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NRS-410V Pathophysiology and Nursing
NRS410 WEEK 1 DISCUSSION
Max Points: 20.0
Max Points: 20.0
The case scenario provided
will be used to answer the discussion questions that follow.
Case Scenario
Ms. G., a 23-year-old
diabetic, is admitted to the hospital with a cellulitis of her left lower leg.
She has been applying heating pads to the leg for the last 48 hours, but the
leg has become more painful and she has developed chilling.
Subjective Data
·
Complains of pain and
heaviness in her leg.
·
States she cannot bear
weight on her leg and has been in bed for 3 days.
·
Lives alone and has
not had anyone to help her with meals.
Objective Data
·
Round, yellow-red, 2
cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount
of thick yellow drainage
·
Left leg red from knee
to ankle
·
Calf measurement on
left 3 in > than right
·
Temperature: 38.9
degrees C
·
Height: 160 cm;
Weight: 83.7 kg
Laboratory Results
·
WBC 18.3 x 10¹² / L;
80% neutrophils, 12% bands
·
Wound culture:
Staphylococcus aureus
Critical Thinking Questions
1.
1. What clinical
manifestations are present in Ms. G and what recommendations would you make for
continued treatment? Provide rationale for your recommendations.
2.
2. Identify the muscle
groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy
Resource Center.”
3.
3. What is the
significance of the subjective and objective data provided with regard to
follow-up diagnostic/laboratory testing, education, and future preventative
care? Provide rationale for your answer.
4.
4. What factors are
present in this situation that could delay wound healing, and what precautions
are required to prevent delayed wound healing? Explain.
NRS410 WEEK 2 DISCUSSION
The American Cancer
Society (ACS) is a nationwide, community-based, voluntary health organization
dedicated to eliminating cancer as a major health problem. Together with its
supporters, ACS is committed to helping people stay well and get well by
finding cures and by fighting back.Critical Thinking Questions:
1. 1. Imagine that a family friend or colleague
has just been diagnosed with cancer. Explain how the American Cancer Society
might provide education and support. What ACS services would you recommend and
why?
2. 2. According to statistics published by the
American Cancer Society, there will be an estimated 1.5 million new cancer
cases diagnosed each year over the next decade. What factors contribute to the
yearly incidence and mortality rates of various cancers in Americans? What
changes in policy and practice are most likely to affect these figures over
time
3. 3. Select a research program from among those
funded by the American Cancer Society. Describe the program and discuss what
impact the research will have on the prevention or treatment of cancer.
GC NRS410 WEEK 3 DISCUSSION
Use the following Case
Scenario, Subjective Data, and Objective Data to answer the Critical Thinking
Questions.
Case Scenario
Mrs. J. is a
63-year-old woman who has a history of hypertension, chronic heart failure, and
sleep apnea. She has been smoking two packs of cigarettes a day for 40 years
and has refused to quit. Three days ago, she had an onset of flu with fever,
pharyngitis, and malaise. She has not taken her antihypertensive medications or
her medications to control her heart failure for 4 days. Today, she has been
admitted to the hospital ICU with acute decompensated heart failure.
Subjective Data
1.
1. Is very anxious and
asks whether she is going to die.
2.
2. Denies pain but
says she feels like she cannot get enough air.
3.
3. Says her heart
feels like it is “running away.”
4.
4. Reports that she is
so exhausted she cannot eat or drink by herself.
Objective Data
1.
1. Height 175 cm;
Weight 95.5 kg
2.
2. Vital signs: T 37.6
C, HR 118 and irregular, RR 34, BP 90/58
3.
3. Cardiovascular:
Distant S1, S2, S3, S4 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.
4. Respiratory:
Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy
blood-tinged sputum; SpO2 82%
5.
5. Gastrointestinal:
BS present: hepatomegaly 4 cm below costal margin
Critical Thinking Questions
What nursing
interventions are appropriate for Mrs. J. at the time of her admission? Drug
therapy is started for Mrs. J. to control her symptoms. What is the rationale
for the administration of each of the following medications?
1. 1. IV furosemide (Lasix)
2. 2. Enalapril (Vasotec)
3. 3. Metoprolol (Lopressor)
4. 4. IV morphine sulphate (Morphine)
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.
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 rationale for
each of the interventions you recommend.
NRS410 WEEK 4 DISCUSSION
Max Points: 20.0
Max Points: 20.0
Use the image in
“Discussion Question Resource: Chest X-Ray” to answer the following Critical
Thinking Questions.
Examine the x-ray of a
patient diagnosed with pneumonia due to infection with Mucor. Refer to the
“Module 4 DQ Chest Xray” resource in order to complete the following questions.
Critical Thinking Questions
1. 1. Explain what Mucor is and how a patient is
likely to become infected with Mucor. Describe the pathophysiologic progression
of the infection into pneumonia and at least two medical/nursing interventions
that would be helpful in treating the patient.
2. 2. Examine the laboratory blood test results
and arterial blood gases provided in “Discussion Question Resource: Laboratory
Blood Test Results.” What laboratory values are considered abnormal? Explain
each abnormality and discuss the probable causes from a pathophysiologic
perspective.
