Clinical Procedure Coding Practice

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Clinical Procedure Coding Practice

(Clinical Procedure Coding Practice)

ICD-PCS Coding

M132 Module 02 Coding Assignment

Find the correct code and explain your rationale for each case study below.

1. Case Study:

PREOPERATIVE DIAGNOSIS:

1. Gangrene right foot.

POSTOPERATIVE DIAGNOSIS:

1. Gangrene right foot.

OPERATION:

1. Right below the knee amputation.

ANESTHESIA: General LMA.

PROCEDURE: The patient was brought to the operative suite where a general LMA anesthesia was induced.

A Foley catheter was inserted. The right foot was s secluded in an isolation bag and the right lower extremity circumferentially prepped and draped in its entirety. Beginning on the right side the skin was marked with a marking pen 4 fingerbreadths below the tibial tuberosity anteriorly with a long posterior flap. The skin was incised circumferentially and the anterior musculature sharply divided exposing the tibia The tibia was cleaned with a periosteal elevator and then transected with the Stryker saw. The fibula was exposed and transected with the bone cutter and the amputation completed by sharply incising the posterior musculature. Bleeding vessels were ligated with 2-0 silk Ligature. There appeared to be adequate bleeding at this level for primary healing. The tibia was then cleaned with a bone rasp and the fibula with a rongeur. The wound was irrigated and ultimately closed without significant tension utilizing interrupted 2-0 vicryl sutures for reapproximation of the fascia and skin staples for reapproximation of the skin.

The right side was dressed with sterile gauze fluff dressings and a Kerlix roll. Estimated blood loss throughout the procedure was approximately 150 mL. The patient received one unit intraoperatively of packed cells because of preoperative anemia. She was transported in stable condition to the recovery room.

2. Case Study:(Clinical Procedure Coding Practice)

PROCEDURE: Open reduction and internal fixation of bilateral tibial plateau fractures.

INDICATIONS: This 23-year old was involved in a serious accident and sustained bilateral tibial plateau fractures

DESCRIPTION OF OPERATION: The patient was brought to the operating room and placed on the operating room table in the supine position. General anesthesia was induced, and after this both lower extremities were prepped and draped in the usual sterile fashion. Attention was first directed towards the left tibial plateau. A standard lateral procedure to reduce the lateral tibial plateau fracture was performed. After a submeniscal arthrotomy was performed, the joint was visualized via the lateral approach. The posterolateral fragments were reduced and the lateral tibial plateau was elevated, restoring the articular surface. K-wires were placed to provisionally hold this reduction. C-arm fluoroscopy was used to confirm good reduction of the joint surface. Next, a 6-hole lateral plateau locking plate from the Stryker sets was selected. This locking plate was advanced down the tibial shaft. Screws were placed to secre the plate to the bone. Four screws were placed in the distal shaft fragments and 4 locking screws in the proximal fragment. A kickstand screw was also placed in the locking mode. After all screws were placed, x-rays exhibited good reduction of the fracture, as well as good placement of all hardware. Next, the wound was thoroughly irrigated with normal saline. The meniscal arthrotomy was closed with the 0 PDS suture, including the capsule. Next, the IT band was closed with 0 Vicryl suture, followed by 2-0 Vicryl sutures for the skin and staples. Attention was then directed toward the right tibial plateau. A similar procedure was performed on the right side. Then, the lateral approach to the lateral tibial plateau was performed, exposing the fracture. The incision was approximately 4 cm on the right side. A 6-hole LISS plate was advanced down the tibial shaft. Four screws were placed in the distal fragments followed by four screws in the locking mode and proximal metaphyseal fragment. Excellent fixation was obtained. The C-arm fluoroscopy was used to confirm excellent reduction of the fracture on both the AP and lateral fluoroscopic images. Next, the wound was thoroughly irrigated and closed in layers. Sterile dressings were applied All wounds were dressed with sterile dressing and the patient was placed into knee immobilizers. The patient was then awakened from anesthesia, and transferred to recovery. The patient will be nonweightbearing for approximately three months on bilateral lower extremities. The patient will receive DVT prophylaxis during this time.

3. Case Study:(Clinical Procedure Coding Practice)

PREOPERATIVE DIAGNOSES:

1. Pelvic pain.

2. History of previous pelvic surgery and ovarian cyst.

POSTOPERATIVE DIAGNOSES:

1. Pelvic pain.

2. History of previous pelvic surgery and ovarian cyst.

OPERATION PERFORMED: Laparoscopic adhesiolysis.

SURGEON: Susan Smith, MD

ANESTHESIA: General endotracheal.

ESTIMATED BLOOD LOSS: Less than 10 mL.

URINE OUTPUT: 70 mL.

IV FLUIDS: 750 mL.

DESCRIPTION OF OPERATION: After informed consent was obtained, the patient was taken to the operating room. She was placed in the dorsal supine position and general anesthesia was induced and prepped and draped in the usual sterile fashion. A Foley catheter was placed to gravity and speculum was placed in the posterior and anterior vagina and the cervix was grasped with a single-toothed tenaculum. A Hulka clamp was then inserted through the cervix into the uterus for uterine manipulations and the tenaculum was removed and attention was then turned to the abdomen.

A supraumbilical incision was made with a scalpel and elevated up with towel clamps. A long Veress needle was then placed and CO2 gas was used to insufflate the abdomen and pelvis. A 10-12 trocar and sleeve were then placed and confirmed via the laparoscope. The dense greater omental adhesions to the anterior abdominal wall were noted immediately. At this time, we were not able to see into the pelvic region. A second 5 mm trocar and sleeve were placed in the left mid quadrant under direct visualization. The ligature device was then placed developing a plane between the omentum and the anterior abdominal wall.

