...ASSIGNMENT GUIDANCE – NRSG258 ASSESSMENT 1: CASE STUDY Dear students here are some guidelines to assist you in writing Assessment 1: Case Study. If, after reading through these, you still have questions please post on the relevant forum. If you are still unsure then please contact your campus specific lecturer to arrange to discuss your assignment. We ask that you bring these guidelines to any meeting and highlight the areas about which you are still unsure. In this case study you do not need an introduction or conclusion for this case study of 1500 WORDS ± 10% due by midnight 8th April Turnitin. Just answer the questions. Turnitin is located in your campus specific block. Although we suggest you do your background reading in the current textbooks for basic information, the case study also requires you to find current literature/research/articles to support your discussion throughout the case study. Do NOT use Better Health Channel, WedMed, dictionaries, encyclopaedias etc. These are NOT suitable academic sources. If you use these you will not meet the criteria for this question and you will lose marks. You must follow the APA referencing format as directed by ACU in your case study and in your reference list. The Library website has examples of how to do this referencing and you can find the correct format at the end of your lectures and tutorials as well as in the free Student Study Guide. This essay should have approximately 10 relevant sources. Textbooks...
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...Pathophysiology II Digestion/Hepatic Case Study Worth 15 pts; July 15, 2014. Name: ___________________________ Directions: Please read the following scenarios and answer the questions that accompany each. Use complete sentences when answering your questions. You will likely need to use your textbook, the class BB site, additional web sites, and your own analytical skills to answers these questions in full. No two people should turn in word for word answers even if you are in the same group. Likewise, information found in resources other than your brain, should also not be copied word for word, but should be rephrased in your own word. Word for word copying in either case will count as plagiarism and no points will then be given for the assignment. Please TYPE out your answers on a separate sheet of paper. Case 1 (7.5 pts) S.M., a young woman in her twenties arrives at your clinic complaining of feelings of pyrosis in her neck, shoulders and jaw. She has had difficulty swallowing her food lately. She self-reports as a smoker. She also reports that she has a low alcohol intake but does drink two or more cups of coffee a day. She is six months along in her first pregnancy. She has a BMI of 22, her BP is 145/90 and her temperature is 37.7oC. Her only reported medications are vitamin C and prenatal tablet supplements daily. Her reported occupation is as a waitress. 1. Give a possible diagnosis for S.M.’s clinical presentations, explaining which symptoms...
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...COLLEGE NURSING NUR 211 Psychiatric-Mental Health Nursing Supplemental Learning Guide Course Objectives * Relate the minimum requirements for the course. * Illustrate the use of competencies for learning. * Formulate own needs and responsibilities relative to meeting course competencies. * Relate course/clinical assignments and evaluation * Distinguish how the major concepts (see Nursing Student Handbook) of the program are affected by the variety of conditions and diseases within this course for all age groups. Outline A. Orientation to course 1. Course descriptions 2. Course outcomes/competencies 3. Textbooks B. Course Requirements 1. Student assignments and responsibilities 2. Minimum level of achievement 3. Evaluation tools C. Course/ Clinical Assignments and Evaluation D. Major Concepts 1. Caring 2. Clinical judgment, clinical reasoning, and nursing judgment 3. Clinical microsystem 4. Collaboration 5. Critical thinking 6. Cultural competence and Diversity 7. Ethics 8. Evidence-based care 9. Healthcare environment 10. Human flourishing 11. Informatics and Information management 12. Integrity 13. Knowledge, skills, and attitudes 14. Leadership 15. Nursing and Nursing Process 16. Nursing-sensitive indicators 17. Patient and Patient-centered care 18. Personal and Professional development 19. Professional identity 20. Quality improvement ...
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...NURSING PROCESS PAPER Student Name: Date of Care: 10/14/09 Date of Admission: 10/10/09 I. HEALTH STATUS | Admitting Dx: COPD Exac/Chest Pain | Pt. Init.D.R | Rm No.353 | Age60 | SexM | RaceCaucasion | ReligionCatholic | OccupationDisabled | Surgery: Medical Treatment: Back Surgery/ Coronary Artery Bypass Grafting COPD Exac/Chest Pain | Chief Complaint/Reason for Hospitalization & Hx. of Present Illness (with 1-8 critical characteristics, Jarvis pg. 85) Chest Pain | | 1.Location: Midsternal chest pain radiating to left arm. 2. Quality/characteristics: Squeezing, tightening, felt like chest was going to explode. 3. Quantity: 8 on a scale from 1-10 4. Setting: at rest 5. Associative factors: SOB and nausea 6. Aggravating/relieving factors: Aggravated by activity, unable to relieve in any position 7. Timing (Onset, duration, frequency): Sudden and constant pain 8. Patient perception: Thought he was having a heart attack. | Other illness or conditions & year of onset. | | AllergiesNKA | COPD- 2004 Deep Vein Thrombosis -2002Anxiety-2000Depression-1998Lumbar/Cervical Spondylosis-1982HTN- 19XX-Patient cannot recall exact year | | Immediate Teaching Needs | | Hospital safety- Reminded patient to call for assistance, call light within reach, non skid footwear for reduction of falls. Talked with patient regarding fall safety. Teach non-pharmachological...
