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Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
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Clearance Models: Noncompartmental Models01:17

Clearance Models: Noncompartmental Models

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Clearance is a pharmacokinetic parameter traditionally defined by compartment models, signifying the rate at which a drug is expelled from the body. However, a noncompartmental model offers an alternative method for assessing clearance, primarily employing empirical data obtained after administering a single drug dose.
The noncompartmental approach capitalizes on extensive sampling data, correlating the volume of distribution to systemic exposure and the administered dosage. This method enables...
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Heart Failure VII: Nursing Interventions01:30

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The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

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Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
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Flail Chest-I01:24

Flail Chest-I

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Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
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Factors Affecting Illness01:18

Factors Affecting Illness

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When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
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Frailty Assessment in an Aging Mouse Model
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CMS Frailty Adjustment Model.

John Kautter, Gregory C Pope

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    Summary
    This summary is machine-generated.

    The Centers for Medicare & Medicaid Services (CMS) developed a frailty adjustment model to better reimburse Medicare managed care organizations (MCOs) for caring for frail, community-dwelling elderly individuals. This model is currently used for specific programs like PACE and may expand in the future.

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    Area of Science:

    • Health economics
    • Geriatric care
    • Public health policy

    Background:

    • Medicare managed care organizations (MCOs) require payment adjustments to account for patient complexity.
    • Frail elderly individuals residing in the community present unique care needs and costs.
    • Existing payment models may not adequately capture the resources required for this population.

    Purpose of the Study:

    • To document the development of the CMS frailty adjustment model.
    • To describe a Medicare payment approach adjusting MCO reimbursements based on enrollee functional impairment.
    • To outline the initial application and future potential of this frailty adjustment model.

    Main Methods:

    • Development of a specific frailty adjustment model by the Centers for Medicare & Medicaid Services (CMS).
    • Focus on functional impairment of community-residing enrollees within MCOs.
    • Application of the model to specialized care programs.

    Main Results:

    • The CMS frailty adjustment model has been developed.
    • This model adjusts payments to MCOs based on the frailty of their community-residing members.
    • The model began application in 2004 for specific organizations.

    Conclusions:

    • The CMS frailty adjustment model provides a mechanism for equitable MCO reimbursement for frail elderly care.
    • Programs like the Program of All-Inclusive Care for the Elderly (PACE) are early adopters.
    • The model's scope may broaden to include more MCOs in the future, improving care for the frail elderly.