The adhesiolysis took place and it took approximately 25 minutes to release all of the omental adhesions from the anterior abdominal wall. We were then able to visualize the pelvis and a blunt probe was placed through the port. The ovary was visualized and photos were taken with no evidence of any ovarian cyst or ovarian pathology or of pelvic endometriosis. The uterus also appeared normal and the left tube and ovary were surgically absent. The appendix was easily visualized and noted to be noninflamed, normal in appearance, and there were no adhesions in the right lower quadrant. The upper abdominal exam was unremarkable. The procedure was terminated at this time. The ports were removed. CO2 gas was allowed to escape. The incisions were closed with 4-0 Vicryl suture. The Hulka clamp was removed. The vagina was noted to be hemostatic. The patient’s anesthesia was awakened from anesthesia, the Foley catheter was removed, and she was taken in stable condition to the recovery room.

 
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Ethical Conduct

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Ethical Conduct

(Ethical Conduct) Discuss nursing ethics based on the case study.

Ethical Conduct

Nursing Ethics in the Context of a Case Study

Nursing ethics is crucial in ensuring that patient care aligns with moral principles. A recent case study highlights the importance of ethical considerations in nursing. In this case, a nurse faced a dilemma when a terminally ill patient requested assistance in ending their life. This situation presents various ethical challenges, requiring a thorough understanding of nursing ethics to navigate effectively.

Respect for Autonomy

Firstly, respect for autonomy is a fundamental ethical principle in nursing. Autonomy refers to the patient’s right to make decisions about their own health care. In the case study, the patient expressed a clear desire to end their suffering through euthanasia. Therefore, the nurse must respect this wish while considering legal and professional boundaries. To support the patient’s autonomy, the nurse should ensure the patient fully understands their options and the potential consequences of their decision. (Ethical Conduct)

Beneficence and Non-Maleficence

Beneficence and non-maleficence are also critical in nursing ethics. Beneficence involves promoting the patient’s well-being, while non-maleficence means avoiding harm. In the case study, the nurse faces a conflict between these principles. Assisting the patient in ending their life may be seen as promoting well-being by alleviating suffering. However, it also involves causing harm. The nurse must carefully weigh these principles to determine the best course of action.

Legal and Professional Considerations

Legal and professional considerations also play a significant role in nursing ethics. The nurse must adhere to the laws and regulations governing their practice. In many jurisdictions, euthanasia is illegal, and assisting a patient in ending their life could result in severe legal consequences. Moreover, professional codes of ethics, such as the American Nurses Association’s Code of Ethics, provide guidelines for nurses. These codes often emphasize the importance of preserving life and prohibit actions that intentionally cause death. Thus, the nurse must balance ethical principles with legal and professional obligations. (Ethical Conduct)

Communication and Compassion

Effective communication and compassion are essential in addressing ethical dilemmas. The nurse should engage in open, honest conversations with the patient and their family. This approach helps to understand their perspectives and provide emotional support. By listening to the patient’s concerns and explaining the ethical and legal constraints, the nurse can build trust and provide compassionate care. Additionally, involving other healthcare professionals, such as physicians and ethicists, can offer valuable insights and support in decision-making.

Ethical Decision-Making Frameworks

Applying ethical decision-making frameworks can guide nurses in resolving complex ethical dilemmas. One such framework is the Four-Box Method, which considers medical indications, patient preferences, quality of life, and contextual features. By systematically evaluating these factors, the nurse can make a well-informed decision. In the case study, this approach could help balance the patient’s desire for euthanasia with the ethical, legal, and professional considerations involved.

Conclusion

Nursing ethics require a careful balance of respecting patient autonomy, promoting well-being, avoiding harm, and adhering to legal and professional standards. In the presented case study, the nurse faces a challenging ethical dilemma when a terminally ill patient requests assistance in ending their life. By applying ethical principles, effective communication, and decision-making frameworks, the nurse can navigate this complex situation. This approach ensures that patient care remains compassionate, ethical, and legally compliant.

References

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

 
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Forensic Analysis and Drug Classification

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Forensic Analysis and Drug Classification

(Forensic Analysis and Drug Classification)

Respond to one of the following:

Option 1: Differentiate between organic and inorganic analysis.  Differentiate between qualitative and quantitative measurement

Option 2: Gas chromatography is one of the basic analysis procedures for the crime lab.  Describe this process and the theory upon which it is based.

Option 3: Describe the Mass Spectrometry process.

Option 4: Describe the X-ray diffraction process.

Option 5: Our text describes five types of microscopes commonly used in forensic analysis.  List them and briefly describe the function of each.

Option 6: Below is a series of twenty-three questions about drugs or drug use. For your original posting, answer one of these questions that has not been answered by anyone else as yet by identifying which question you are answering by number.  There should be enough questions that each of you can answer a separate one.

Following are descriptions of behavior that are characteristic among users of certain classes of drugs. For each description, indicate the class of drug (narcotics, stimulants, and so forth) for which the behavior is most characteristic.

1. slurred speech, slow reaction time, impaired judgment, reduced coordination
2. intense emotional responses, anxiety, altered sensory perceptions
3. alertness, feelings of strength and confidence, rapid speech and movement, decreased appetite
4. drowsiness, intense feelings of well-being, relief from pain

Following are descriptions of behavior that are characteristic among users of certain classes of drugs. Name at least one drug that produces the described effects.

5. slurred speech, slow reaction time, impaired judgment, reduced coordination
6. intense emotional responses, anxiety, altered sensory perceptions
7. alertness, feelings of strength and confidence, rapid speech and movement, decreased appetite
8. drowsiness, intense feelings of well-being, relief from pain

Following are descriptions of hypothetical drugs. According to the Controlled Substances Act, under which drug schedule would each substance be classified?

9. This drug has a high potential for psychological dependence, it currently has accepted medical uses in the United States, and the distributor is not required to report to the U. S. Drug Enforcement Administration.
10. This drug has medical use in the United States, is not limited by manufacturing quotas, and may be exported without a permit.
11. This drug must be stored in a vault or safe, requires separate records keeping, and may be distributed with a prescription.
12. This drug may not be imported or exported without a permit, is subject to manufacturing quotas, and currently has no medical use in the United States.

The figure on page 143 shows a chromatogram of a known mixture of barbiturates. Based on the figure, answer one of the following questions.

13, Which barbiturate detected by the chromatogram had the longest retention time?
14. Which barbiturate had the shortest retention time?
15. What is the approximate retention time of amobarbital?