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...construct and organize knowledge • ability to integrate and synthesize knowledge • ability to apply quantitative and qualitative concepts Proficiency • ability to solve practical problems • ability to collaborate with multiple disciplines • ability to communicate effectively • ability to practice competently and skillfully in a changing health-care environment Culture Care Values • ability to preserve/maintain cultural identities • ability to accommodate/negotiate diverse life ways • ability to re-pattern/restructure health-care delivery methods • ability to apply ethical and legal principles to health care The Associate of Science in Nursing Program (ASN) is a two-year program of study combining didactic and clinical nursing courses as well as general education courses. The Program prepares beginning nurses who function as providers and leaders of direct and indirect nursing care for diverse individuals, families, and groups. The ASN graduates function as collaborative members within the discipline of nursing and the health care team. The ASN graduates use basic knowledge of therapeutic nursing interventions, communication, culture, critical thinking,...
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...(Provide reference listing using APA format) Reference List Criteria for Case Study I. Introduction – purpose of paper A. Significance B. Objectives II. Assessment a. Include date of admission; date of care; allergies; history b. Address and list analysis of Gordon’s Functional Patterns (list all 11). Integrate treatments, meds, nursing implications, and related assessments in paper. Includes nutritional analysis. III. Literature Review (at least three resources at least one professional journal) a. Disease Description b. Diagnostic Confirmation c. Signs & Symptoms (textbook vs. patient’s actual symptoms being experienced) d. Treatment and Rationale e. Disease Outcome Expectations f. Rehab needs g. Related to client situation IV. Nursing Plan of Care a. Problems Prioritized (list 3 diagnosis) b. Actual Diagnosis c. Potential Diagnosis d. Outcome e. Goals (short and long term) f. Actions/actual diagnosis g. Actions/potential diagnosis h. Rationales (resources documented) i. Evaluation/Revision V. Discharge Planning a. Resources for coping b. Knowledge/Teaching c. Referrals/Continuing Care VI. Summary VII. Format a. Length of paper should be - between 15-20 pages typed b. APA format c. Cover page, reference page, etc… d. Grammar, punctuation, sentence structure, etc… Faculty Signature_______________________________________________ Date________________________________ Name__________________________ Semester______________________ |Criteria...
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...rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format. To maintain patient confidentiality any identifying features have been removed in keeping with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (NMC, 2008) the patient will be referred to as Mr X. Mr X was an 80-year-old male admitted to ITU, from the Medical Assessment Unit, with increasing respiratory failure. His initial clinical observations were: Systolic Blood Pressure: 100mmHg MAP: 58mmHg Heart Rate: 120 beats per minute Lactate: 3.2mmol/l Temperature: 38.6* These clinical observations indicated that the patient was experiencing a systemic inflammatory response syndrome (SIRS) as the patient had a pyrexia above 38*C and a heart rate above 90 beats per minute. The results of the blood cultures and chest radiograph indicated pneumonia. The patient’s condition was now treated as sepsis. Sepsis is characterized by SIRS, which is complicated by a severe infection (Neveire, Parsons and Wilson 2008). The pathophysiology of systemic inflammatory response, experienced by Mr X is portrayed in Table 1: Table 1 Morton et al 2005 Mediator | Source | Main Effect | Histamine | Mast Cells, Basophils,Platelets | Vasodilation, Increased Vascular Permeability | Nitric Oxide...