3. 3. What medications and medical treatments are
likely to be prescribed by the attending physician on this case? List at least
three medications and three treatments. Provide rationale for each of the
medications and treatments you suggest.
NRS410 WEEK 5 DISCUSSION
Max Points: 20.0
The case scenario
provided will be used to answer the discussion questions that follow.
Case Scenario
Mr. C., a 32-year-old
single man, is seeking information at the outpatient center regarding possible
bariatric surgery for his obesity. He reports that he has always been heavy,
even as a small child, but he has gained about 100 pounds in the last 2–3
years. Previous medical evaluations have not indicated any metabolic diseases,
but he says he has high blood pressure, which he tries to control with sodium
restriction and sleep apnea. He current works at a catalog telephone center.
Objective Data
·
Height: 68 inches;
Weight 134.5 kg
·
BP: 172/96, HR 88, RR
26
·
Fasting Blood Glucose:
146/mg/dL
·
Total Cholesterol:
250mg/dL
·
Triglycerides: 312
mg/dL
·
HDL: 30 mg/dL
Critical Thinking
Questions
1. What health risks associated with obesity does
Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?
2. Mr. C. has been diagnosed with peptic ulcer
disease and the following medications have been ordered: (a) Magnesium
hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3
hours after mealtime and at bedtime; (b) Ranitidine (Zantac) 300 mg PO at
bedtime; and (c) Sucralfate / Carafate 1 g or 10ml suspension (500mg / 5mL) 1
hour before meals and at bedtime.
The patient reports
eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan
an administration schedule that will be most therapeutic and acceptable to the
patient.
1. Assess each of Mr. C.’s functional health patterns
using the information given (Hint: 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).
2. What actual or potential problems can you
identify? Describe at least five problems and provide the rationale for each.
GC NRS410 WEEK 2 ASSIGNMENT
Details:
Write a paper
(1,250-1,750 words) describing the approach to care of cancer. In addition,
include the following in your paper:
1. 1. Describe the diagnosis and staging of
cancer.
2. 2. Describe at least three complications of
cancer, the side effects of treatment, and methods to lessen physical and
psychological effects.
3. 3. Prepare this assignment according to the
APA guidelines found in the APA Style Guide, located in the Student Success
Center. An abstract is not required.
This assignment uses a
grading rubric. Instructors will be using the
rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
You are required to
submit this assignment to Turnitin. Refer to the directions in the Student
Success Center. Only Word documents can be submitted to Turnitin.
NRS410 WEEK 3 CASE STUDY 1
Details:
In a short essay
(500-750 words), answer the Question at the end of Case Study 1. Cite references
to support your positions.
Prepare this
assignment according to the APA guidelines found in the APA Style Guide,
located in the Student Success Center. An abstract is not required.
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
You are required to
submit this assignment to Turnitin.
Case Study 1
Case Study 1
Ms. A. is an
apparently healthy 26-year-old white woman. Since the beginning of the current
golf season, Ms. A has noted increased shortness of breath and low levels of
energy and enthusiasm. These symptoms seem worse during her menses. Today,
while playing in a golf tournament at a high, mountainous course, she became
light-headed and was taken by her golfing partner to the emergency clinic. The
attending physician’s notes indicated a temperature of 98 degrees F, an
elevated heart rate and respiratory rate, and low blood pressure. Ms. A states,
“Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take
1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During
the summer months, while playing golf, she also takes aspirin to avoid
“stiffness in my joints.”
Laboratory values are
as follows:
Hemoglobin = 8 g/dl
Hematocrit = 32%
Erythrocyte count =
3.1 x 10/mm
RBC smear showed
microcytic and hypochromic cells
Reticulocyte count =
1.5%
Other laboratory
values were within normal limits.
Question
Considering the
circumstances and the preliminary workup, what type of anemia does Ms. A most
likely have? In an essay of 500-750 words, explain your answer and include
rationale.
NRS410 WEEK 3 CASE STUDY 2
Details:
In a short essay
(500-750 words), answer the Question at the end of Case Study 2. Cite
references to support your positions.
Prepare this
assignment according to the APA guidelines found in the APA Style Guide, located
in the Student Success Center. An abstract is not required.
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
You are required to
submit this assignment to Turnitin.
Case Study 2
Case Study 2
Mr. P is a 76-year-old
male with cardiomyopathy and congestive heart failure who has been hospitalized
frequently to treat CHF symptoms. He has difficulty maintaining diet
restrictions and managing his polypharmacy. He has 4+ pitting edema, moist
crackles throughout lung fields, and labored breathing. He has no family other
than his wife, who verbalizes sadness over his declining health and over her
inability to get out of the house. She is overwhelmed with the stack of medical
bills, as Mr. P always took care of the financial issues. Mr. P is despondent
and asks why God has not taken him.
Question
Considering Mr. P’s
condition and circumstance, write an essay of 500-750 words that includes the
following:
·
Describe your approach
to care.
·
Recommend a treatment
plan.
·
Describe a method for
providing both the patient and family with education and explain your
rationale.