Do you like having multiple choices from which to select a response, or do you prefer everyone answering the same question? GB

 
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Engineering Industrial Waste Solutions

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Engineering Industrial Waste Solutions

(Engineering Industrial Waste Solutions)
Industrial & Hazardous Waste Management
This unit has assessed engineering principles applicable to industrial and hazardous waste management. Steps were evaluated for an adsorption system design using engineering principles and presenting engineering calculations for waste treatment.

The steps in the lesson were accomplished by the required reading of an article describing laboratory adsorption tests for lead and zinc removal. The lesson used the article’s data combined with engineering principles to design a prototype lead treatment system, and a required article presented a novel method for reducing leather tanning waste.

For this assignment, prepare a PowerPoint presentation that assesses engineering principles applicable to industrial and hazardous waste management by evaluating steps for an adsorption system design using engineering principles and presenting engineering calculations for waste treatment.

Specifically address the following items in your PowerPoint presentation.

  • Provide a title and introduction.
  • Summarize the Durga, Ramesh, Rose, and Muralidharan Required Unit Resources article.
  • List the steps required for design of a prototype adsorption system.
  • From Required Unit Resources, use the Yusuff and Olateju article’s equation (7) for the Radke-Prausnitz isotherm to evaluate qe for a Ce lead concentration of 10 mg/L. Show your calculation.
  • Explain how your value of qe determined from the equation compares to the value in Yusuff and Olateju’s article exhibit 10a. Do you think there is an error in the equation? Explain.
  • In the unit lesson, if the prototype’s wastewater flow is 500 gpd instead of 100 gpd and the influent lead concentration is still 10 mg/L, what would be the lead inflow rate in units of grams per day? Show your calculation.
  • Provide a summary of your PowerPoint information.

Your PowerPoint presentation must be at least 15 slides in length with a title slide and reference slide (title and reference slides do not count toward the minimum slide count). You should utilize at least the two Required Unit Resources: the Durga et al. and the Yusuff and Olateju articles. Ensure you refer to the unit lesson as you are creating your PowerPoint presentation.

Please adhere to APA Style when creating citations and references for this assignment. Do not include slide notes in your presentation. Be sure to use fonts that are large enough to view from a distance. This includes any fonts within images that you use. Be sure to cite and reference all information and images.

 
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OSHA Inspection Legal Procedures

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OSHA Inspection Legal Procedures

(OSHA Inspection Legal Procedures)

OSH 3525, Legal Aspects of Safety and Health 1

Course Learning Outcomes for Unit IV Upon completion of this unit, students should be able to:

6. Outline employer rights and responsibilities following an OSHA inspection. 6.1 Discuss an employer’s options to contest OSHA citations and penalties.

Reading Assignment OSHA’s Field Operations Manual (FOM): Chapter 7: Post-Citation Procedures and Abatement Verification Occupational Safety and Health Administration. (2011). Field Operations Manual. Retrieved from

https://www.osha.gov/OshDoc/Directive_pdf/CPL_02-00-159.pdf

Unit Lesson When an Occupational Safety and Health Administration (OSHA) inspection results in citations and penalties, employers can react in many different ways, including disbelief, anger, and confusion about what is required. However, there are some specific requirements that all employers must follow, and some options that are available under the Act. Employees also have some rights after the inspection is complete and citations and penalties have been issued. Many discussions about what can be done after an inspection has been completed are limited to employers, and the rights of employees are not considered.

The OSHA inspection process is supposed to be transparent to employees. This means that the employer has to post any citations that were issued by OSHA. The citations must be posted in the location where the violation(s) occurred, or nearby, and must remain posted for at least 3 days or until the violation(s) have been abated, whichever is longer. Some employers mistakenly believe that they do not have to post the citation notice if they are going to contest the citations. This belief is incorrect. The citation notice must be posted whether the employer is going to contest the citations or not. These posting requirements are specified in 29 CFR 1903.16. Employers can be further cited and penalized if they fail to post a copy of the original citations. Additionally, any abatement certification documents, abatement plans, progress reports, and a notice of informal conference made by the employer to OSHA

concerning the citations must be posted so employees can see the responses. The Act provides both employers and employees with certain rights after the completion of an inspection. These rights are designed to ensure that both the employer and employee have the ability to contest citations and penalties that they believe are unfair. There are several processes available ranging from informal discussions to formal legal proceedings. The employer may decide to simply accept and abate all the citations and pay the proposed penalties. If the

UNIT IV STUDY GUIDE

(OSHA Inspection Legal Procedures)

Employer Rights and Responsibilities after an OSHA Inspection

(US Dept. of Labor, 2011)

Employer chooses this option, they must complete the abatement prior to the abatement date specified in the Notice of Citations and Penalties and pay the penalty(ies). 29 CFR 1903.20 provides a process for both employers and employees (or their representative) to request an informal conference with the area director, or their representative. An employee may desire to have an informal conference because they believe their safety or health concerns were not adequately addressed by the OSHA inspection. An employer may desire the informal conference because they believe the citations and penalties were too harsh, because they do not understand some part of the citation or penalty, or to highlight some additional information about their health and safety program(s) to the area director that they believe may mitigate the severity of the citations and penalties. In some cases, the area director may agree to reduce the severity and/or amount of the penalty(ies). If this occurs, an informal settlement agreement may be reached and further litigation avoided.​

It should be noted that employees, or their representatives have the right to participate in any informal conference. This is the reason a notice of an informal conference must be posted in or near the area where citations occurred. Many health and safety experts recommend that an employer always request an informal conference after citations and penalties are issued. Employers must remember that the informal conference does not delay the 15 working days that the employer has to file a notice of contest. Therefore, the employer must schedule the informal conference early enough to allow time to file a Notice of Contest, if necessary. If the employer does not file a Notice to Contest within 15 working days, the citation becomes a final order. This means that the area director can no longer change the seriousness of citations or the penalties because they have become final orders.​