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...shock is systemic inflammatory response syndrome (SIRS) secondary to a documented infection. This response is a state of acute circulatory failure characterized by persistent arterial hypotension despite adequate fluid resuscitation or by tissue hypoperfusion (manifested by a lactate concentration >4 mg/dL) unexplained by other causes. Sepsis can occur in stages that may progress from uncomplicated sepsis, to severe sepsis, to shock. Despite efforts to decrease shock with the use of antibiotics, the incidences continue. Septic shock is the leading cause of death in noncoronary ICU patients. More than 18 million cases of severe sepsis occur each year, this results in 1,400 deaths worldwide every day (Hinkle, 2014). Background In the past, the terms sepsis and septicemia have referred to several ill-defined clinical conditions present in a patient with bacteremia. These 2 terms have often been used interchangeably; however, only about half of patients with signs and symptoms of sepsis have positive results on blood culture. Serious bacterial infections at any site in the body, with or without bacteremia, are usually associated with important changes in the function of every organ system in the body. These changes are mediated mostly by elements of the host immune system against infection. Shock is deemed present when volume replacement fails to increase blood pressure to acceptable levels and when associated clinical evidence indicates inadequate perfusion of major organ systems...
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...CASE STUDY 29-Emphysema Scenario D.Z., a 65 year old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD; emphysema). He has a past medical history (PHM) of hypertension (HTN), which has been well controlled by enalapril (Vasotec) for the past 6 years, and a diagnosis (Dx) of pneumonia yearly for the past 3 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious when he tells you that he has been a 2-pack-per-day smoker for 38 years. He complains of (C/O) sleeping poorly and lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 F, SaO2 88%. His admitting diagnosis is chronic emphysema with an acute exacerbation, etiology to be determined. His admitting orders are as follows: diet as tolerated; out of bed with assistance; oxygen to maintain SaO2 of 90%; maintenance IV of D5W at 50mL/hr; intake and output (I & O); arterial blood gasses (ABGs) in am; CBC with differential, basic metabolic panel (BMP), and theophylline (Theo-Dur) level on admission; chest x-ray (CXR) q 24h; prednisone 60mg/day PO; doxycycline 100 mg PO q 12h x 10 days, PO bid; heparin 5000 units SC q12h; albuterol 2.5 mg (0.5 mL) in 3 mL normal saline (NS) and ipratropium 500 mg by nebulizer q4-6h; enalapril 10 mg PO q am. 1. Explain the pathophysiology of emphysema. 2. Are D.Z.’s VS and SaO2 appropriate...
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...Unit 1 Case Study F.C. is a 54-year-old man with a history of chronic heavy alcohol use. He has frequent bouts of gastrointestinal bleeding for which he has been hospitalized on six separate occasions over the years. He continues to drink and exhibits most of the common manifestations of alcoholic cirrhosis. He was recently hit by a car and was hospitalized for a broken leg. He appeared to be under the influence of alcohol at the time of the accident and had a blood alcohol level of 0.18. F.C.’s family reports that his mental functioning has deteriorated significantly over the past few months. Discussion Questions 1. What are the common manifestations of alcoholic cirrhosis? Which of these are secondary to hepatocellular failure? Which are secondary to portal hypertension? - The effects of alcohol depend on the level of alcohol consumption and how long the person has been drinking alcohol as well. Common manifestations of alcoholic cirrhosis vary however jaundice, vomiting, fever, nausea and portal hypertension are the most common symptoms. Jaundice is a symptom that is secondary to hepatocellular failure. When jaundice occurs, the bilirubin metabolic cycle is impaired due to the breakdown of cells within the liver tissue. The destruction of these cells enables bilirubin to decrease and not be inherited correctly. Portal hypertension is caused cirrhosis. Vascular resistance and blood flow play an essential role in the development. The complication arises as a massive...
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...Competence is the ability of an individual to do a job properly. It is the combination of knowledge, skills and behavior used to improve the performance. The American Nurses Association defines a competency as “an expected level of performance that integrates knowledge skills, ability and judgment”. In these terms, the competency among ADN and BSN looks same, but there are some differences in various levels. In simple terms ADN is a “technical” nurse and BSN is a “professional” nurse. This difference is because ADN is trained mostly on clinical skills, while BSN training is focused on leadership, nursing research, management as well as clinical skills. Currently in United States Associated degree nurses usually receive this in 2 years on a community college settings. The Associate degree programs are designed to train students to provide entry level care in hospital settings. A large present of nurses take the associate degree pathway because of the shortened amount of time to begin work as a registered nurse and it is less expensive, compare to BSN program. The ADN demonstrate the competences in various aspect of patient care. This includes prevention, promotion, rehabilitations, maintenance and restoration of health of individuals of all age. Most of the competences the ADN applied to his or her work from the daily work experiences. Once graduated from school the ADN has to go through a period of orientation. Up on starting the carrier ADN is able to do the assessment...
