Case Study: Mrs. J.

Start Date & Time

Nov 14, 2022, 12:00 AM

Due Date & Time

Nov 20, 2022, 11:59 PM

Status

Active

Rubric

View Rubric

Assessment Traits

Requires Lopeswrite

Assessment Description

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

Is very anxious and asks whether she is going to die.

Denies pain but says she feels like she cannot get enough air.

Says her heart feels like it is "running away."

Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

Height 175 cm; Weight 95.5kg.

Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.

Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.

Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.

Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

IV furosemide (Lasix)

Enalapril (Vasotec)

Metoprolol (Lopressor)

IV morphine sulphate (Morphine)

Inhaled short-acting bronchodilator (ProAir HFA)

Inhaled corticosteroid (Flovent HFA)

Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.'s situation. Include the following:

Describe the subjective and objective clinical manifestations present in Mrs. J.

Describe four cardiovascular conditions in which Mrs. J is at risk, and that may lead to heart failure. What can be done in the form of medical/nursing interventions to prevent the development of heart failure in each of the presented conditions?

By following the nursing process, were the interventions at the time of admissions beneficial for Mrs. J? Would you change any of the interventions to ensure patient independence and prevent readmission?

Explain each of the seven medications listed in the scenario above. Include the classification, the action, and the rationale for each of these. Discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.

Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications. Explain how the rehabilitation resources and modifications will assist the patients' transition to independence and prevent readmission.

 Considering Mrs. J.'s current and long-term tobacco use, discuss what options for smoking cessation should be offered. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. 

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Topic 2 DQ 1

Start Date & Time

Nov 21, 2022, 12:00 AM

Due Date & Time

Nov 23, 2022, 11:59 PM

Status

Upcoming

Assessment Description

Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors. Outline steps for prevention or health promotion for the patient and family.

Topic 2 DQ 2

Start Date & Time

Nov 21, 2022, 12:00 AM

Due Date & Time

Nov 25, 2022, 11:59 PM

Status

Upcoming

Assessment Description

Discuss characteristic findings for a stroke and how it affects the lives of patients and their families. Discuss the nurse's role in supporting the patient's psychological, emotional, and spiritual needs. Provide an example integrating concepts from the "Statement on the Integration of Faith and Work" located in Class Resources.

CLC - Evidence-Based Practice Project: Intervention Presentation on Diabetes Part 1

ssessment Description

This is a Collaborative Learning Community (CLC) assignment.

As a group, identify a research or evidence-based article published within the last 5 years that focuses comprehensively on a specific intervention or new treatment tool for the management of diabetes in adults or children. The article must be relevant to nursing practice. 

Submit a reference and a working link to the article as a word document. 

Case Study: Mr. M.

Assessment Description

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no known allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

Temperature: 37.1 degrees C

BP 123/78 HR 93 RR 22 Pox 99%

Denies pain

Height: 69.5 inches; Weight 87 kg

Laboratory Results

WBC: 19.2 (1,000/uL)

Lymphocytes 6700 (cells/uL)

CT Head shows no changes since previous scan

Urinalysis positive for moderate amount of leukocytes and cloudy

Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.'s situation. Include the following:

Describe the subjective and objective clinical manifestations present in Mr. M.

Based on the information presented in the case scenario, state what primary and secondary medical diagnoses should be considered for Mr. M. Formulate a nursing diagnosis from the medical diagnosis and explain why these should be considered and what data is provided for support.

What abnormalities would you expect to find and why when performing your nursing assessment using the identified primary and secondary medical diagnoses. 

Describe the physical, psychological, and emotional effects Mr. M.'s current health status may have on him. Discuss the impact it can have on his family.

Discuss what interventions can be put into place to support Mr. M. and his family.

Given Mr. M.'s current condition, discuss at least four actual or potential problems he faces. Provide a rationale for each.

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.  

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Topic 3 DQ 1

Assessment Description

Discuss how elimination complexities can affect the lives of patients and their families. Discuss the nurse's role in supporting the patient's psychological, emotional, and spiritual needs. Provide an example integrating concepts from the "Statement on the Integration of Faith and Work" located in Class Resources

Topic 3 DQ 2

Assessment Description

Discuss how functional health patterns help a nurse understand the current and past state of health for a patient. Using a condition or disease associated with an elimination complexity, provide an example. Include the possible pathophysiological causes of the condition or disease.

