Since the start of the pay-for-performance and the patient protection and affordable care act (aca), there has been intense pressure on the healthcare sector to improve quality of care while reducing expenses, specifically related to pharmacy. the stress has been exacerbated by expensive specialty medications, egregious price increases for some sole-source drug products, and the escalation of generic drug prices. identify the strategic fundamentals of the problem and what mistakes were made in either the planning or implementation of the pay-for-performance and the patient protection/aca.

Explain the pathophysiologic changes that can cause the signs and symptoms associated with common bile duct obstruction.

An african american young adult is admitted to the emergency department in sickle cell crisis with a report of 10/10 pain. the patient is known to several of the nurses and physicians in the department who have labeled the patient as a “drug seeker”. initial discussion post: identify one (1) intervention that can be taken by the rn to reduce the stigma and improve management of acute and chronic pain associated with sickle cell disease. does the intervention apply only to the patient? does it apply only to the interprofessional team? does it apply to both the patient and the members of the interprofessional team? explain and support your answer.

Anurse is reviewing the medical record of a client who is receiving vancomycin daily. the nurse should review which of the following laboratory results prior to administering the next dose? a. blood glucose level b. serum creatinine level c. total iron-binding count d. thyroid-stimulating hormone level