The ability of the employer or employee to formally contest citations, penalties, and abatement dates is extremely important for ensuring due process is provided. The contest process means the employer or employee does not have to accept the views of the compliance officer(s) and the area director without any ability to defend themselves or challenge what is perceived as an inadequate or over reactive response to an employee complaint. An employer or employee does not have to contest every citation and penalty. In fact, in most cases, only a portion of the citations and penalties are challenged. Once a formal notice to contest is filed, the case is in litigation and the area director cannot take any additional actions until the case is heard by an administrative law judge (ALJ) assigned to the case.​

There are many federal agencies that use ALJs. The ALJs that hear contested OSHA citations are from the Occupational Safety and Health Review Commission (OSHRC). The OSHRC was created along with OSHA after the Act was passed. It should be noted that the OSHRC is an independent organization, separate from OSHA and the Department of Labor. This separation was by design to make sure there is no undue influence over the OSHRC. This helps ensure the hearings are impartial. We will study the OSHRC and ALJs in more detail in Units VI and VII.​

The Citation and Notification of Penalty document will specify state abatement dates for each citation. The dates are set by the compliance officer performing the inspection based on his/her best estimate of the time required to complete the abatement. Employers have the right to formally petition for an extended abatement date if they believe they will not be able to meet the original date. 29CFR 1903.1 contains specific requirements for filing a Petition for Modification of Abatement Date (PMA).​

The final document OSHA requires for citations is abatement certification. Abatement certification is required for all citations that have become final orders, except “quick-fix” items that were corrected during the inspection. 29CFR 1903.19 contains specific requirements for abatement certifications. The regulation includes some more extensive documentation for more serious violations. The Citation and Notification of Penalty will typically specify which violations require additional certification. The area director may require an abatement plan to be submitted for some violations, especially if the abatement is complicated or may take an extended period of time. The area director may also require the abatement plan to include interim measures to protect employees during the extended abatement process. If an abatement plan is required, the employer may be required to periodically submit progress reports.

OSH 3525, Legal Aspects of Safety and Health 3

(OSHA Inspection Legal Procedures)

UNIT x STUDY GUIDE

Title

References Missling, T. (2011, July 28). US Department of Labor [Digital image]. Retrieved from https://flic.kr/p/afYuLP Occupational Safety and Health Administration. (n.d.). Purpose and scope, 29 CFR § 1903.1. Retrieved from

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9605 Occupational Safety and Health Administration. (n.d.). Posting of citations, 29 CFR § 1903.16. Retrieved from

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9621 Occupational Safety and Health Administration. (n.d.). Abatement verification, 29 CFR § 1903.19. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9624

Occupational Safety and Health Administration. (n.d.). Informal conferences, 29 CFR § 1903.20. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9628

Occupational Safety and Health Administration. (2011). Field Operations Manual. Retrieved from

https://www.osha.gov/OshDoc/Directive_pdf/CPL_02-00-159.pdf

Suggested Reading If you are interested in learning more about inspections and abatement, review the resources below: Occupational Safety and Health Administration. (n.d.). All about Occupational Safety and Health

Administration. Retrieved from https://www.osha.gov/archive/Publications/osha2056.html Occupational Safety and Health Administration. (n.d.). Employer rights and responsibilities following a federal

OSHA inspection. Retrieved from https://www.osha.gov/Publications/osha3000.pdf Occupational Safety and Health Administration. (n.d.). OSHA inspections. Retrieved from

https://www.osha.gov/Publications/osha2098.html Occupational Safety and Health Administration. (n.d.). OSHA’s abatement verification regulation. Retrieved

from https://www.osha.gov/Publications/Abate/abate.html Occupational Safety and Health Administration. (n.d.). Petitions for modification of abatement date. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9619

Learning Activities (Non-Graded) OSHA has a hierarchy of controls that must be used for abatement of hazardous conditions. You can view OSHA’s Hierarchy of Controls at the website below: https://www.osha.gov/dte/grant_materials/fy10/sh-20839-10/hierarchy_of_controls.pdf Review the Hierarchy of Controls, and summarize the different types of abatement techniques that would fit into each category.

 
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Comparative Analysis of Energy

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Comparative Analysis of Energy

(Comparative Analysis of Energy)

Name:

 Date:

 Instructor’s Name:

 Assignment: SCIE211 Phase 4 Lab Report

 Title: Comparative Analysis of Energy

 Instructions: You will write a 1-page lab report using the scientific method.

When your lab report is complete, post it in Submitted Assignment files.

 Part I: Using the lab animation, fill in the data table below to gather your data, and use it to help you generate your hypothesis, outcomes, and analysis.

Energy Source Fuel (Coal)/Uranium Needed (tons) CO2 Emissions
(tons)		 Sulfur Dioxide and Other Emissions (tons) Radioactivity mSv (millisievert) Solid Waste (tons) Accidents
Coal
Nuclear

Part II: Write a 1-page lab report using the following scientific method sections:

  • Purpose
    • State the purpose of the lab.
  • Introduction
    • This is an investigation of what is currently known about the question being asked. Use background information from credible references to write a short summary about concepts in the lab. List and cite references in APA style.
  • Hypothesis/Predicted Outcome
    • A hypothesis is an educated guess. Based on what you have learned and written about in the Introduction, state what you expect to be the results of the lab procedures.
  • Methods
    • Summarize the procedures that you used in the lab. The Methods section should also state clearly how data (numbers) were collected during the lab; this will be reported in the Results/Outcome section.
  • Results/Outcome
    • Provide here any results or data that were generated while doing the lab procedure.
  • Discussion/Analysis
    • In this section, state clearly whether you obtained the expected results, and if the outcome was as expected.
    • Note: You can use the lab data to help you discuss the results and what you learned.

Provide references in APA format. This includes a reference list and in-text citations for references used in the Introduction section.

Give your paper a title and number, and identify each section as specified above. Although the hypothesis will be a 1-sentence answer, the other sections will need to be paragraphs to adequately explain your experiment.

When your lab report is complete, post it in Submitted Assignment files.

 
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Fundamentals of Epidemiology Knowledge

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Fundamentals of Epidemiology Knowledge

(Fundamentals of Epidemiology Knowledge)

Question 1 .