·
Provide a teaching
plan (avoid using terminology that the patient and family may not understand).
NRS410 WEEK 4 assignment
Details:
This is a CLC
assignment.
As a group, observe
the simulated “Home Visit With Sallie Mae Fisher” video
(.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php”
title=”http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php”>http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).
Refer to “Sallie Mae
Fisher’s Health History and Discharge Orders” for specifics related to the case
study used to inform the assignment.
Using “Home Visit With
Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge
Orders,” complete the following components of this assignment:
Essay Portion
After viewing the home
visit, write an essay of 500-750-words in which you do the following:
1. 1. Identify, prioritize, and describe at least
four problems.
2. 2. Provide substantiating evidence (assessment
data) for each problem identified.
3. 3. Identify and describe at least four medical
and/or nursing interventions.
4. 4. Discuss your rationale for the
interventions identified.
Prepare this step of
the assignment according to the APA guidelines found in the APA Style Guide,
located in the Student Success Center. An abstract is not required.
Scripted Dialogue Portion
Utilizing the
information learned from the home visit, health histories, and discharge
orders, write a scripted dialogue in which you provide Sallie Mae with
education that describes her problems and the interventions identified to
improve her condition. Consider Sallie Mae’s physiological, psychosocial,
educational, and spiritual needs when developing your dialogue.
Your dialogue should
resemble a script. The following is an example of a few sentences from a
scripted dialogue:
Nurse: “Good
morning, Salle Mae, my name is ______ and I will be your nurse today. I
understand you are experiencing problems with ________.”
APA format is not
required for this part of the assignment, but solid academic writing is
expected.
Refer to “Home Visit
With Sallie Mae Fisher Grading Criteria.”
Entire Assignment
You are required to
submit this assignment to Turnitin. Refer to the directions in the Student
Success Center. Only Word documents can be submitted to Turnitin.
Sallie Mae Fisher’s Health History
and Discharge Orders
Sallie Mae Fisher Health History
Ms. Fisher is an
82-year-old female with a history of chronic congestive heart failure (CHF),
atrial fibrillation, and hypertension. During the last 6 months, she has been
hospitalized four times for exacerbation of her CHF. She was discharged home
last Saturday from the hospital after a 3-day stay to treat increased dyspnea,
an 8-pound weight gain, and chest pain.
Ms. Fisher is recently
widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but
works full time and has family issues of her own. Therefore, family support is
limited.
Hospital Discharge Instructions
·
Mountain Top Home
Health to evaluate cardio-pulmonary status, medication management, and home
safety.
·
Medical Equipment
Company to deliver oxygen concentrator and instruct patient in use. O2 at 2 liters per nasal
prongs PRN.
·
Prescriptions given at
discharge:
o Digoxin 0.25 mg once
a day
o Lasix 80 mg twice a
day
o Calan 240 mg once a
day
·
Order written to
continue other home meds.
Sallie Mae’s Home Medication List
·
Zocar 50 mg once a day
·
Minipres 1 mg once a
day
·
Vasotec 10 mg twice a
day
·
Prilosec 20 mg once a
day
·
Furosemide 40 mg once
a day
·
Effexor 37.5 mg at
bedtime
·
Lanoxin 0.125 mg every
other day
·
Multivitamin once a
day
·
Potassium 40 mEq once
a day
·
Ibuprofen 400 mg q 4
hours as needed for pain
·
Darvocet N 100 mg q 4
hours as needed for pain
·
Nitroglycerin
ointment, apply 1 inch every day
GC NRS410 WEEK 5 assignment
Details:
Identify a research or
evidence-based article that focuses comprehensively on a specific intervention
or new diagnostic tool for the treatment of diabetes in adults or children.
In a paper of
750-1,000 words, summarize the main idea of the research findings for a
specific patient population. Research must include clinical findings that are
current, thorough, and relevant to diabetes and the nursing practice.
Prepare this
assignment according to the APA guidelines found in the APA Style Guide,
located in the Student Success Center. An abstract is not required.
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
You are required to
submit this assignment to Turnitin. Refer to the directions in the Student
Success Center. Only Word documents can be submitted to Turnitin.
Details:
Based on the summary
of research findings identified from the Evidence-Based Project—Paper on
Diabetes that describes a new diagnostic tool or intervention for the treatment
of diabetes in adults or children, complete the following components of this
assignment:
Develop a PowerPoint
presentation (a title slide, 6-12 slides, and a reference slide; no larger than
2 MB) that includes the following:
1. 1. A brief summary of the research conducted
in the Evidence-Based Project – Paper on Diabetes.
2. 2. A descriptive and reflective discussion of
how the new tool or intervention may be integrated into practice that is
supported by sound research.
While APA format is
not required for the body of this assignment, solid academic writing is
expected, and in-text citations and references should be presented using APA
documentation guidelines, which can be found in the APA Style Guide, located in
the Student Success Center.
You are not required
to submit this assignment to Turnitin, unless otherwise directed by your
instructor. If so directed, refer to the Student Success Center for directions.
Only Word documents can be submitted to Turnitin.
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