1.) Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-hour observation for mild concussion following a motor vehicle accident. Randy lost consciousness during the accident and was very confused when he arrived in the ER after EMS transport. He is an Iraq war veteran and he seemed to think after the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual problems from a couple of explosive incidents that occurred while he was in Iraq. The physician is unsure whether Randy’s current symptoms are from the car accident or from prior injuries so he has referred him for consultations to both a neurologist and to a behavioral health specialist.Based on the above please discuss the following.Pathophysiology of concussive injuries and treatmentNeurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)Current best practices associated with post-traumatic stress disorder (PTSD)Nursing interventions you would include in this patient’s plan of care2.) What is the impact of Centers for Medicare and Medicaid Services (CMS) payment denial on the healthcare system?What are the implications for our nursing practice related to use of standardized terminology for documentation?How do evidence-based practice guidelines impact patient outcomes and necessitate improved practice care?
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