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...HSC 4555 Spring 2015 Unit 4 Case Study A 45-year old man presented to the hospital with alcohol withdrawal. After drinking a pint of brandy daily for the past 5-6 years, he decided to stop drinking 4 days ago. he experienced tremors and then visual and auditory hallucinations. On arrival at the hospital, he was diaphoretic and tachycardiac, with a pulse rate of 102. His chemistry results are shown below: Na+ | 130 mmol/L | K+ | 3.7 mmol/L | Cl- | 90 mmol/L | CO2 | 20 mmol/L | BUN | 81 mg/dL | Creatinine | 4.0 mg/dL | Magnesium | 1.4 mg/dL | Alcohol | Negative | Total Protein | 7.1 g/dL | Albumin | 3.7 g/dL | Medical history included arthritis, hypertension, depression, and alcoholism. He had been taking an anti-inflammatory medication for arthritis and an antidepressant. Overnight, he became agitated and required increasing doses of a benzodiazepine, together with physical restraints for behavior control. The next morning, he was transferred to the ICU where he was evaluated for acute renal failure. The patient was rehydrated and his arthritis and antidepressant medication were withheld. Lab test results are listed below: Na+ | 139 mmol/L | K+ | 3.5 mmol/L | Cl- | 107 mmol/L | CO2 | 23 mmol/L | BUN | 16 mg/dL | Creatinine | 1.4 mg/dL | Discussion Questions: 1.) Is the patient still in acute renal failure? Explain your answer. * Yes, the patient is still in acute renal failure. Acute renal failure, also called acute...
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...Curriculum Development Paper Identification of the educational need and rationale. Prevention is better than the cure, medical technology and development of hospitals as the focus of health care practice. The CDC estimated a total of 1.7 million patients in the hospital that gets a nosocomial infection and 99,000 will die from the infection. This results to one patient death in every five minutes, hospitalized patients Hospital acquired pneumonia is currently the second most common nosocomial infection in the United States and is associated with high mortality and morbidity (Seymann, 2008). Higher rates of hospital-acquired pneumonia (HAP), functional decline, pressure ulcers, and falls are a few factors that leads to prolonged bed-rest . HAP Iis a pneumonia that begins within 48 hours after hospitalization and does not incubate at the time of admission. Because individuals with hospital-acquired pneumonia usually have underlying illnesses and are exposed to more dangerous bacteria, it tends to be more deadly than community-acquired pneumonia (Seymann, 2008). Those at risk include patients with a compromised immune system, are HIV positive, have been hospitalized for more than two days, reside in a nursing home, have COPD, diabetes, heart failure, are elderly, alcoholics or have other underlying disorders (Smeltzer, et al). A new report regarding the high death rate due to hospital acquired pneumonia was a an issue that could not be ignored by congress in light of the...
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...Introduction and pathophysiology of the disease: Malaria is one of the most common dangerous and infectious diseases in all the world specially in south Asia and Africa. In 109 countries, there are about billions of people at risk from infection of malaria. Each year there are about 200 to 250 million cases of malaria disease and so leading to death many of them and most of them are children and their age is under five years. The organism that causes all this dangerous is a microscopic parasite (5 species of it) of genus plasmodium and their names are Plasmodium falciparum, Plasmodium ovale, Plasmodium knowlesi, Plasmodium malariae and Plasmodium vivax. Plasmodium falciparum is the most predominates in Africa and the most dangerous type that...
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...Case Study James Morasco College of Southern Nevada – Nursing 211 Clinical Professor Judith Alewel, MSN, RN October 15, 2012 Introduction AV is a 57 year old male whom presented to the Emergency Department of Valley Hospital Medical Center in Las Vegas, NV on September 7, 2012 with the classic signs and symptoms of a left-sided middle cerebral artery (MCA) infarct and was admitted to the medical intensive care unit (MICU). These signs included left sided facial drooping, non-reactive left pupil, right sided weakness in the upper and lower extremities, and the inability to speak. Along with the signs and symptoms of the stroke, a 12-lead EKG revealed that he also has atrial fibrillation. The initial computerized tomography (CT) scan of his brain revealed nothing, but a subsequent MRA (magnetic resonance angiogram) concluded that he did, in fact, have an occluded branch of the left MCA that eventually converted to become hemorrhagic and he was admitted to the MICU. The MRA also found a persistent left trigeminal artery, which is insignificant to his presenting disease process. Along with all of this, a two dimensional echocardiogram revealed some significant hearts problems that will be discussed later. I cared for this patient during the clinical shift on September 18, 2012. History and Physical The only history and physical that was available in this patient’s chart was some narrative comments from his daughter notated by the physician, and this is most likely due to...
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