OMSB OMSB_OEN - Omani Examination for Nurses

When an incident such as a patient fall occurs, specific protocols must be followed to ensure proper documentation and quality improvement processes.

Writing the Incident Report Immediately: The nurse should document the incident as soon as possible to ensure accurate details are captured.

Investigating the Root Cause of the Incident: This is essential to prevent future occurrences and improve patient safety. It involves a thorough analysis of the factors that led to the incident.

Writing the Incident Report by the Assigned Nurse: The nurse who witnessed or discovered the incident is typically responsible for documenting it, ensuring first-hand accuracy.

Documenting the Incident Report in Patient's Record: This is incorrect. Incident reports are meant for internal use to track and analyze incidents and should not be included in the patient’s medical record. Including it in the patient's record can potentially compromise confidentiality and affect the patient’s care.

References:

The Joint Commission: Sentinel Event Policy and Procedures

National Patient Safety Foundation: Guidelines for Incident Reporting

Caregiver stress is a significant factor that can lead to the abuse of older adults. Caring for elderly individuals, especially those with complex health needs, can be physically and emotionally demanding, leading to burnout and stress in caregivers. This stress can manifest as abusive behavior towards the elderly. Exploitation, while a form of elder abuse, is not the most common; physical and emotional abuse are more prevalent. Most cases of elder abuse go unreported, and health care providers are mandated to report suspected, not just verified, cases of elder abuse.

Asthma Management:

When a patient does not respond to a single controller medication like Fluticasone (a corticosteroid), a step-up in therapy is often required.

Treatment Strategies:

Chest Physiotherapy and Increased Oral Fluid:Helpful but not primary interventions for improving pulmonary function in asthma.

Intravenous Hydrocortisone:Typically for acute severe exacerbations, not chronic management.

Adding Salmeterol (Long-acting Beta Agonist):Combined with an inhaled corticosteroid (ICS), it can improve asthma control by reducing symptoms and preventing exacerbations.

References:

Global Initiative for Asthma (GINA) guidelines

National Heart, Lung, and Blood Institute (NHLBI)

In this scenario, the nurse is assuming the role of an advocate. Advocacy involves acting on behalf of patients to ensure they receive the necessary services and support. This includes communicating with authorities to improve access to healthcare services, especially in underserved areas like rural communities. By addressing barriers and promoting patients' needs, the nurse helps to ensure equitable access to care and resources.

Diabetes Mellitus and Pregnancy:

Mothers with diabetes mellitus, especially if poorly controlled, have a higher risk of having babies with congenital anomalies.

Common Conditions in Infants:

Congenital Heart Defects (CHDs):These are the most common congenital anomalies seen in babies born to mothers with diabetes. This includes conditions like ventricular septal defect, atrial septal defect, and transposition of the great arteries.

Other Possible Conditions:Although cystic fibrosis, polycystic kidney disease, and developmental dysplasia of the hip can occur in newborns, they are not directly associated with maternal diabetes.

References:

American Diabetes Association (ADA)

Centers for Disease Control and Prevention (CDC)

Macular edema is a complication of non-proliferative diabetic retinopathy. It involves swelling or thickening of the macula due to fluid leakage from blood vessels, leading to vision problems. Non-proliferative diabetic retinopathy is an early stage of diabetic retinopathy where blood vessels in the retina are damaged but do not yet proliferate. Nystagmus, glaucoma, and cataracts are not specificcomplications of non-proliferative diabetic retinopathy. Macular edema is a key concern and requires timely management to prevent vision loss.

Treatment and Contagious Period:

Streptococcal pharyngitis (strep throat) is highly contagious, and patients need to follow specific guidelines to prevent spreading the infection.

Health Instructions:

Full course of therapy:Ensures complete eradication of the bacteria and reduces the risk of complications.

Replace toothbrush:Prevents reinfection from bacteria that may remain on the old toothbrush.

Avoid sharing food:Prevents transmission of the infection to others.

Returning to work:Patients should wait until they are no longer contagious, usually 24 hours after starting antibiotic therapy and being fever-free, before returning to work.

References:

Centers for Disease Control and Prevention (CDC) guidelines on Strep Throat

Mayo Clinic guidelines on Streptococcal Pharyngitis

Phenelzine is a monoamine oxidase inhibitor (MAOI) used to treat major depressive disorder. Patients taking MAOIs must avoid foods high in tyramine to prevent hypertensive crises. Parmesan cheese, beef liver, and raisins are high in tyramine and should be avoided. Garlic, fish, egg yolks, milk, peanuts, tomatoes, black beans, and pears do not typically contain high levels of tyramine and are generally safe to consume while taking MAOIs. The dietary restrictions are crucial to preventing dangerous interactions and maintaining patient safety.

Leg Ulcers Management:

Leg ulcers, especially chronic ones, require specific treatments to promote healing and prevent infection.

Medical Management Options:

Anticoagulant therapy:Typically used for conditions like deep vein thrombosis, not directly for leg ulcers.

Decompression therapy and Positive pressure therapy:Not standard treatments for leg ulcers.

Hyperbaric Oxygenation:This treatment involves breathing pure oxygen in a pressurized environment. It increases oxygen delivery to tissues, promotes healing, reduces inflammation, and fights infection, making it an effective treatment for chronic leg ulcers.

References:

Wound Healing Society guidelines on leg ulcer treatment

National Institutes of Health (NIH) on Hyperbaric Oxygen Therapy