Health Medical
NRS 410V Grand Canyon University Pathophysiology and Nursing Management Case Study

NRS 410V

NRS

Question Description

Can you help me understand this Nursing question?

Case Study: Mrs. J.

It is necessary for a 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

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is "running away."
  4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5kg.
  2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
  3. 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.
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
  5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)
  5. Inhaled short-acting bronchodilator (ProAir HFA)
  6. Inhaled corticosteroid (Flovent HFA)
  7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.'s situation. Include the following:

  1. Describe the clinical manifestations present in Mrs. J.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
  7. 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.

Unformatted Attachment Preview

Course Code NRS-410V Class Code NRS-410V-O500 Criteria Content Percentage 80.0% Clinical Manifestations of Mrs. J. 10.0% Evaluation of Nursing Interventions at Admissions 10.0% Cardiovascular Conditions Leading to Heart Failure and Interventions 10.0% Nursing Interventions for Older Patients to Prevent Problems Caused by Multiple Drug Interactions 10.0% Health Promotion and Restoration Teaching Plan 15.0% Method for Providing Education to Prevent Hospital Readmissions 15.0% COPD Triggers and Options for Smoking Cessation 10.0% Organization, Effectiveness, and Format 20.0% Thesis Development and Purpose 5.0% Argument Logic and Construction 5.0% Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Paper Format (use of appropriate style for the major and assignment) 2.0% Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 3.0% Total Weightage 100% Assignment Title Case Study: Mrs. J. Unsatisfactory (0.00%) Clinical manifestations are omitted. Evaluation of appropriateness of nursing interventions at the time of admission and explanation of the rationale for each of the medications listed are not discussed. Fewer than three cardiovascular conditions that may lead to heart failure, and medical or nursing interventions to prevent the development of heart failure in each condition, are described. Fewer than three nursing interventions that can help prevent problems caused by multiple drug interactions in older patients are presented. A health promotion and restoration teaching plan for the patient is omitted. A method for providing education to the patient for the maintenance of prescribed medications that prevents future hospital admissions is omitted. The method is not appropriate for the client or health status. COPD triggers exacerbating return visits and options for smoking cessation are omitted. Paper lacks any discernible overall purpose or organizing claim. Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Template is not used appropriately, or documentation format is rarely followed correctly. Sources are not documented. Total Points 120.0 Less Than Satisfactory (75.00%) Clinical manifestations are partially presented. There are major omissions and inaccuracies. Evaluation of appropriateness of nursing interventions at the time of admission is partially presented. An incomplete explanation for each of the medications listed is presented. The discussion contains significant inaccuracies. Four cardiovascular conditions that may lead to heart failure are partially described. Medical or nursing interventions to prevent the development of heart failure in each condition are incomplete. There are significant inaccuracies. Four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients are partially presented. A health promotion and restoration teaching plan for the patient is partially presented. Multidisciplinary resources for rehabilitation and any modifications that may be needed are omitted or incomplete. An explanation for how rehabilitation resources and modifications assist patient transition to independence is omitted or incomplete. A method for providing education to the patient for the maintenance of prescribed medications that prevents future hospital admissions is partially summarized. The method may not be relevant to for this situation. More information is needed. There are major inaccuracies. Some COPD triggers exacerbating return visits are partially presented. Options for smoking cessation are incomplete; it is unclear if the options are relevant to the patient. Thesis is insufficiently developed or vague. Purpose is not clear. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Satisfactory (79.00%) Clinical manifestations are summarized. An overview of the general symptoms is presented. Some findings are incomplete. Evaluation of appropriateness of nursing interventions at the time of admission is summarized. A general explanation and some rationale for each of the medications listed are presented. There are minor inaccuracies. Four cardiovascular conditions that may lead to heart failure are summarized. Medical or nursing interventions to prevent the development of heart failure in each condition are generally discussed. There are some inaccuracies. Four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients are summarized. Overall, the discussion meets assignment criteria but requires more rationale for the interventions. There are minor inaccuracies. A health promotion and restoration teaching plan for the patient is summarized. Multidisciplinary resources for rehabilitation and any modifications that may be needed are generally presented. A summary for how rehabilitation resources and modifications assist patient transition to independence is presented. There are minor inaccuracies. A method for providing education to the patient for the maintenance of prescribed medications that prevents future hospital admissions is summarized. The method is generally appropriate. Some rationale is provided for support. General COPD triggers exacerbating return visits are generally presented. Some options for smoking cessation relevant to the patient are summarized. Some support or information is needed. Thesis is apparent and appropriate to purpose. Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Appropriate template is used. Formatting is correct, although some minor errors may be present. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Good (89.00%) Subjective and objective clinical manifestations are described. Overall, the clinical manifestations are accurate and reflect observed and perceived signs and symptoms. Evaluation of appropriateness of nursing interventions at the time of admission is discussed. An explanation and general rationale for each of the medications listed are presented. Some information is required for accuracy or clarity. Four cardiovascular conditions that may lead to heart failure are described. Medical and nursing interventions to prevent the development of heart failure in each condition are discussed. There are minor inaccuracies, or information is needed for clarity. Four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients are discussed. Overall, the discussion meets assignment criteria and general rationale for the interventions is provided. A health promotion and restoration teaching plan for the patient is presented. Multidisciplinary resources for rehabilitation and any modifications that may be needed are discussed. An explanation for how rehabilitation resources and modifications assist patient transition to independence is presented. A method for providing education to the patient for the maintenance of prescribed medications that prevents future hospital admissions is described. Overall, the method is appropriate. General rationale is provided for support. Key COPD triggers exacerbating return visits are outlined. General options for smoking cessation relevant to the patient are summarized. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Appropriate template is fully used. There are virtually no errors in formatting style. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Excellent (100.00%) Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms. Evaluation of appropriateness of nursing interventions at the time of admission is thoroughly discussed. A well-supported explanation for each of the medications listed is presented. Strong and compelling rationale is provided. Four cardiovascular conditions that may lead to heart failure are clearly described. Medical and nursing interventions to prevent the development of heart failure in each condition are discussed. Overall, the discussion demonstrates insight into medical and nursing interventions used to prevent heart failure. Four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients are discussed. The discussion fulfills the assignment criteria and strong rationale for the interventions is provided. A well-developed health promotion and restoration teaching plan for the patient is presented. Multidisciplinary resources for rehabilitation and any modifications that may be needed are clearly discussed. An strong explanation for how rehabilitation resources and modifications assist patient transition to independence is presented. The overall A method for providing education to the patient for the maintenance of prescribed medications that prevents future hospital admissions is thoroughly described. The method is clearly appropriate for the client and prevents readmission. Strong rationale is provided for support. Comments All appropriate COPD triggers exacerbating return visits are clearly outlined. Strong options for smoking cessation are detailed and are highly relevant to the patient. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Writer is clearly in command of standard, written, academic English. All format elements are correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Points Earned ...
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Final Answer

Attached.

Outline
Topic: Pathophysiology
1. 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.
2. 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.
3. 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.
4. 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.
References


Running head: PATHOPHYSIOLOGY

1

Pathophysiology
Student’s Name
Institutional Affiliation

PATHOPHYSIOLOGY

2
Clinical Manifestations

The significant symptoms noted in the patient are respiratory based. The patient exhibited
breathing difficulties and said she had challenges regarding walking. The patient also coughed
frothy blood-stinged sputum. As such, over the last three days, the patient has had obstacles
concerning walking short distances and a productive cough. Other indicators included: nausea,
fever, and malaise. The patient also had a total weight of 95.5 kg and 175 cm. The heartbeat rate
was 118. Mrs. J had a blood pressure of 90/58, and the res...

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Carnegie Mellon University

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