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However to cheap vfend 200 mg without a prescription avoid cardiac and skeletal muscle weakness and respiratory depression due to vfend 200mg line hypophosphatemia order 200 mg vfend mastercard, careful phosphate administration may be indicated in patients with cardiac dysfunction cheap vfend 200 mg visa, anemia or respiratory depression and 6 in those with serum phosphate level <0. Magnesium: Magnesium replacement has not been shown to be beneficial so only consider if the patient has symptomatic hypomagnesaemia or has symptomatic or significant hypocalcaemia. This is indicated by the patient being mentally alert, serum osmolality < 315mosmol/L and they are able to eat normally. Antibiotic Therapy: An infective source should be sought on clinical history and examination. Anitibiotics should be given when there are clinical signs of infection or imaging / laboratory results suggest its presence. Clinically cerebral edema is characterised by deterioration in the level of consciousness, with lethargy, decrease in arousal and headache. Neurological deterioration may be rapid with seizures, pupilllary changes, bradycardia and respiratory arrest. The elderly and those with impaired cardiac function are particularly at risk and fluid resuscitation should be carefully monitored in these patients using advanced hemodynamic monitoring. These are two life threatening complications that can be prevented by close monitoring of potassium levels. Kearney, T & Dang C 2007, Diabetic and endocrine emergencies, Postgrad Med J, 83:79 86 5. Joint British Diabetes Societies Inpatient Care Group 2013, the Management of Diabetic Ketoacidosis in adults, accessed from. Insulin + K is achieve remaining replacement of fluid management as per above 60mins – 6 hours. Excipients with known effect Lyrica 25 mg hard capsules Each hard capsule also contains 35 mg lactose monohydrate. Lyrica 50 mg hard capsules Each hard capsule also contains 70 mg lactose monohydrate. Lyrica 100 mg hard capsules Each hard capsule also contains 11 mg lactose monohydrate. Lyrica 200 mg hard capsules Each hard capsule also contains 22 mg lactose monohydrate. Lyrica 300 mg hard capsules Each hard capsule also contains 33 mg lactose monohydrate. Epilepsy Lyrica is indicated as adjunctive therapy in adults with partial seizures with or without secondary generalisation. Neuropathic pain Pregabalin treatment can be started at a dose of 150 mg per day given as two or three divided doses. Based on individual patient response and tolerability, the dose may be increased to 300 mg per day after an interval of 3 to 7 days, and if needed, to a maximum dose of 600 mg per day after an additional 7-day interval. Epilepsy Pregabalin treatment can be started with a dose of 150 mg per day given as two or three divided doses. Generalised anxiety disorder the dose range is 150 to 600 mg per day given as two or three divided doses. Based on individual patient response and tolerability, the dose may be increased to 300 mg per day after 1 week. Discontinuation of pregabalin In accordance with current clinical practice, if pregabalin has to be discontinued, it is recommended this should be done gradually over a minimum of 1 week independent of the indication (see sections 4. As pregabalin clearance is directly proportional to creatinine clearance (see section 5. For patients receiving haemodialysis, the pregabalin daily dose should be adjusted based on renal function. Elderly Elderly patients may require a dose reduction of pregabalin due to a decreased renal function (see section 5. Pregabalin should be discontinued immediately if symptoms of angioedema, such as facial, perioral, or upper airway swelling occur. Dizziness, somnolence, loss of consciousness, confusion and mental impairment Pregabalin treatment has been associated with dizziness and somnolence, which could increase the occurrence of accidental injury (fall) in the elderly population. In the clinical studies where ophthalmologic testing was conducted, the incidence of visual acuity reduction and visual field changes was greater in pregabalin-treated patients than in placebo-treated patients; the incidence of fundoscopic