The first step in any epidemiological investigation is to ____.

Answer

understand causation establish risk factors track trends and determine if particular diseases are increasing or decreasing in the population describe the population demographically by age, race, sex, education, and other relevant indicators

Question 2 .

One of the important concepts from the Nuremberg Code is that of ____, which means that the subject understands the scope of the study and can make an informed decision to participate.

Answer

informed consent voluntary consent beneficence primary agent

Question 3 .

A disease or condition that affects a greater than expected (normal) number of individuals within a population, community, or region at the same time is referred to as an ____.

Answer

epidemic endemic outbreak epidemic threshold

Question 4 .

The normal occurrence of a disease or condition common to persons within a localized area is known as a(n) ____.

Answer

transmission pandemic endemic epidemic

Question 5 .

Reproductive health studies ____.

Answer

the role of genetics in disease development the occurrence and risk factors for disease such as cancer, heart disease, and diabetes that are slow to develop but span many years the distribution and risk factors for injuries, either accidental or intentional normal reproductive processes and problems that can occur including infertility, birth defects, and low birth weight

Question 6 .

The course of a disease, if left untreated, is referred to as ____.

Answer

transmission control measure natural history geographic pattern

Question 7 .

Physical, biological, social, cultural, and behaviors that influence health are known as ____.

Answer

risk factors health-related states agents determinants

Question 8 .

James Lind (1716-1794) observed the effect of time, place, weather, and diet on the spread of disease by ____.

Answer

comparing sick persons to well persons applying the germ theory to public health introducing randomization when conducting clinical trials applying the germ theory to hygiene practices

QUestion 9

The aspect of consistency means that ____.

Answer

an increasing amount of exposure increases the risk the association should be compatible with existing theory and knowledge the association is consistent when results are repeated in studies in different settings using different methods the findings agree with currently accepted understanding of pathological processes

QUestion 10

The modern epidemiologic triangle includes groups of populations, causative factors, and ____.

Answer

alternate explanations risk factors results coherence

Question 11

For chronic diseases, the time between exposure and symptoms is called the ____ period, which can range from a few months to many years.

Answer

latency incubation temporal plausibility

Question 12

Risk factors or exposures that we think might affect the outcome are known as ____.

Answer

indirect causes direct causes dependent variables independent variables

QUestion 13

Identifying diseases prior to the clinical stage means that prevention efforts can begin immediately. Because the disease is already present, this is an example of ____ prevention.

Answer

primary secondary tertiary quaternary

QUestion 14 The time between infection and clinical disease is referred to as a(n) ____.

Answer

a plausible period temporal period incubation period latency period

Question 15 .

A proportion measured over a period of time is known as a ____.

Answer

period prevalence prevalence proportion point prevalence rate

Question 16

The representation of a numerator as a fraction of a denominator is known as a(n) ____.

Answer

proportion rate incidence rate specific rate

Question 17 .

Prevalence equals ____.

Answer

incidence times duration of disease incidence divided by duration of disease incidence plus duration of disease incidence divided by duration of disease times 100

Question 18 .

While many people are used to hearing proportions represented as a percentage, many population samples in epidemiology are often presented per ____.

Answer

1,000 10,000 100,000 1,000,000

.Question 19 .

By definition, the disease or condition used to identify a case is determined by the ____.

Answer

hypothesis conclusion prevalence incidence

Question 20 .

A person in the population or study group identified as having the particular disease, health disorder, or condition under investigation is known as a ____.

Answer

person time case suspect case proportion

QUestion 21:

The number of new cases of disease in a specified time (usually one year) divided by the population “at-risk” to develop the disease is known as ____.

Answer

prevalence proportion incidence rate contingency case severity

Question 22 .

The number of existing cases of disease divided by the population is known as ____.

Answer

crude rate person time incidence rate prevalence proportion

Question 23 .

If a bacterium carries several resistance genes, it is called a ____.

Answer

multidrug resistant drug or super-drug multidrug resistant bacterium or superbug resistant bacterium or streptococcus bacterium killer bacterium or deadly bacterium

.Question 24 .

The disease carrier of most concern is known as a(n) ____, which is an infected person who never gets clinically ill, but can transmit the etiologic agent to others.

Answer

healthy or passive carrier pregnant carrier convalescent carrier active carrier

Question 25 .

____ is the transmission of a disease from mother to child during pregnancy or delivery.

Answer

Horizontal transmission Vertical transmission Lateral transmission Polar transmission

Question 26

There is ____ in the overall crude death rate in the United States from the year 1900 until 1996.

Answer

a definite increase a slight decrease hardly any change a clear decline

Question 27 .

The probability of death due to infectious disease in sub-Saharan Africa is ____%, but only ____% in developed countries, such as the United States.

Answer

22; 1.1 35; 10 66; 11 50; 22

Question 28 .

One of the most important emerging problems with the control of infectious diseases has to do with ____.Answer

deadly parasitic infections antibiotic resistant viral infections antibiotic resistant bacterial infections vaccine resistant viral infections

Question 29 .

A(n) ____ is an infected individual capable of transmitting disease during and after clinical disease.

Answer

convalescent carrier passive carrier active carrier inactive carrier

Question 30 . ____ is the transmission of a disease from person to person, and may be directly from one person to another, or indirectly from one person through an intermediate item to another person.

Answer

Horizontal transmission Vertical transmission Quick transmission Polar transmission

 
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Human & Environment Assignments

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Human & Environment Assignments

(Human & Environment Assignments)

Name ________________________ Sec. _________

Chapter 2: The Chemistry of Life

Guided Reading Activity

Module 2.6 pH is a measure of the acidity of a solution.

Answer the following questions as you read the module:

  1. A solution where water is the solvent is called a(n) solution.

  2. Label the diagram with the following terms: hydroxide ion and hydrogen ion.

  3. What are two negative effects of too much acid in nature?

  4. Complete the pH scale with the following terms/phrases: greater H+, lower H+, H+ = OH−.

  5. As the pH increases the [ H+ ] ____, and as the pH decreases the [ H+ ] ____.

A) decreases; increases
B) increases; decreases
C) increases; stays the same
D) decreases; stays the same

  1. Complete the following table regarding acids and bases.

 

Acids Bases
Effect on H+ when dissolved in H2O
pH range
Example

  1. The pH in your cells is dropping. You have buffers to minimize this change in pH. Briefly explain what the buffer would do in this situation with respect to the H+ concentration in your cells.

