\u00a0
\nIt is necessary for an RN-BSN-prepared 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.
\nEvaluate the Health History and Medical Information for Mrs. J., presented below.
\nBased on this information, formulate a conclusion based on your Assessment, and complete the Critical Thinking Essay assignment, as instructed below.
\nHealth History and Medical Information
\nHealth History
\nMrs. 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 Helpance 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.
\nSubjective Data<\/p>\n
Is very anxious and asks whether she is going to die.
\nDenies pain but says she feels like she cannot get enough air.
\nSays her heart feels like it is “running away.”
\nReports that she is exhausted and cannot eat or drink by herself.<\/p>\n
Objective Data<\/p>\n
Height 175 cm; Weight 95.5kg.
\nVital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90\/58.
\nCardiovascular: 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.
\nRespiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
\nGastrointestinal: BS present: hepatomegaly 4cm below costal margin.<\/p>\n
Intervention
\nThe following medications administered through drug therapy control her symptoms:<\/p>\n
IV furosemide (Lasix)
\nEnalapril (Vasotec)
\nMetoprolol (Lopressor)
\nIV morphine sulphate (Morphine)
\nInhaled short-acting bronchodilator (ProAir HFA)
\nInhaled corticosteroid (Flovent HFA)
\nOxygen delivered at 2L\/ NC<\/p>\n
Critical Thinking Essay
\nIn 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:<\/p>\n
Describe the clinical manifestations present in Mrs. J.
\nDiscuss 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.
\nDescribe 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.
\nTaking 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.
\nProvide 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 Help the patients’ transition to independence.
\nDescribe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
\nOutline 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.<\/p>\n
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.
\nPrepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.\u00a0
\nThis assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.\u00a0<\/p>\n
PLEASE FOLLOW RUBRICS
\n\u00a0Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived \u00a0Assessment 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. signs and symptoms.\u00a0
\n\u00a0Four 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.\u00a0
\n\u00a0Four 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.\u00a0
\n\u00a0A 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 Help patient transition to independence is presented. The overall discussion is well-supported.\u00a0
\n\u00a0A 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.\u00a0
\n\u00a0All appropriate COPD triggers exacerbating return visits are clearly outlined. Strong options for smoking cessation are detailed and are highly relevant to the patient.\u00a0
\n\u00a0All appropriate COPD triggers exacerbating return visits are clearly outlined. Strong options for smoking cessation are detailed and are highly relevant to the patient.\u00a0
\n\u00a0Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.\u00a0
\n\u00a0Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"
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