changes was greater in placebo-treated patients (see section 5. Renal failure Cases of renal failure have been reported and in some cases discontinuation of pregabalin did show reversibility of this adverse reaction. Withdrawal of concomitant anti-epileptic medicinal products There are insufficient data for the withdrawal of concomitant anti-epileptic medicinal products, once seizure control with pregabalin in the add-on situation has been reached, in order to reach monotherapy on pregabalin. The following events have been mentioned: insomnia, headache, nausea, anxiety, diarrhoea, flu syndrome, nervousness, depression, pain, convulsion, hyperhidrosis and dizziness, suggestive of physical dependence. Convulsions, including status epilepticus and grand mal convulsions, may occur during pregabalin use or shortly after discontinuing pregabalin. Congestive heart failure There have been postmarketing reports of congestive heart failure in some patients receiving pregabalin. These reactions are mostly seen in elderly cardiovascular compromised patients during pregabalin treatment for a neuropathic indication. This may be attributed to an additive effect due to concomitant medicinal products. A meta-analysis of randomised placebo controlled studies of anti-epileptic drugs has also shown a small increased risk of suicidal ideation and behaviour. Patients (and caregivers of patients) should be advised to seek medical advice should signs of suicidal ideation or behaviour emerge. When pregabalin and opioids will be used in combination, measures to prevent constipation may be considered (especially in female patients and elderly). Misuse, abuse potential or dependence Cases of misuse, abuse and dependence have been reported.

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Restriction of sodium vfend 200 mg amex, potassium and phosphorus Considerations for insulin and/or insulin intakes should be considered on an individual basis based secretagogue users on the results of laboratory tests cheap vfend 200mg otc. Although registered dietitians cannot order diabetes medications for people with diabetes order 200mg vfend with mastercard, they remain inte Recommendations gral in the decision of which agent/regimen may be best • Diabetic nephropathy should be managed by limit suited for the eating habits and lifestyle of people with ing protein intake to generic vfend 200 mg 0. Carbohydrate counting these individuals should be taught to recognize the early Carbohydrate counting can aid the person with diabetes symptoms of hypoglycemia and to treat this immediately in achieving better blood glucose control while providing with at least 10–15 g of carbohydrate. In the Diabetes treatment with carbohydrate until the symptoms of hypo Control and Complications Trial, participants with a glycemia disappear often results in extreme hyperglycemia consistent carbohydrate intake generally found it easier to prior to the next meal. Ideally,a capillary blood glucose test attain target blood glucose than those who ate carbohy should be done before consuming carbohydrate to confirm drate inconsistently (119,125). However, since the focus is a low blood glucose level exists and 10–20 minutes after on carbohydrate, care must be taken to help the persons eating to confirm treatment was appropriate. In the Hypoglycemia may occur immediately after or during future, more insulin analogues, both fast and slow-acting, meals in individuals using regular insulin or fast-acting will likely be available. As well, new insulin secretagogues insulin analogues who have started the meal with their are expected to be available in the near future. In this instance, dietitians and other diabetes health care team members glucose administered against the mucosal lining of the need to educate themselves continually regarding the mouth may be the most effective method of treatment. To actions of these new medicines and possible effects on help avoid such an incident, fast-acting analogue insulin lifestyle that these medicines may have. Registered dietitians users should be reminded to eat immediately or no later unfamiliar with diabetes medications and management than 15 minutes after injection of insulin (120). People strategies are encouraged to contact diabetes educators with frequent hypoglycemic episodes of this nature, which who have expertise in this area. Of interest, those on Recommendations a fast-acting analogue may experience less hypoglycemia • the registered dietitian should work with the compared to those on regular insulin (121). However, used in combination with insulin and/or an • All insulin and insulin secretagogue users, their families insulin secretagogues, the risk of hypoglycemia exists. Low and support persons should be instructed on how to blood glucose in insulin and/or insulin secretagogue users prevent, recognize and treat low blood glucose. Weight • Care should be taken to ensure those instructed to use Weight often increases in people newly started on carbohydrate counting for blood glucose control are insulin and those with previous poor control who are also instructed on the basics of healthy eating and attempting to achieve better control. The registered dietitian is a key Guidelines for Healthy Eating and Recommended Strategies for member in assisting the individual in reaching these goals. Ottawa: Minister of Supply and Services Canada; Attaining and maintaining blood glucose and lipid levels 1990. The effect of intensive insulin diabetes-related complications and any concomitant con treatment of diabetes on the development and progression of ditions is vital to maintaining the physiological health of long-term complications in insulin-dependent diabetes mellitus. The com Government Publications Centre; 1990: Cat No H49 ments from members of the Clinical and Scientific Section 42/1990E. Source and amount of carbohydrate affect postprandial glucose and insulin in normal subjects. Effects of soy protein on glycemic index improves dietary profile and metabolic control in renal function and proteinuria in patients with type 2 diabetes. Effect on serum administration of maltitol on plasma glucose,plasma sorbitol,and lipids of very high fiber intakes in diets low in saturated fat serum insulin levels in man. Dietary Fiber in Health large study to evaluate the renal and cardiovascular effects of an & Disease. Elevated intakes intake and the progressive nature of kidney disease: the role of of supplemental chromium improve glucose and insulin hemodynamically mediated glomerular injury in the pathogen variables in individuals with type 2 diabetes. The prevention and treatment female adolescents with insulin dependent diabetes mellitus. Canada’s Physical Activity Guide to Healthy Active tional insulin undertreatment in adolescent females with Living. Ethnic minorities, health care of spreading the nutrient load: effects of increased meal fre systems, and behavior. Vegetarian diet: relevance in renal the diets of Siberian Chukotka and Alaska Native adults and disease. Mealtime treatment of overweight and obesity in adults: executive treatment with insulin analog improves postprandial hyper summary. Intensive insulin therapy and weight gain intermittent very-low-calorie diet improve clinical outcome Effects of a behavioral the Diabetes Control and Complications Trial: implication for weight loss program stressing calorie restriction versus calorie clinical practice. National High Blood Pressure Education Program Working care group of the Multiple Risk Factor Intervention Trial. Physical fitness and blood pressure (meta-analysis); impaired glucose tolerance in the Pima Indians. High blood glucose tion on blood pressure, renin, aldosterone, catecholamines, concentration is a risk factor for mortality in middle-aged cholesterols, and triglyceride: a meta-analysis. Effects of chronic and acute protein administration on renal function in patients with chronic renal insufficiency. Comparison of a vegetable-based (soya) and an animal-based low-protein diet in predialysis chronic renal failure patients. This chart relies on current evidence, especially from randomized controlled trials that have evaluated patient oriented outcomes. Direct Individualize approach comparisons between agents have not been done so one is left to evaluate each drug for its relative advantages & disadvantages.

