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NRS 410V Pathophysiology and Nursing

 

NRS 410 Topic 1 Mandatory Discussion Question



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.

 

NRS 410 Week 1 Assess your Knowledge of Foundational Concepts

 

Details:

Assess your knowledge of foundational concepts essential to the nursing management of client health by taking the interactive quiz, located in the media “Arterial Blood Gas Interpretation.” http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_self-assessment-v1.1.php

The quiz is designed as a tool for self-assessment. When you encounter questions that seem vaguely familiar, click on the media’s study materials, which are organized by topic (e.g., anatomy, biology, chemistry, pharmacology). This media will serve as a refresher for the concepts that build upon one another in nursing practice.

You will have the opportunity to retake the quiz until you achieve a passing score of 100%.

Once completed, please save your results and submit to the instructor.

 

NRS 410 Topic 2 Mandatory Discussion Question

 

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.

 

 

NRS 410 Topic 3 Mandatory Discussion Question

 

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.

 

 

NRS 410 Topic 4 Mandatory Discussion Question



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.

 

 

NRS 410 Topic 5 Mandatory Discussion Question

 


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.

 

 

NRS 410 Topic 2 Assignment Approach to Care

 

 

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.

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.

 

 

NRS 410 Topic 3 Case Study One

 

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.

 

 

NRS 410 Topic 3 Case Study Two

 

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).

 

 

NRS 410 Topic 4 Assignment Collaborative Learning Community Home Visit with Sallie Mae Fishe

 

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

 

 

NRS 410 Topic 5 Assignment Benchmark – Evidence-Based Practice Project—Paper on Diabetes

 

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.

 

 

NRS 410 Topic 5 Evidence-Based Practice Project—Intervention Presentation on Diabetes

 

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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