Case Study: Mr. C.

Requires Lopeswrite

Assessment Description

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

Height: 68 inches; weight 134.5 kg

BP: 172/98, HR 88, RR 26

3+ pitting edema bilateral feet and ankles

Fasting blood glucose: 146 mg/dL

Total cholesterol: 250 mg/dL

Triglycerides: 312 mg/dL

HDL: 30 mg/dL

Serum creatinine 1.8 mg/dL

BUN 32 mg/dl

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.'s potential diagnosis and intervention(s). Include the following:

Describe the subjective and objective clinical manifestations present in Mr. C.

Describe the potential health risks for obesity that are of concern for Mr. C. Explain whether bariatric surgery is an appropriate intervention.

Assess each of Mr. C.'s functional health patterns using the information given. Discuss at least five actual or potential problems you can identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)

Explain the stages of renal disease that leads to end-stage renal disease (ESRD). What factors contributed to Mr. C’s ESRD? 

Consider ESRD prevention and health promotion opportunities. Describe what type of patient education for ESRD should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.

Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Include aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Topic 4 DQ 1

Assessment Description

Discuss characteristic findings of an immune dysfunction. Explain what symptomology the patient would exhibit and how these symptoms may complicate daily living and relationships.

Topic 4 DQ 2

Assessment Description

Discuss what symptoms are associated with hypersensitivity and anaphylaxis. and how the nurse differentiates these from other conditions or issues. What steps should be taken if the nurse suspects anaphylaxis?

Benchmark - Nursing Process: Approach to Care

Assessment Description

The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

Describe the different types of diagnostic methods utilized to identify possibility of cancer. Explain the numeric and Tumor, Node, Metastasized (TNM) method of staging of cancer after the confirmed diagnosis.

Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.

Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.

Explain what the American Cancer Society (ACS) might provide for education and support. What ACS services could a nurse recommend for these patients and why?

Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases demonstrating the delivery of holistic and patient-focused care.

How does an interdisciplinary research approach (which includes liberal arts, science studies, mathematics, social and physical sciences), build on the foundational nursing knowledge related to cancer research?

You are required to cite a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN-BSN

1.1: Incorporate liberal arts and science studies into nursing knowledge.

3.1 Utilize the nursing process to provide safe and effective care for patients across the life span.

Topic 5 DQ 1

Assessment Description

Choose one of the following health dysfunctions: musculoskeletal, metabolic, or multisystem. Describe pathophysiological changes, abnormal findings, and symptoms of the chosen health dysfunction. How does it affect the patient’s functions?  

Topic 5 DQ 2

Explain the modifiable and nonmodifiable risk factors for osteoporosis. How can a nurse support the patient to manage the health condition and restore the patient to optimal health?

CLC - Evidence-Based Practice Project: Intervention Presentation on Diabetes Part 2

This is a Collaborative Learning Community (CLC) assignment.

As a group, identify a research or evidence-based article published within the last 5 years that focuses comprehensively on a specific intervention or new treatment tool for the management of diabetes in adults or children. The article must be relevant to nursing practice.

Create a 12-15 slide PowerPoint presentation (not including the title page and references) on the study's findings and how they can be used by nurses as an intervention. Include speaker notes for each slide and additional slides for the title page and references.

Include the following:

Describe the intervention or treatment tool and the specific patient population used in the article.

Summarize the main idea of the research findings for the specific patient population. The research presented must include clinical findings that are current, thorough, and relevant to diabetes and nursing practice.

Provide a description of how the treatment tool or intervention can be integrated into nursing practice. Provide evidence to support your discussion. Reflect how the  treatment tool or intervention will affect nursing practice and the disease process.

Explain why psychological, cultural, and spiritual aspects are important to consider for a patient who has been diagnosed with diabetes. Describe how support can be offered in these respective areas as part of a plan of care for the patient. Provide examples.

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.