Case Study: Mrs. J. Assignment Essay

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. Case Study: Mrs. J. Assignment Essay

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.

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Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself. Case Study: Mrs. J. Assignment Essay

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. 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.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

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

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, 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.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered. Case Study: Mrs. J. Assignment Essay

You are required to cite to a minimum of two 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. An abstract is not required.

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. Refer to the LopesWrite Technical Support articles for assistance.

Case Study: Mrs. J. Assignment Essay

Assignment: Analysis of a Pertinent Healthcare Issue

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system. Assignment: Analysis of a Pertinent Healthcare Issue

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected. Assignment: Analysis of a Pertinent Healthcare Issue

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To Prepare:

Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.

Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.

Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).

Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.Assignment: Analysis of a Pertinent Healthcare Issue

Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.

Looking Ahead

The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper. Assignment: Analysis of a Pertinent Healthcare Issue

 

Health History and Medical Information

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 know 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 Health History and Medical Information.

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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

1. Temperature: 37.1 degrees C

2. BP 123/78 HR 93 RR 22 Pox 99%

3. Denies pain

4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

1. WBC: 19.2 (1,000/uL)

2. Lymphocytes 6700 (cells/uL)

3. CT Head shows no changes since previous scan

4. Urinalysis positive for moderate amount of leukocytes and cloudy

5. 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:

1. Describe the clinical manifestations present in Mr. M.

1. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.

2. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.

3. 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.

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

5. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each Health History and Medical Information.

RUBRICS:

Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms.

A detailed discussion on what primary and secondary medical diagnoses should be considered for Mr. M. is presented. Strong rationale and reliable data are used to explain why the diagnoses are relevant and should be considered.

A thorough discussion of abnormalities a nurse would expect to find during a nursing assessment is presented. Strong rationale and evidence are provided for support.

A thorough discussion of the effects of the health status on the physical, psychological, and emotional aspects of the patient, and the impact the health status has on the family, is presented. Strong support for the discussion is provided.

All relevant interventions that can be put into place to support Mr. M. and his family are thoroughly discussed.

Four or more actual or potential problems faced by the patient are thoroughly discussed. The posed problems are clearly related to his condition. Strong rationale is provided and supports Health History and Medical Information

Application And Interpretation Of Public Health Data

The chi-square test of independence is used to determine whether two or more samples of cases differ on a nominal level variable. A Pearson correlation is used to determine the relationship between two continuous variables. Both the chi-square test of independence and correlation are widely used in the analysis of public health data.

The purpose of this assignment is to practice calculating and interpreting the Pearson correlation coefficient and a chi-square test of independence. After analyzing the data, communicate the results in a PowerPoint presentation. Refer to the Using and Interpreting Statistics: A Practical Text for the Behavioral, Social, and Health Sciences textbook and instructional videos for assistance completing this assignment Application And Interpretation Of Public Health Data.

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Part 1

Use SPSS and the Topic 2 “Health Behavior Data Set” and complete the following:

1. Conduct a Pearson correlation to determine the relationship between age and annual income.
2. Conduct a chi-square test to determine the relationship between sex and smoking status.
3. Export the SPSS output for the Pearson correlation and chi-square tests.

Part 2

Create an 8-10 slide PowerPoint to discuss the findings for either the chi-square or correlation findings. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end.

Include the following: Application And Interpretation Of Public Health Data

1. Explain why the statistical test is most appropriate for analyzing the data and whether the assumptions were met.
2. What are the null and alternative hypotheses?
3. What is the decision rule?
4. What is the test statistic and p-value?
5. How do you interpret the results? (What was done? What was found? What does it mean? What suggestions are there for the creation of a health promotion intervention?)

General Requirements

Submit the SPSS exported output and the PowerPoint to the dropbox.

APA style is not required, but solid academic writing is expected.

You are required to submit this assignment to LopesWrite.

STUDY MATERIALS

Read Chapters 13 and 15in Using and Interpreting Statistics: A Practical Text for the Behavioral, Social, and Health Sciences.

URL: http://www.gcumedia.com/digital-resources/macmillan-learning/2016/using-and-interpreting-statistics_a-practical-text-for-the-behavioral-social-and-health-sciences_ebook_3e.php

Read “Correlation of Sleep Quality With Physical Activity and Memory Among Young Adults,” by Dubey, Tiwari, and Siddiqui, from Indian Journal of Physiotherapy and Occupational Therapy (2019).

URL:https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135203343&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

Read “The Role of Community-Wide Wearing of Face Mask for Control of Coronavirus Disease 2019 (COVID-19) Epidemic Due to SARS-CoV-2,” by Cheng et al., from Journal of Infection (2020)Application And Interpretation Of Public Health Data.

URL: https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0163445320302358?via%3Dihub

Explore the “Adolescent and School Health” page located on the Centers for Disease Control and Prevention website.

URL: https://www.cdc.gov/healthyyouth/

Utilize topics from the Loom Help Center website for assistance on installing Loom software and software usage.

URL: https://www.gcumedia.com/digital-resources/opentest-inc/2018/loom_1e.php

View “Conducting a Pearson Correlation and Chi-Square Test in SPSS,” by GCU Academics – Nursing (2020). Use this resource to assist you in completing the topic assignment.

URL: https://www.gcumedia.com/lms-resources/student-success-center/? Application And Interpretation Of Public Health Data

NURS6053-WEEK3-REPLY1 Paper

To begin with, competing needs greatly impact the development of policies in organizations all across the country.  The competing needs of workforce and patients are two that I feel are held in high priority.  Policies are put into place to better the patient and the workplace as a whole.  Polices are put into place to make the nurse and healthcare team care for the patients in the most holistic way possible.  Becoming ethically aware is very important because it allows nurses to identify the problems of patients and figure out ways to best treat those patients (Milliken, 2018).  Policies are put into place because of the workforce.  There is a need for policies to set up a standard for healthcare professionals to practice under to ensure that the patients are receiving the best care possible.  By setting up policies for the workforce, we can give the employees guidelines to go by to make sure the job is done effectively and efficiently.  Also, by setting up payment policies that are competitive with other companies, organizations can help to relieve the healthcare issue of nursing shortage.  The policy of raising payment to the employees help to make that organization competitive and alleviate the nursing shortage at that organization.  Nursing shortage greatly impacts patient outcomes and patients’ satisfaction.  The nursing shortage can lead to prolonged wait time for care, prolonged wait time for lab results and increased errors in the healthcare system as a whole (Buerhaus et al. 2005).  NURS6053-WEEK3-REPLY1 Paper

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The needs of patients may be the most important when discussing policies.  There are multiple policies put into place to ensure that the patients receive the most affordable and quality care.  For example, there are certifications, exams, and licensures the healthcare staff must have in order to care for the patients.  These are all put into place for patient safety.  Patient safety is at the forefront of healthcare and will remain at the forefront forever.  These policies impact the nursing shortage because it could place a strain on the nurses and may cause some people to deter away from the profession.  However, these are policies that must be put into place to make sure the patients are receiving safe and effective cares at all times.  With inappropriate nurse-patient ratios and decreased nursing satisfaction comes an increase in negative outcomes for the patients (Peate, 2020).  Yet, all of these certifications and licensure are a must to ensure the nurses are capable and quality healthcare professionals.

In conclusion, there are multiple needs to be considered when discussing implementation of policies.  Healthcare is always changing but the most important thing will always be the patient and that is what should remain of the highest priority. NURS6053-WEEK3-REPLY1 Paper