In recent years discount vfend 200mg with amex, an increasing trend in the se topical corticoseroids and is available as ointment and roidal disorders has been observed due to buy discount vfend 200 mg the sysemic lotion 0 vfend 200mg for sale. The frequency of corticoseroid use is at leas this drug is slower than other topical corticoseroids; twice a day and should not be used for longer than 2 therefore buy vfend 200mg cheap, its repeated prescription leads to accumula weeks. Corticoseroids can cause irreparable side ef tion of the drug in the skin and can prolong the duration fects in terms of their form and percentage of the drug of its efect, exacerbation of side efects, and increased (Merrill 2015; Klunk, Domingues & Wiss 2014). Generally it is not suitable for children and should not be used more than once a Hydrocortisone ointment acts as an anti-infammatory day (Jungersed et al. It mus be applied be added when there is a suspicion of bacterial infec to the skin immediately if it is used simultaneously tion. These drugs are usually used 2-3 times a day and with other types of burn creams; however, short-term should not be used longer than 10 days. If no improve use of this drug does not usually have a specifc com ment occurs, oral antibiotics which are efective agains plication (Rasu et al. In children over 2 years of saphylococci (cephalexin) and sreptococci (penicillin age, it should not be used more than 2 times a day and macrolides for those allergic to penicillin) are recom longer than 7-10 days unless prescribed by a physician. When saphylococcus is resis Its dose in children younger than 2 years has not been tant to penicillin, treatment with triamcinolone, sul determined yet (McQuesion 2011). Number 1 Client-Centered Nursing Care Retapamulin is categorized with clindamycin and tions (Bodin, Godoy & Philips 2015). It afects immediately infants (<1500 g), although fuconazole is preferable in with low doses (Dhingra, Parakh & Ramachandran such cases (Ban & Tan 2010). Side efects side efects during topical use include burning, itching, occur rarely and more often in the form of irritation. The duration of treatment is 7-10 days and several times a day, which is Bacitracin (polysoprin) is a bactericide antibiotic with reduced to twice daily in combination with triamcino limited activity and little topical absorption, and is used lone (Liu et al. It is often used in combination drug used in the treatment of various types of fungal with other topical agents (Schwartz & Mutairi 2010). Clotrimazole sops fungus growth by pre It does not generate serious side efects and has no sys venting cell proliferation, but could also be fatal for the temic absorption, but some cases of severe dermatitis fungus due to the amount of usage (Crowley & Gal have been reported. Side efects of Clotrimazole are very day until complete recovery (Weinberg & Tyring 2010). The antifungal efect of Clotrimazole is more than nysatin and it is not recommended for children under Mupirocin is an efective topical antibiotic agains the age of two (Hoeger, Stark & Jos 2010). In children over one ing concerns regarding drug resisance, use of longer month old, nysatin can be a good alternative. Common side efects include contact dermatitis with anticoagulant drugs (Segura-Bedmar, Martinez (O’Dennell, Gelone & Safdar 2014), pruritus and rash & Pablo-Sanchez 2011). Long-term use drug is prescribed in the diaper area for children over may lead to the increase of fungal growth (Kharazmi et 4 weeks after each diaper change for up to 7 days. The mechanism of mupirocin action is difer safety of the drug in children under one year old is un ent from other antibiotics and it works by sopping the clear. Preventive use may lead to drug resisance (Rai protein to the bacteria which usually causes the death et al. Antifungals Ketoconazole and econazole nitrate are both anti fungal imidazole, which are now used less due to the Over the pas two decades, fungal infections have replacement by more efective and safer treatments signifcantly increased (Qian et al. It is worth mentioning that remarkable advances in diagnosic methods and anti the gel form of this drug has a remarkable potential for fungal drug research over the pas 10 years, the prob treatment as a