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What is the major payer in home health nursing?
Medicare
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Medicare Homecare Criteria
- Homebound
- Plan of care
- Skilled Need
- Intermittent and Part-time (limited frequency and duration)
- Reasonable/Necessary (improving...NOT stable, no change, chronic conditions)
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Medicare hospice benefit is for patients with a _______ month prognosis
6 months
Typically diagnosed with: CHF, Cancer, COPD
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A nurse in an outpatient clinic arranges a referral for home nursing for a patient seen in the clinic who
A) Has severe multiple sclerosis with an open decubitis ulcer
- A - skilled need and homebound
- B - needs a hospital
- C/D - nothing says needs can't be met in a clinical
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When documenting a home visit which of the following statement supports continued eligibility for Medicare reimbursement?
A) PICC dressing changed. No erythema or discharge. Wife demonstrates correct technique to flush line and administer infuesion
- A - Not homebound
- C - Stable
- D - Making progress toward goal but still in need
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HIV Risk factors
- Unprotected sexual contact (anal, vaginal, oral)
- Blood exposure
- Birth mother with risks
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What is the most important factor of the maternal-fetus transmission rate?
Maternal viral load
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What is the gold standard for HIV testing?
(ELISA is run twice and western blot to confirm)
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Why is drug adherence critical?
Resistance to it
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What is the importance of HLA-B*5701 testing?
Associated to hypersensitivity to abacavir
(If positive = NO abacavir)
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CD4 cell count
What are the numbers for low, medium and high risk for opportunistic infections?
- Low > 500
- Medium 500-350
- High < 350
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A combination of 3 or more potent antiretroviral agents is:
- HAART
- (prevents HIV replication)
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Antiretroviral Medications
Side effects:
- Fat redistribution
- Hypercholesteremia, Hyperlipidemia
- Diabetes
- Lactic acidosis
- Osteoporosis
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ACDEFGHI of Prevention:
- Antiretroviral therapy
- Circumcision, Counseling
- Diaphragm
- Exposure prophylaxis
- Female controlled microbicides
- Genital tract infection (STI) control
- HSV-2 suppressive treatment
- Immunization
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