Please read the first and second PowerPoint and the summaries an

Please read the first and second PowerPoint and the summaries and write comments like 5-7 sentence for each what do you think on 2 scenarios. First PowerPoint and summary  1- Emergency Departments are always trying to improve their care in order to better serve their communities. It is very important that nurses are able to execute excellent care in a timely manner. The “national recommendation is for an initial electrocardiogram (ECG) to be obtained within 10 minutes of arrival to the emergency department; this is first-line diagnostic testing for patients presenting with symptoms suggestive of myocardial infarction (MI)” (Stanfield, 2018). Time is very important with patients suffering from MI because delay in treatment can cause a lot of tissue damage and lead to death. According to Stanfield, if treatment occurred within 30 minutes there was a chance at reversing the negative effects. The purpose of this project was to determine if training and guideline implementation for the first nurse (nurse stationed in the ED lobby) would improve overall door-to-ECG times.   Reference: Stanfield, L. (2018). Practice Improvement: Improvement of Door-to-Electrocardiogram Time Using the First-Nurse Role in the ED Setting. Journal of Emergency Nursing, 44, 466–471.  2- Second PowerPoint and summary  Hypothyroidism in Women Summary Hypothyroidism is the second most common type of endocrine disorder affecting women at reproductive age. The risk of developing this disease increases with age, during pregnancy, the postpartum period, and menopause. The most common cause of hypothyroidism in the United States is Hashimoto’s thyroiditis, which is 5 to 10 times more likely to occur in women than men. Diagnosing hypothyroidism can be very challenging due to the symptoms being similar to those of depression and increased age. Health history and diagnostic tests such as TSH and T4 are crucial factors to diagnosing hypothyroidism; along with risk factors of, age older than 60 years, type 1 diabetes mellitus or other autoimmune disorders, Graves’ disease, postpartum thyroiditis, turner syndrome and down syndrome, primary pulmonary hypertension, lithium use, family history, amiodarone use, iodine deficiency, radiologic therapy (especially in neck area), multiple sclerosis. There are 3 classifications of hypothyroidism; primary, subclinical, and central, which are differentiated by TSH and T4 levels. If properly treated and TSH level is therapeutic, level on prescribed dosage of levothyroxine will undergo TSH level evaluation at least every 12 months. If left untreated, physical and mental abnormalities, fetal anomalies including physical and mental defects, hyperlipidemia, coronary artery disease, and a life-threatening complication of untreated hypothyroidism called myxedema coma, associated with sever hypothermia, bradycardia, seizures, and decreased cardiac output eventually resulting in a coma can occur.

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