topical agent due to controlled release lem of early diagnosis is a major challenge due to the of the drug, better antifungal activity, and good sorage complexity of the patients’ clinical profles and conse sability (Verma & Pathak 2012). Potential side efects of antifungal drugs are Ciclopirox is an antifungal topical drug with antimi allergic reactions such as burning and itchy sensation crobial activity. Itching and burning prevention and treatment of yeas-derived skin infec have been reported after topical use of this drug. Number 1 blind sudies have demonsrated that it is more efective It also has a protective efect agains infammation in than clotrimazole and has the same general profle and the diaper area by reducing skin hydration. The dosage is usually Other drugs 1-2 times a day depending on the needs of the child and the doctor’s preference (Rai et al. N is a combination of triamcinolone (corticoseroid), nysatin (antifungal), and neomycin Petrolatum (petroleum jelly, parafn gel) is a non (antibacterial). This drug has less skin metabolism, and odorous combination of refned semi-solid hydrocar therefore the sysemic absorption of the drug is rela bons used in many primary bases of children creams tively high, resulting in a high probability of sysemic and lotions. It is usually used twice wound healing properties, and is considered as one of a day, and the use of this combination is only jusifable the mos common preventive and therapeutic agents in for short-term treatment (less than two weeks) of skin in diaper dermatitis (Speight 2014). It also has medium fammation associated with bacterial infection or candi risk safety rating. Sensitization and skin thinning are not unexpect Pharmacis, petrolatum deprives skin of water and oxy ed after prolonged use (Al-Faraidy & Al-Natour 2010). It is usually used as an obsructive barrier in the preparation of topical agents Zinc oxide has nearly zero solubility in water and mild used for the skin (Panahi et al. This ointment acts as a physical barrier to water absorption, and by inhibiting Herbal medicines the adhesion and penetration of microorganisms, reduc es bacterial infections in mild dermatitis (Gupta et al. Zinc oxide ointment a long hisory in many parts of the world; however, their 5% can be used to reduce the symptoms of diarrhea composition, oxidation, light sensitivity and biological induced diaper dermatitis (Bae et al. The use of medicinal plants as antibacterial and combination with potassium and it is used as a topical anti-infammatory drugs is common in Iranian general treatment for dermatitis in children in combination with medicine, and no signifcant adverse efects have been glycerin (Del val, kontoravdi & Nagy 2010). In Ointment for vitamins (A, D, D3) contains the mos mos cases, the treatment duration is 7-10 days at leas 3 essential vitamins needed for the skin and is used as a times a day or after each diaper change when necessary preventive and therapeutic agent for skin protection and and according to the doctor’s preferences (Panahi et al. It has moisurizing, antimicrobial, and anti Calendula irritation properties with little fat. It is well absorbed and easily washed of and available in 30 g tubes ointment Calendula ointment is a non-seroidal anti-infam and cream.

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A6436 Obstruction in Patients with Symptomatic Asthma buy cheap vfend 200mg online, Independent of Body Mass Index Score/S generic vfend 200mg visa. A6437 and Decreases Inflammation by 2 Weeks After Treatment Initiation in Patients with Uncontrolled Persistent Asthma/A purchase vfend 200 mg with mastercard. A6438 P1263 Safety and Tolerability of Once-Daily Tiotropium RespimatAr P69 the Development of a Novel ProteaseTag Immunoassay for Add-On Therapy in African-American Patients with the Detection and Quantification of Active Plasmin/D order vfend 200 mg mastercard. Vestbo, Parma, Italy, A6448 the information contained in this program is up to date as of March 9, 2017. A6462 Anti-Inflammatory/Anti-Fibrotic Compound, Reduces Pulmonary Emphysema and Cutaneous Hyperplasia in Facilitator: M. A6468 the information contained in this program is up to date as of March 9, 2017. Discussion: 