Part 1: Pathophysiology<\/p>\n
J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.
\nPast Medical History (PMH):<\/p>\n
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.
\nLabs:
\nHb 12.7 g\/dl; Hct 38.8% WBC 8.2; Glycemia 74mg\/dl; Creatinine 0.8 mg\/dl; BUN 9.8 mg\/dl; AST 21 U\/L ALT 17 U\/L; Bil T 1.90 mg\/dl; Ind 0.69 mg\/dl; Dir 1.21 mg\/dl.<\/p>\n
Diagnostic test:
\nEndoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma. Pancreas Ultrasound Done Through an Endoscope. The head of the pancreas has a 4 cm solid mass that is getting into the Wirsung duct. The solid mass was strong enough to get into the superior mesenteric vein. There is a 1.5 cm metastatic perilesional node found. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.
\nCase study questions:<\/p>\n
One paragraph per question. Total six questions, six paragraphs<\/p>\n
1. Describe the potential most common sites for metastasis on J.C and (One paragraph):<\/p>\n
a. why?<\/p>\n
2. Describe the tumor cell markers and (One paragraph):<\/p>\n
a. Why tumor cell markers are ordered for a patient with pancreatic cancer?<\/p>\n
3. Classify the tumor based on the TNM Stage classification based on the case study described, and (One paragraph):<\/p>\n
a. Why this classification important?<\/p>\n
4. Describe characteristics of malignant tumors regarding it (One paragraph):<\/p>\n
a.Cells<\/p>\n
b. Growth<\/p>\n
c. Ability to spread.<\/p>\n
5. Describe the carcinogenesis phase when a tumor metastasized (One paragraph) .<\/p>\n
6. Select and describe the tissue level that is affected on the patient discussed above: Epithelial, Connective, Muscle, or Neural (One paragraph).<\/p>\n
Part 2: Nursing role transition<\/p>\n
Three paragraphs per question. Total two questions, six paragraphs<\/p>\n
1. Describe three barriers that have slowed down the progress of advanced practice nursing (One paragraph per each barrier- Total of six paragraphs)<\/p>\n
2. Describe one strategy for each barrier to help overcome these limits (Three paragraph per each startegy- Total six paragraphs)<\/p>\n
Part 3: Psychology<\/p>\n
One paragraph per question. Total three questions, three paragraphs<\/p>\n
1. According to psychology, what is a Crisis Intervention and (One paragraph):<\/p>\n
a. Describe the types of Crisis<\/p>\n
2. Describe the nurse’s Interventions during the crisis (One paragraph).<\/p>\n
3. Name and describe all types of Therapy for Care (One paragraph).<\/p>\n","protected":false},"excerpt":{"rendered":"
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