Category: Nursing

Preliminary Care Coordination Plan for Hypertension Management

Posted on | by Kelvin

 

Develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.
Scenario

Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.

To prepare for this assessment, you may wish to:

Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
Allow plenty of time to plan your chosen health care concern.

 

Understanding Acute Myocardial Infarction: A Case Study of Mr. W.G.

Posted on | by Kelvin

 

Cardiovascular
Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and having had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. In route to the hospital, the patient was placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills.

Case Study Questions

For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors.
What would you expect to see on Mr. W.G. EKG and which findings described on the case are compatible with the acute coronary event?
Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarct, which would be the most specific laboratory test you would choose and why?
How do you explain that Mr. W.G temperature has increased after his Myocardial Infarct, when that can be observed and for how long? Base your answer on the pathophysiology of the event.
Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarct. Elaborate and support your answer.

Case Study Analysis: J.D. and Iron Deficiency Anemia

Posted on | by Kelvin

Hematopoietic:

J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy.

Past Medical History (PMH):
Upon reviewing her past medical history, the gynecologist notes that her patient is a G5P5with four pregnancies within four years, the last infant having been delivered vaginally four months ago. All five pregnancies were unremarkable and without delivery complications. All infants were born healthy. Patient history also reveals a 3-year history of osteoarthritis in the left knee, probably the result of sustaining significant trauma to her knee in an MVA when she was 9 years old. When asked what OTC medications she is currently taking for her pain and for how long she has been taking them, she reveals that she started taking ibuprofen, three tablets each day, about 2.5 years ago for her left knee. Due to a slowly progressive increase in pain and a loss of adequate relief with three tablets, she doubled the daily dose of ibuprofen. Upon the recommendation from her nurse practitioner and because long-term ibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on a regular basis to prevent gastrointestinal bleeding. Patient history also reveals a 3-year history of HTN for which she is now being treated with a diuretic and a centrally acting antihypertensive drug. She has had no previous surgeries.

Case Study Questions

Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.
Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.
Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells?
The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia.
In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.
If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.
Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.

 

 

Clinical Experience Reflection: Week in Primary Care

Posted on | by Kelvin

You are a Family Nurse Practitioner student doing clinical rotation hours in a Primary Care clinic.
Describe your clinical experience for this week.
Did you face any challenges, any success? If so, what were they?
Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
Mention the health promotion intervention for this patient.
What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
Support your plan of care with the current peer-reviewed research guideline.

 

Factors Inhibiting the Early War Against AIDS

Posted on | by Kelvin

 

Watch the film, And the Band Played On. This film may be available on the Internet through free sites such as Youtube and Vimeo (please note: accessing these sites is at your own risk). You may also view the film for purchase online through sites such as Amazon or HBO.

Movie: And the Band Played On (1993), Roger Spottiswoode (Director). Depicts how the CDC discovered how HIV was being transmitted. The film is both entertaining and educational, and it depicts the principles of epidemiology, human behavior, and society’s view of controversial topics.

What factors inhibited the early war against acquired immunodeficiency syndrome (AIDS)? Do you believe the AIDS outbreak could have been stopped? Why or why not? What role does advocacy play in the film? How much publicity does HIV/AIDS receive today? Whats the story of HIV/AIDS in the 21st century? Explain.

Environmental Migration: The Rohingya Crisis

Posted on | by Kelvin

 

Select an event that occurred due to environment-triggered human migration in the past decade. Environmental triggers include natural disasters such as tsunamis, floods, famines, and pandemics or human-created emergencies such as wars, genocides, and religious persecutions. Research literature on it and answer the following prompts. Must use at least 2-3 scholarly resources on the incident.Summarize the information in the reading. Identify whether the environmental migration is due to a natural disaster or human-made emergency, and if it is intranational or international. In the example, which social factors intersected and impacted the environmental migration? Discuss 2-3 physical and mental health impacts of environmental migration on people. Next, how do you view your role as a healthcare professional in advocating for people displaced by an environmental migration?

Embracing Diversity in Speech-Language Pathology: A Personal Reflection

Posted on | by Kelvin

 

In an essay, address the following items in your response:The SJSU Speech-Language Pathology Program is committed to enhancing diversity and improving access to this profession. Reflect on your lived experiences, training, or study of multiple cultures, languages, and identities. What insights have you gained that have implications for your SJSU graduate education and future work as a speech-language pathologist?