Guided Reading Activity

Module 2.7 All life on Earth is based on carbon.

Answer the following questions as you read the module:

  1. The element is essential to an organic compound.

  2. What is meant by the term carbon skeleton, and how can carbon skeletons vary?

  3. Is the following molecule an organic compound?

  4. The oxygen atom in ethyl alcohol forms a polar covalent bond with the carbon atom. Does ethyl alcohol readily interact with water? Hint: Revisit module 2.5 if necessary.

  5. Identify any functional groups from the following molecule.

  6. help to determine the overall properties of molecules.

  7. Complete the table that describes the four classes of large biological molecules.

 

Carbohydrates Proteins Lipids Nucleic acids
Example
Function of example

Guided Reading Activity

Module 2.8 Most biological macromolecules are polymers.

Answer the following questions as you read the module:

  1. Much of your mass consists of large biological molecules called .

  2. _________________ is the process by which polymers are broken into monomers.

A) Metabolism
B) Dehydration synthesis
C) Macromolecules
D) Hydrolysis

  1. A common polymer is starch. We break starch down for use as an energy source. Is starch digestion hydrolysis or dehydration synthesis?

  2. Complete the following diagram using the following terms: dehydration synthesis and hydrolysis.

  3. Which of the following best describes the following process: glucose + glucose → maltose + H2O?

A) Polarity
B) Hydrolysis
C) Metabolism
D) Dehydration synthesis

  1. Complete the following diagram illustrating dehydration synthesis and hydrolysis.

  2. is the total of all reactions that take place in your cells.

  3. How are dehydration synthesis and hydrolysis opposites of each other?

Guided Reading Activity

Module 2.9 Carbohydrates are composed of monosaccharides.

Answer the following questions as you read the module:

  1. Which of the following is not a characteristic of carbohydrates?

A) Energy source for animals
B) Inclusion of monosaccharides
C) Use as a structure in plants
D) All of the above

  1. The monomers of carbohydrates are .

  2. Glucose is a monosaccharide. Is glucose also a carbohydrate? Briefly explain your answer.

  3. Glucose and fructose both have the molecular formula C6H12O6, yet they are different molecules. Glucose and fructose are .

  4. Two monosaccharides joined by a dehydration synthesis would form a(n) . List two examples of a disaccharide.

  5. Complete the following illustration regarding monosaccharides and polysaccharides. Glucose is used to construct which polysaccharides?

  6. Complete the following table regarding monosaccharides and polysaccharides.

Human & Environment Assignments

Starch Glucose Cellulose Glycogen
Monomer or polymer
Function

Guided Reading Activity

Module 2.10 Lipids are a diverse group of hydrophobic molecules.

Answer the following questions as you read the module:

  1. The one feature common to all lipids is that they are .

  2. A tanker is carrying crude oil from Alaska to a port in California. During the trip, the ship’s hull is ruptured and it spills the crude oil into the Pacific Ocean. The oil sits on top of the water and does not mix with it. What characteristic must be true about the oil?

  3. A cell’s membrane consists, in large part, of a molecule called a phospholipid. Does a phospholipid “love” or “fear” water? Briefly explain your answer.

  4. Complete the following diagram of a phospholipid.

  5. The two layers of phospholipids that make up a cell’s membrane are arranged so that they are facing tail to tail. What would be the effect of this interior core of phospholipid tails? Hint: Keep in mind what you already know about phospholipid tails.

  6. True or false: Cholesterol is used within the cell to help maintain the structure of the cell’s membrane.

  7. Which of the following is not a lipid?

A) Triglycerides
B) Cholesterol
C) Anabolic steroids
D) All of the above

  1. Are both steroids and triglycerides in your body? If so, give a function performed by each.

Guided Reading Activity

Module 2.11 Your diet contains several different kinds of fats.

Answer the following questions as you read the module:

  1. There are two kinds of triglycerides. What are they?

  2. Which fatty acid tail from the following diagram is saturated? Which one is unsaturated? Briefly explain your answers.

  3. Saturated means that an object can hold no more of something. Briefly explain why the terms saturated and unsaturated are good descriptors for the molecules they describe.

  4. You are a biochemist working for a food manufacturer. You are working to identify a new fat you have discovered in a plant from a rainforest of Brazil. During your investigation, you determine that the fat tends to be a liquid at room temperature, and a biochemical analysis reveals too few hydrogen atoms for the amount of carbon that is present. What kind of fat have you likely discovered?

  5. An unsaturated fat can be turned into a solid or semi-solid state by __________________________.

A) omega-3 fatty acidification
B) hydrophilic
C) hydrogenation
D) unsaturation

  1. Two students are discussing triglycerides. One student tells the other that all fats are bad for your health. The second student disagrees with that statement. Which student is correct? Briefly explain your answer.

Guided Reading Activity

Module 2.12 Proteins perform many of life’s functions.

Answer the following questions as you read the module:

  1. A protein’s determines its function.

  2. _____ are the monomers from which large proteins are constructed.

A) Polymers
B) Amino acids
C) Polypeptides
D) Peptide bonds

  1. Identify the peptide bond in the following illustration.

  2. You are a biochemist working for a pharmaceutical company. You are identifying a new molecule you have isolated from a species of bat. You determine that the molecule contains a carboxylic acid group and a group of atoms that would give the molecule unique hydrophilic properties. The power goes out before you can finish your analysis. Based on what you know so far, what kind of molecule is it? What else might you have learned from it if the power had not gone out?

  3. True or false: Amino acids are joined together through a dehydration synthesis reaction forming a peptide bond.

  4. Complete the table on protein structure.

Human & Environment Assignments

Polypeptide Folded chain Multiple chains
Description

  1. Proteins serve many functions within your body. List three functions served by proteins in your body. Additionally, list a specific protein that performs that function.

