Nursing Client Report
1200 words client report
Asthma And Stepwise Management
Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To prepare:
· Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients including adults and children.
· Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.
· Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
What to do:
· Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.
· Explain the stepwise approach to asthma treatment and management.
· Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
Please pay attention to drug-drug interactions.
The NLH guidelines for asthma are a good reference.
– This work should have Introduction and conclusion
– This work should have at 4 to 6 current references (Year 2012 and up)
– Use at least 2 references from class Learning Resources
The following Resources are not acceptable:
1. Wikipedia
2. Cdc.gov- nonhealthcare professionals section
3. Webmd.com
4. Mayoclinic.com
Required Readings
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
- Chapter 18, “Otitis Media and Otitis Externa” (pp. 243-252)
This chapter compares the causes and pathophysiology of two common ear infections—otitis media and otitis externa. It also identifies types of drugs used to treat these ear infections. - Chapter 24, “Upper Respiratory Infections” (pp. 259-374)
This chapter explores the causes, pathophysiology, and diagnostic criteria of two upper respiratory infections—the common cold and sinusitis—as well as drug therapy for both infections. It also covers monitoring patient response and patient education of drug therapy for these infections. - Chapter 25, “Asthma” (pp. 377-392)
This chapter examines the causes, pathophysiology, pharmacogenomics, and diagnostic criteria of asthma. It also outlines suggested drug therapy plans for asthmatic patients. - Chapter 26, “Chronic Obstructive Pulmonary Disease” (pp. 395-406)
This chapter explains the causes and pathophysiology of chronic obstructive pulmonary disease (COPD). It also examines the process of selecting, administering, and managing drug therapy for COPD patients. - Chapter 27, “Bronchitis and Pneumonia” (pp. 407-424)
This chapter begins by examining the causes, pathophysiology, and diagnostic criteria of acute bronchitis, chronic bronchitis, and community-acquired pneumonia. It then explores the process of selecting, administering, and managing drug therapy for patients with bronchitis and pneumonia.
Nursing Assessment
1……..A patient is admitted to the unit. He is a diabetic on chronic hemodialysis. He has an Arteriovenous (A-V) graft, which is annulated each time he undergoes dialysis treatments. You notice an area on his graft arm that is red and warm to the touch. He states that he has had this on his arm for several weeks. He asked the dialysis staff about the area, but they told him to apply warm compresses to the site. The staff at the dialysis center continues to use the graft, but they are careful to avoid the area when they cannulate for his treatments. Now the patient presents with extreme low back pain, fever, nausea, and swelling of his lower extremities. On checking his fasting serum glucose, you notice that the reading is 159 (Normal fasting blood glucose range 64 to 110 mg/dl), and his white blood cell count is 36,000 (normal range is 4,500-10,000 white blood cells/mcl). He states that his sugars were normally well controlled, but in the past ten days he seems to be requiring more insulin.
- How would you proceed with this patient?
- What could be the underlying problem?
2……..This patient presents with an AV graft that is red and warm to touch. He probably has cellulitis. Cellulitis is a bacterial infection that can be staphylococcal or streptococcal in nature (Eden, 2014). It is often marked by a reddened skin area that is warm-hot to touch. For this patient, his WBC is already elevated at 36,000, and he now presents with nausea and vomiting, fever, back pain, and lower extremity swelling. What started out as a local infection has now probably spread and become more systemic. I would get a set of vital signs first. It is known that he is febrile; an accurate temperature would be important to know how high it is. It may require an antipyretic, like Tylenol or Ibuprofen. An elevated heart rate would be a normal finding for one with a fever. A low blood pressure would be an indicator of how aggressive the medical staff should respond. This patient could be on the verge of becoming septic; this would need to be ruled out. Additional labs would need to be drawn: Lactic acid ( used as an indicator for sepsis), blood cultures x 2 sets, chemistry panel, with magnesium and phosphorus. This is a renal patient; a baseline evaluation of his renal function and electrolytes would need to be established. A CBC has already been done. This patient would definitely need antibiotics; once the blood cultures are drawn he could be started on a broad spectrum antibiotic. Along with the vital signs, I would get a weight on the patient. This is a renal patient who is presenting with edema to his legs. This could be due to his poor renal function, or it could be due to some other underlying cause. I probably would start the patient on a “gentle” rehydration bolus of IV fluids. Again, this is a renal patient. If this patient has not been feeling well, his oral intake may have been poor and he could have become dehydrated. This patient also complains of pain. A pain assessment would be performed. This patient would also be given analgesic for his pain as well as an anti-emetic for his nausea. Another consideration would be to place a vascular catheter to use until the AV graft could be further assessed for infection. A nephrologist or vascular surgeon would need to be consulted for that. Lastly, this patient’s blood sugars would need to be monitored and treated. It is normal response for a diabetic’s blood sugar to rise during an illness; consequently, his insulin requirements may increase as well.
Week 9 – Chapter 35
Two-week-old Tabitha has infant respiratory distress syndrome. Eighty-year-old Anthony has emphysema, and 50-year-old Jenny has pulmonary fibrosis.
a. Why are the mechanics of breathing greatly compromised in all these cases?
Public Health My First Paper Was On Pre-Diabetes
Respond to the following:
Select a public health evaluation program. You may use the Healthy People 2020 Initiatives, CDC, or select another local, state, or federal program of your choice.
