Discussion: The nursing interventions at the time of her admissions were appropriate for Mrs J

Discussion: The nursing interventions at the time of her admissions were appropriate for Mrs J

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Case Study: Mrs. J.
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 clinical manifestations present in Mrs. J.
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.
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 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. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
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.
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.

Answer preview to discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J.

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Identify the problem that you will address throughout your clinical practicum.

Identify the problem that you will address throughout your clinical practicum.

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NURS-FPX 4900 Assessment 1 Problem Identification

Use a provided template to develop a 2-4 page submission in which you research and define a patient, family, or population health problem relevant to personal practice.Important: Complete this assessment first and complete all other assessments in the order they are presented.In this assessment, you will lay the foundation for the work that will carry through your capstone experience and guide the practice hours to complete the work in this course. The purpose of this assessment is to allow you to define a patient, family, or population health problem that is relevant to your personal practice and to begin building a body of evidence that will inform your approach to your practice hours, the intervention you design, and the professional product you will deliver.

DEMONSTRATION OF PROFICIENCY

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Lead people and processes to improve patient, systems, and population outcomes.

Define a patient, family, or population health problem that is relevant to personal practice.

Competency 2: Make clinical and operational decisions based upon the best available evidence.

Analyze evidence from the literature and professional sources to support decisions related to defining and guiding nursing actions related to a health problem.

Competency 7: Implement patient-centered care to improve quality of care and the patient experience.

Propose strategies to improve patient or population outcomes related to a health problem.

Competency 8: Integrate professional standards and values into practice.

Reflect on state board nursing practice standards relevant to a selected health problem.

Communicate professionally with clear, logically organized writing, using correct grammar, spelling, and APA style.

Important: Complete this assessment first and complete all other assessments in the order they are presented.

PROFESSIONAL CONTEXT

Nurses are leaders in problem identification and solution, planning and implementing patient care strategies to address problems in the home, hospital, and community. This assessment will help you develop a problem statement for a patient, family, or population health concern.

INSTRUCTIONS

Throughout this capstone course, you will be investigating a patient, family, or population health problem relevant to your practice. For this assessment, you will identify the problem that you will address throughout your clinical practicum in this course, as well as begin to establish your evidence and research base to plan, implement, and share findings related to your project. The Problem Identification Template [DOC] will guide you through development of a problem statement, evidence collection and analysis, and best practices to help you create your implementation plan for the second assessment in this course.Your submission for this assessment will be the completed template. When working through the template, you may use the resources provided in this course; however, most of your research and search for evidence will be conducted by you. Use the Capella University Library, professional organization and government resources, and relevant organizational best practices as sources of evidence. This is the capstone course for your BSN degree; your goal is to demonstrate your achievement of the program outcomes through your work on this project.The following are some health issues that would be appropriate for your project:

Diabetes self-management.

Hypertension management and prevention.

Medication reconciliation within a family or group.

Parkinson’s disease support group.

Patient family education communication improvements.

Postoperative home care.

This list is by no means exhaustive. You should choose a patient, family, or population health issue that is relevant to your practice and organization; you must be able to study the problem in your clinical practicum effectively.Your submission will be assessed based on the following criteria:

Define a patient, family, or population health problem and realistic goals relevant to personal practice.

Analyze evidence from the literature and professional sources to define and guide nursing actions related to a health problem.

Propose strategies to improve patient or population outcomes related to a health problem.

Reflect on state board nursing practice standards relevant to an identified health problem.

Communicate professionally, with writing that is clear, logically organized, and uses correct grammar, spelling, and APA style.

CORE ELMS

Completion of this course requires a face-to-face clinical practicum. You are required to log your time in the CORE ELMS system just as you have for past courses with direct interaction. The CORE ELMS link is located in the left-hand navigation pane.

ADDITIONAL REQUIREMENTS

Length of submission: Use the provided template. Most submissions will be 2 to 4 pages. You do not need to include a title page. Be sure to complete the reference page at the end of the template.

Number of references: Cite a minimum of 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old.

APA formatting: Make sure that in-text citations and reference list follow current APA style.

Portfolio Prompt: Remember to save the assessment to your ePortfolio. After you complete your program you may want to consider leveraging your Portfolio as part of a job search or other demonstration of your academic competencies.

Answer preview to identify the problem that you will address throughout your clinical practicum

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Explains the different blood vessels in the body and their function.

Explains the different blood vessels in the body and their function.

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Develop a presentation. (10 slides)

Imagine that you have been asked to develop an in-service training about blood pressure. Develop a PowerPoint presentation that:

Explains the different blood vessels in the body and their function

Explains how to take a blood pressure

Includes a brief discussion of hypertension and shock

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Step 2 Write a quiz.

Write a 10-question quiz to check comprehension of the material contained in your presentation. Create an answer key to the quiz as well.

Answer preview to explains the different blood vessels in the body and their function

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Late-stage Alzheimer’s disease

Late-stage Alzheimer’s disease

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An older client was recently discharged from the hospital for evaluation of seizure activity. His history reveals that he has late-stage Alzheimer’s disease, Parkinson’s disease, hypertension, and type II diabetes mellitus, which is controlled by diet. He lives at home, where his wife and daughter take care of him. His discharge medications include phenytoin (Dilantin), 100 mg BID; hydrochlorothiazide (HydroDIURIL), 50 mg QD; levodopa (Sinemet), 25/100 TID; and haloperidol (Haldol), 1 mg before bed. The client has been referred for home care nursing follow-up.

Questions:

On the initial home visit by the nurse, what assessments should be made?

The wife and daughter need teaching about his antiepileptic medication. What teaching should be included?

During the initial home visit, the client experiences a generalized seizure. What action should the nurse take?

Answer preview to on the initial home visit by the nurse what assessments should be made

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Get a 10 % discount on an order above $ 50
Use the following coupon code :
NURSING10