA has the following vital signs: T, 40.1oC; BP, 78/40 mmHg; pulse, 140 bpm; and respiration, 30 per min. O2 saturation is 94% on room air; blood glucose, 96 mg/dL. He responds to commands, but is disoriented to place and time.

Physical examination is significant for diffuse petechiae, a rash on the palms of both hands and abdomen, splinter hemorrhages, and splenomegaly. There is a questionable pericardial rub without murmur. He cannot provide a medical history, but a CRNA colleague believes he is divorced and lives alone. The colleague thinks he was in good health, but did notice that the patient left a number of tissues with spots of blood in the trash can of the physicians’ lounge bathroom approximately 2 weeks ago.

Which diagnosis is LEAST likely at this point?

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