Health History and Medical Information Case Study

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. Health History and Medical Information Case Study
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

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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:

1 Describe the subjective and objective clinical manifestations present in Mrs. J.
2 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?
3 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?
4 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.
5 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.
6 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.

Health History and Medical Information Case Study

 

NURS 8302 Leading Organizations for Quality Improvement Initiatives

Preparation to begin your DNP Project begins with the meeting with an organization to explore a gap in practice or a practice change that you might address as your DNP Project. Preparing for this meeting includes following the instructions in your NURS 8302 course and reviewing the guidelines for your practicum assignment 1. Address the following in a 4–5-page paper using the APA 7 template for writing graduate papers found at https://academicguides.waldenu.edu/writingcenter/templates/general

Introduction

• Identify the organization, location, and participants at the meeting. Indicate the role each person plays in the organization.
• How did you first approach the organization? NURS 8302 Leading Organizations for Quality Improvement Initiatives
• Why did you select this organization?
• Does the organization have akey person for the organization who oversees students doing DNP projects?
• If there is no key person, who represented nursing and/or nursing students at the meeting.
  

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Describe the DNP Project

• Describe exactly what you did toexplain the DNP project process at Walden University.
• What questions did the participants have and how did you respond?
• How did you and the organization identify possible gaps in practice or practice changes that might be addressed by the DNP project.
• Describe the gap or problem and citetwo sources that justify the gap or problem in nursing.
• What approach (clinical practice guideline, staff education, quality improvement initiative) did you discuss to address a practice gap or practice change?
• What questions did the organization representatives have, and what were your responses?
• How does the proposed practice change support positive social change, diversity, equity, and inclusion?

NURS 8302 Leading Organizations for Quality Improvement Initiatives

Social Determinants of Health

According to the Centers for Disease Control and Prevention (2022), “Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life… SDOH are one of three priority areas for Healthy People 2030, along with health equity and health literacy. Healthy People 2030 sets data-driven national objectives in five key areas of SDOH: healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment. Some examples of SDOH included in Healthy People 2030 are safe housing, transportation, and neighborhoods; polluted air and water; and access to nutritious foods and physical health opportunities”.  Social Determinants of Health

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https://www.cdc.gov/about/sdoh/index.html

To Prepare:
* Reflect on the concept of social determinants of health as presented in the resources.
* Contemplate whether digital inclusion or broad band access should be added to the 5 key areas of social determinants of health.
* Using the optional outside resources or other peer reviewed journal articles, consider how electronic health records, mobile health, patient portals, or telemedicine can impact and be impacted by the social determinants of health.

Post?a description of your views on whether or not digital inclusion or broad band access should be added as a key area to the social determinants of health. Be specific and provide examples that support your position. Explain how electronic health records, mobile health, patient portals, or telemedicine can impact and be impacted by the social determinants of health. Support your explanation with the required or optional resources.
Paper Format: APA

Social Determinants of Health

 

Contemporary Issues Teenagers Face Today Assignment

Assessment Description

Research the range of contemporary issues teenagers face today.

In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

Describe the contemporary issue and explain what external stressors are associated with this issue. Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.  Contemporary Issues Teenagers Face Today Assignment

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Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented.  You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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.

Contemporary Issues Teenagers Face Today Assignment