Analyze the selected program by explaining the purpose of the program and background; the goals, measureable objectives, related activities; and the established outcomes for the program.
Examine the funding streams or vehicles for this program.
Explain how the findings of the program evaluation may be used to change a disease or public health issue.
Submission Details:
- Give reasons and examples in support of your responses.
Community Nursing Week 3 Assignment
Research the different nursing care facilities in your community. Discuss the pros and cons of the facility in terms of what they offer. Provide a brief report with the following questions:
• What is the basic rate for room, board, and services (it’s a good idea to get this information in writing)?
• What services are covered by this rate?
• Are there other services available and how much do they cost?
• What are the payment policies?
• What is the refund policy if someone leaves before the end of a month?
• What is the policy for rate increases?
• How long has the current administration been in place?
• Is there enough staff available to meet my needs?
• Is there frequent staff turnover?
• Is some level of nursing care provided (RN, LPN, Nursing
• Assistant)? How often is it available?
• Who will help me with medications if I need it (e.g. reminding me to take them, opening the bottle)?
• Can someone administer medications to me if I can’t take them myself (e.g. applying medication to my skin, putting a pill in my mouth)?
• Can someone help me if I need special care (e.g. caring for a wound)?
• What happens if I have an emergency? Can I get help right away?
• Are staffs suitably dressed, personable, and outgoing?
• Do the staff members treat residents with respect and dignity?
• Do staff members treat each other in a professional manner?
• What language does most of the staff speak?
• What type of help with personal care is available (e.g. bathing, dressing)?
• How flexible is the schedule for receiving help with personal care?
• What, if any, transportation services are available? (e.g. medical appointments, shopping, religious services).
• Will staff arrange for activities (e.g. hair appointment, concert)?
• How does the home support and accommodate personal hobbies?
• Are there regularly planned activities that I will enjoy?
• Will I be able to attend religious services of my choice?
• Can I bring my pet with me when I move?
• When can I have visitors?
• Are there shops, a library, a park, or other amenities within walking distance?
• Is the home close to activities I enjoy?
• Is the home on a bus line?
• Is there an outside area to sit, walk, or garden?
• Are there shops, a library, a park, or other amenities within walking distance?
• Is the home close to activities I enjoy?
• Is the home on a bus line?
• Is there an outside area to sit, walk, or garden?
• Is the floor plan easy to follow?
• Are doorways, hallways, and rooms accommodating to wheelchairs and walkers?
• Are there hand rails to help with walking and in the bathroom?
• Are cupboards and shelves easy to reach?
• Are there nonskid floors and firm carpets to assist walking?
• Does the home have good natural and artificial lighting?
• Is the home clean, free of odors, and well heated and cooled?
• Does the home meet my standards of cleanliness?
• Is the home free from obvious environmental hazards?
• Are the home’s rooms clean, safe, and adequate for my needs?
• Will I have free use of common areas, such as the kitchen, activity rooms, toilet facilities, dining room, or grounds?
• Can I smoke in my room or in common areas?
• What furniture is provided?
• Can I bring along some of my furniture or other personal items?
• Can I adjust the temperature of my room?
• Is there a sit-down shower?
• Can I have my own personal phone line or internet connection?
• Are emergency procedures clearly posted?
• Am I able to lock my room and/or are there locked areas in each room for personal valuables?
• Is the food pleasing, nutritious, adequate, and attractively served?
• What if I don’t like what is being served?
• Can I cook in my room?
• Are snacks available?
• Are there specific meal times or are they flexible?
• Is there a refrigerator available to store my personal food?
• Will the home meet my dietary or cultural food preferences?
• Can I request special foods?
• Do other residents socialize with each other and appear happy and comfortable?
• Do residents speak favorably of the facility?
• Do the residents look like people I want to live with?
• How are room changes and roommate concerns addressed?
• Is there a resident group that meets?
• Do any of the other residents have a history of violent or other problem behaviors? How are these situations handled by staff?
CT 2 Healthcare Information
Create a Power Point Presentation that describes data quality characteristics by researching four articles on data quality. Describe the five common dimensions of data quality and how EHR data is used as a source of longitudinal data for population studies.
Your presentation should meet the following structural requirements:
- Be 7-8 slides in length, not including the cover or reference slides.
- Be formatted according to the APA Writing style.
- Provide support for your statements with in-text citations from a minimum of four (4) scholarly articles. Two (2) of these sources may be from the class readings, textbook, or lectures, but two (2) must be external.
- Presentation notes are required for each slide and should be put in the notes section to support the slide content. These can be part of the presentation or delivered as a separate document. If you opt for the former, be aware that the presentation cannot be submitted in PDF format, which does not make notes visible to the instructor.
- Utilize the following headings to organize the content in your work:
- Introduction
- Assessment
- Recommendations
- Conclusion
TARDINESS AND EFFECTS OF BEING TARDY IN PATIENT CARE AND UNIT FLOW
300 WORD APA STYLE PAPER ON TARDINESS AND THE EFFECTS OF BEING TARDY ON PATIENT CARE AND UNIT FLOW
PLEASE INCLUDE JOURNAL ARTICLE REFERENCE REGARDING TARDINESS AND NURSING
Reflective Journal Week 1
See attached documents for instructions.
How A Bill Becomes A Law
Open the attach below….
We accept