11:15-12:00: authors will be present for individual discussion Mathews, J. A6485 12:00-1:00: authors will be present for discussion with assigned facilitators P1050 How Do Severe Chronic Obstructive Pumonary Disease Patients at Stable State After Exacerbation Sleep and Breathe Facilitator: M. A6476 P1053 Inspiratory to Expiratory Ventricular Volume Changes in Smokers and Their Relationship to Emphysema/E. A6477 the information contained in this program is up to date as of March 9, 2017. A6504 Persistent Asthma Before and After Undergoing Bronchial Thermoplasty: A Pilot Study/A. A6496 Density Measures: Role of Quality Control Measures in Assuring Measurement Reliability. A6507 Best Performance During Long-Term Treatment of Severe P1519 the Cluster Analysis of Elastase-Induced Emphysema in Mice Asthma/P. A6509 the information contained in this program is up to date as of March 9, 2017. Zulueta, P1522 Airway Wall Thickness Measured in Small Airways In Vivo Pamplona, Spain, p. A6514 Area H, Hall B-C (Middle Building, Lower Level) P1526 Imaging Feature Reduction and Optimization: Refinement of a Lung Nodule Computer Aided Diagnosis Tool/J. A6515 Discussion: 11:15-12:00: authors will be present for individual discussion P1527 Development of A Lung Cancer Pig Model: Non-Invasive 12:00-1:00: authors will be present for discussion with assigned facilitators Characterization with Computed Tomography/E. A6517 P843 Wait Times from Diagnosis to Treatment of Obstructive Sleep P1529 Ultrasound as a Noninvasive Tool to Diagnose Trapped Apnea in Ontario: A Population-Based Cohort Study/M. A6519 P844 Profile of Continuous Positive Airway Pressure Treated Patients P1531 Analysis of Radioaerosol Distribution from Pulmonary 2D in Ontario, Canada, 2006-2013: A Population-Based Cohort Scintigraphy Using Anatomical 3D Information/L. A7681 the information contained in this program is up to date as of March 9, 2017. A6534 Airway Pressure Therapy in Coronary Artery Disease Patients with Non-Sleepy and Sleepy Obstructive Sleep Apnea/F. Balachandran, P853 Maternal Sleep Disordered Breathing Potentially Fatal for the S. P865 Quality of Life Challenges in Sleep Apnea Experience of Discussion: 11:15-12:00: authors will be present for individual discussion Sleep Laboratory from Cluj-Napoca, Romania/D. A6547 P866 High Health Literacy Demands of Patient Education Materials Facilitators: J. A6551 the information contained in this program is up to date as of March 9, 2017. A6564 Area H, Hall B-C (Middle Building, Lower Level) Viewing: Posters will be on display for entire session. Discussion: 11:15-12:00: authors will be present for individual discussion Worsley, D. A6565 12:00-1:00: authors will be present for discussion with assigned facilitators Facilitators: S. A6556 P193 Bilateral Multiple Sclerosing Hemangioma: A Clinical and Imagistic Diagnostic Challenge/D. A6557 P194 Incidental Thyroid Cancer Found Post Pneumonectomy for Lung Adenocarcinoma: A Case Report/C. A6568 P878 Changes in Body Mass Index and Automatic Continuous Positive Airway Pressure Requirements in Obstructive Sleep P196 A Rare Case of Papillary Endobronchial Squamous Cell Apnea: A Retrospective Longitudinal Analysis/E. A6571 the information contained in this program is up to date as of March 9, 2017. A6590 P201 An Unusual Presentation of a Common Disease: Lung Cancer Presenting as Persistent Eye Pain/B. A6591 P202 Typical Presentation of Atypical Disease: A Case of Angio-Immunoblastic Lymphoma/A. A6578 P222 Primary Cardiac Sarcoma Presenting as Pulmonary P206 Primary Pulmonary Intravascular Large B-Cell Lymphoma: A Embolism/E. A6598 P209 Incidental Finding of Basaloid Squamous Cell Carcinoma of the Thymus During Nuclear Stress Test Using Technetium P226 Unusual Radiographic Appearance of Advanced Lung (99mTc) Sestamibi/A. A6599 P210 Tumor Heterogeneity in Lung Cancer: How High Should Your P227 Differentiating Post-Stereotactic Body Radiation Therapy Suspicion Be A6583 for Better Decision Guidelines During Follow Up of Non-Small Cell Lung Cancer/B. A6587 Area C, Hall B-C (Middle Building, Lower Level) P215 A Rare Case of Cutaneous Melanoma Recurring After 15 Years Viewing: Posters will be on display for entire session.