  2. Protein shape is crucial to its proper function. Students have difficulty grasping this idea and how changing shape affects function. Briefly explain how the words tasty and nasty can serve as a good analogy for a teacher trying to explain this concept to students.

Guided Reading Activity

Module 2.13 Enzymes speed chemical reactions.

Answer the following questions as you read the module:

  1. A protein that speeds up chemical reactions is a(n) .

  2. True or false: A chemical reaction changes the shape of the enzyme permanently. If false, make it a true statement.

  3. Complete the following diagram regarding enzymes and substrates.

  4. Briefly explain what would happen if you altered the shape of an enzyme’s active site. Remember that an enzyme is a protein.

  5. The amount of energy needed to perform a chemical reaction is the __________________________.

A) activation energy
B) substrate energy
C) active site
D) inhibition site

  1. Complete the following diagram, which illustrates activation energy.

  2. In pole vaulting, the higher the bar is placed, the more difficult it is to clear it. Explain why this is a good analogy to help students understand enzymes and activation energy.

 
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Managing OSHA Compliance Challenges

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Managing OSHA Compliance Challenges

(Managing OSHA Compliance Challenges)

BOS 3525, Legal Aspects of Safety and Health Unit I to Unit VIII Assignment

We received a non-formal complaint recently from one of your current employees. The complaint alleges that employees there are performing welding operations on stainless steel in an area with inadequate ventilation.

This employee also states that they frequently “cough up” black sputum, and that they are worried about the health consequences caused by this lack of ventilation.

The complaint further states that no air sampling has been performed to evaluate the employees’ exposures to welding fumes. And, that when asked for respirators, they were given “dust masks” with one strap, which were purchased at the local hardware store. The effectiveness of these dust masks for the exposure that is present is also in question.

Part 1

Draft a letter in response to the complaint. Your letter should summarize why you believe the complaint is invalid and no on-site inspection is required. Keep in mind, simply stating that the complaint is invalid is not adequate. You must support your opinions in the letter.

Part 2

(Answer the following question on the page 2 of your word document) Answer the questions below in a few sentences.

1. Where does this type of complaint fit on OSHA’s Priority criteria?

2. What factors could have made this complaint non-formal rather than formal?

3. What steps could you take as the employer to identify the employee who filed the complaint? 4. What factors could result in this complaint being reclassified as a formal complaint?

Save both parts of this assignment in one word document to submit for grading.

Unit II Assignment

Discussion Question(Managing OSHA Compliance Challenges)

Question 1

Under what conditions can an employee be denied access to the opening conference, walk-around, and closing conference? Your response should be at least 75 words in length.

Question 2

If the OSHA compliance officer requests documents that are not related to a formal complaint, what options do you believe the employer has? Your response should be at least 75 words in length.

Question 3

If OSHA determines that an employer’s response to a non-formal complaint is adequate, what options does the employee filing the non-formal complaint have? Your response should be at least 75 words in length.

Question 4

Can an employee request that an attorney or union representative attend a private conference with the compliance officer? If the union demands to have a representative present, does the employee have to comply? Your response should be at least 75 words in length.

Unit II Assignment(Managing OSHA Compliance Challenges)

You receive a follow-up call from the area director saying the employee filing the original non-formal complaint has provided additional information about the alleged health situation and submitted a formal complaint using the OSHA-7 form, making the complaint a formal complaint. A few days later, an OSHA compliance officer shows up at your facility to perform a comprehensive inspection. The compliance officer presents the proper credentials, and you verify that the compliance officer is employed by OSHA and assigned to the local office.

During the opening conference, the compliance officer provides you with the formal complaint, alleging that employees are exposed to hazardous concentrations of metal fumes in welding areas of the plant, that you have not performed any air sampling to determine exposure levels, that adequate ventilation is not present in welding areas, and that adequate respiratory protection has not been provided to welders. As a part of the inspection, the compliance officer requests the following documents:

  •  Chemical inventory list;
  •  OSHA 300 logs;
  •  Hazard Communication Program, including training records;
  •  any sampling data that you have;
  •  Respiratory Protection Program, including medical clearance letters and training records;
  •  written hazard assessment for personal protective equipment (PPE) used at the facility;
  •  Safety Data Sheets (SDSs) for the metals you use in the production process and any welding rods/wire used in the welding area; and
  •  any other written programs you have that are required by an OSHA regulation.

The compliance officer takes a walk-through tour of the facility, spending extra time in the welding areas. During the walk-through, the compliance officer points out several issues believed to be apparent violations. The issues are as follows:

  •  Heavy haze is present in the welding area.
  •  Individuals wearing half-mask air-purifying respirators have full beards.
  •  Employees are using chemicals that could be injurious to the eyes, and no emergency eyewash is present.
  •  Eyewash is present in another area of the plant that is covered in dust, and there is no indication of recent operation or inspection.
  •  Employees are using chemicals that could be absorbed through the skin and are not using any gloves.
  •  Employees are performing maintenance inside a press with no lock-out/tag-out applied.
  •  No written lock-out/tag-out program is available at the time of the inspection.
  •  Welding operation is performed near flammable materials, and no fire watch present.
  •  There is no record of training for fork truck drivers.
  •  Extension cords are stretched across walkways.
  •  Three containers are present in the plant with no label present on any of the containers.
  •  An employee could not find a SDS for the chemical he or she was using.

The compliance officer asks for a private conference room and a list of non-managerial employees. He tells you that he intends to interview four non-managerial employees before leaving for the day. He also states that he will return the next day to collect some air samples at the facility.

You are worried about the number of citations and penalties that you may face. Provide a document summarizing the steps you would take as soon as the compliance officer leaves, and the steps you believe you could have taken during the walk-through that may have resulted in a quick-fix penalty reduction.

Your document must be at least three pages in length, not counting the title or reference pages. You must also include at least one reference using appropriate APA style.

Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

Unit III Assignment(Managing OSHA Compliance Challenges)

You receive a document (linked below) by certified mail. After reading the document, prepare a response that summarizes the approach you would take to the citations and penalties that have been proposed. Be sure to include the following in your response:

  •  Steps you are required to take,
  •  Options available to you,
  •  Contacts you would make, and
  •  Documentation necessary to respond to the citations and penalties.

Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited and a reference provide using APA style.  Click here to access the OSHA citation document for this assignment. Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

Unit IV Assignment(Managing OSHA Compliance Challenges)

Based on the Citation and Notification of Penalty letter you received in Unit III, prepare a document that summarizes at least five actions you would take as soon as possible after you reviewed the letter. For each of the actions, you must state the following:

  •  the exact action,
  •  why you believe the action is required for the citations and penalties,
  •  how you believe the actions will assist in responding to the citations and penalties, and
  •  resources you would use to accomplish the action.

You must support your actions with reliable sources. Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited, and a reference must be provided using APA style.

Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

Unit V Assignment(Managing OSHA Compliance Challenges)

You managed to schedule an informal conference with the area director at the regional OSHA office four days after you receive the Notice of Citations and Penalty. Based on the citations and penalties you received in Unit III, prepare a document that lists the citations and penalties you wish to discuss with the area director.

You should summarize what you are trying to accomplish in regard to each citation/penalty you choose, to include:

  •  The information you will use to try and accomplish your goal,
  •  The information you will take with you to the meeting, and
  •  Who will accompany you to the meeting.

You must support your actions with reliable sources. Your grade will be based on your ability to present a case to your professor (serving as the area director) to reduce either the severity of some citations, or the amount of some penalties. If you simply state that you accept the citations and penalties as written, you will receive a minimal score on the assignment.

Your response must be a minimum of two pages in length, not including the title page and reference page. You must use at least one reference in the paper. All sources must be cited in the text and on the reference page, using APA style.

 

Unit VI Assignment(Managing OSHA Compliance Challenges)

You fail to reach an informal settlement agreement with the area director. You file a Notice to Contest within the required 15-day period. Your case is assigned to an administrative law judge (ALJ). Prepare a document summarizing the case you will submit to the ALJ. The document should discuss the following at a minimum:

  •  Which citations and penalties you would contest,
  •  the reasoning behind each contested citation and/or penalty,
  •  Documents you would bring to the hearing,
  •  Individuals you would use at the hearing,
  •  How the case before the ALJ differs from the informal conference,
  •  What information will be presented before the ALJ that was not presented in the informal conference, and
  •  What information you would request from OSHA as part of discovery.

You must support your actions with reliable sources. Your grade will be based on your ability to present a case to your professor, serving as the ALJ, to reduce or vacate either the severity of some citations or the amount of some penalties. If you simply state that you accept the citations and penalties as written, you will receive a minimal score on the assignment.

Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited in the text and on the reference page, using APA style.

Unit VII Assignment(Managing OSHA Compliance Challenges)

Assume that a fatality occurred at your facility one month prior to the OSHA inspection. Review the citations and penalties that were assessed to your facility, and respond to the following questions:

• Which of the citations could be referred to the U.S. DOJ for criminal proceedings?

• What conditions would have to be met before the citations could be referred for criminal proceedings?

• Which individuals working at your facility could face criminal charges under the Act?

• What would be the maximum prison sentence and fines that any individual would face?

• What would be the maximum fine that the company would face?

• If you were facing criminal charges under the Act, what would be your best defense?

• How could you involve the OSHRC in the criminal case(s)?

Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited in the text and on the reference page, using APA style.

Unit 8- Question Answer

1. Summarize the procedures required to achieve Star status under OSHA’s Voluntary Protection Program (VPP).

2. Describe the role that Challenge Administrators play in the OSHA Challenge voluntary cooperative program.

3. Provide your opinion as to which OSHA voluntary cooperative program would be the most beneficial to a small business that prints business cards and letterhead.

4. Discuss the benefits that OSHA alliances provide to employers and workers in general industry.

 
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ENVIROMENTAL SCIENCE- CASE STUDY

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ENVIROMENTAL SCIENCE- CASE STUDY

ENVIROMENTAL SCIENCE- CASE STUDY

Bioaccumulation in Aquatic Ecosystems

Part II

1. What is in some fish and shellfish that has caused the EPA and FDA to issue the restriction?

2. Why is there a restriction for pregnant women and young children, but not the rest of the population?

3. Do pregnant women have to avoid all fish? Explain your answer.

4. Should Amanda have avoided the pan-seared tuna for lunch?

Part III

1. What human actions lead to increased mercury levels in the environment?

2. How does the mercury end up in fish? Draw a flow chart following the mercury path.

3. Where in the United States are mercury wet deposition levels highest? What do you think explains this pattern?

4. The EPA criterion for human health is 0.3 ug/g. Which fish species have average mercury concentrations that exceed the EPA limits?

5. The concern level for piscivorous (fish-eating) mammals is 0.1 Hg ug/g. Which fish species have average mercury concentrations that exceed this limit? Why is the mercury level for piscivorous mammals lower than the level for human health?

6. Should you be concerned about mercury toxicity if you catch and eat a largemouth bass in a local lake? Why or why not?

7. In which samples were mercury concentrations the highest (fi sh, streams, or sediment)? Why do you think this is?

Part IV

1. Draw a food web for Lake Washington using the species and food preferences given in Table 3. Start with phytoplankton (algae) as the base of your web and then build up the food chain.

2. Label the species in your food chain as either high (>100 ug/kg), medium (20-100 ug/kg), or low (below20 ug/kg) mercury concentrations. Which types of animals have the highest levels of mercury? Which types of animals have the lowest? Why do you think this is?

Final Activity

1. Imagine you are Tara. Write an email to your friend Amanda explaining what you have learned about mercury. Be sure to convey the aspects of your learning that will be most useful to Amanda.

2. Find two other examples of compounds that biomagnify. Explain how each compound and/or toxin enters the biosphere and what impacts it has on living organisms in general and humans in particular.

3. Distinguish between bioaccumulation and biomagnifi cation and design a mnemonic device for the distinction.

 
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