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To comply with section 16 of the Nursing Homes Act purchase 200 mg vfend, which states: “When a resident moves to generic vfend 200 mg online another nursing home or is admitted as a patient of a regional health authority as defined in the Regional Health Authorities Act vfend 200mg for sale, a summary of the resident’s record relating to generic 200 mg vfend overnight delivery medical diagnosis, treatment, diet and other similar matters shall be sent to that nursing home or regional health authority. The nursing home must ensure that the medical record of a resident shall contain the following: • the date, time and findings of an examination and treatment; and • confirmation in writing of all verbal orders for treatment, medications or other medical procedures. The nursing home must ensure thatalternatives to discharge have been considered and, where appropriate, tried. The nursing home must ensure that the resident /his next of kin or legal representative is kept informed and given an opportunity to participate in the discharge planning and that his or her wishes are taken into consideration. The nursing home must provide a written notice, at least fifteen days, to the resident and to his next of kin or legal representative except where the operator believes, on reasonable grounds, that the immediate discharge of the resident to the custody of another person is necessary for the safety of the resident or of other residents or staff. The written notice must set out a detailed explanation ofthe supporting facts, justifying the nursing home’s decision to discharge the resident. The nursing home is responsible to give the required notice to the resident andto the Director if the resident has no next of kin or legalrepresentative. The nursing home must complete the standard discharge form required by the regulations. To monitor trends regarding safety and identify issues that needs further clarification and/or development of policy/standard. The nursing home reports, within 24 hours of any major incident or accident that affects or may affect the health and safety of the residents or staff, to Nursing Home Services, using the following telephone number 506 457 6983. Adult Protection, Coroner, Public Health or other agencies are notified, as soon as possible, by the nursing home when applicable. Note: the standard does not displace present policies or procedures that exist in nursing homes on risk management (Refer to section 7(l) (e) of the Nursing Home Act, and section 10 of the Regulation 85-187). Expenditure for the comfort and clothing allowance • the Department of Social Development recognizes the resident’s independence in spending their comfort and clothing allowance. Ownership of the Resident’s Comfort and Clothing Allowance • Comfort and clothing allowance is considered part of the resident’s assets. Monitoring and disposal of accumulated allowance upon death • Upon the death of the resident, all monies remaining in the resident’s comfort and clothing account will go towards first paying any outstanding debts owing to the resident’s comfort and clothing account. It should be given either to the resident’s executor or the resident’s representative. The nursing home planning new construction, renovations or alterations to a nursing home with a value of more than ten thousand dollars receives approval from Nursing Home Services • for the conceptual plan before proceeding to detail planning • for the detailed plan before it is submitted to tender • for financial arrangements • before making any legal commitments to the project • before awarding of contract 2. Major interior/exterior renovations/repairs or construction may directly/indirectly affect the daily operation of the nursing home. A modified license is issued during a period of major interior/exterior construction, renovations/repairs or alterations. During the period of construction, renovation or alterations, the nursing home • ensures the plan is implemented • informs the regional liaison officer of any problems occurring 5. Once project is completed, • the nursing home receives an approval from the regional liaison officer before opening or occupying the space. Licence: means a licence issued under section 4 and includes a renewal of a licence. Registered Nurse: Means the holder of a current certificate of registration under the Nurses Act. The nursing home must have a monitoring system in place that uses actual paid worked hours to ensure Section 18 (c) of Regulation 85-187 is being followed. Paid worked hours indicate the number of hours worked by care staff on duty in the nursing home on a 24-hour basis. Any temporary exception to this standard during the implementation of skills mix change must be approved by the Director of Nursing Home Services. Comprehensive Care Plan includes a set of individualized interventions triggered within the domains of function, mental, spiritual and physical health, social, support and service use. The comprehensive care plan shall be completed within 18 days of the admission date. Short-term Stay – an admission for temporary residency in a nursing for the purpose of providing care to a person who has met the criteria for a relief care bed. The Nursing Home shall ensure that policies and procedures are in place for establishing and maintaining care plans. A preliminary care plan shall be developed for each resident and communicated to direct care staff within 24 hours of the resident’s admission to the home. Upon discharge, a Discharge Tracking Only assessment shall be completed, which includes identification information, intake history and discharge components. Data entry into the Momentum system shall be completed within the next seven days. The nursing home shall ensure that the care plan is reviewed and revised when there is a significant change in condition. The comprehensive care plan must identify the resident and must include, at a minimum, the following: a. Any risks the resident may pose to himself or herself, including any risk of falling and interventions to mitigate those risks; b. Any risks the resident may pose to others, including any potential behavioral triggers and safety measures to mitigate those risks; c. The type and level of assistance required related to activities of daily living; d. Known health conditions, including allergies and other conditions of which the nursing home should be aware upon admission, including interventions; f. And, diet orders, including food texture, fluid consistencies and food restrictions.

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