Case Study, Chapter 5, Evidence-Based PracticeTwo professional registered nurses are interested in evidence-based practice and have developed research questions to study.  The nurses discuss what evidence-based practice is all about and are trying to determine if the organizational culture supports nurses who seek out and use research to change long-standing practices that are rooted in tradition rather than science.1. What is the best explanation of the difference between evidence-based practice and best practices?2. The two registered nurses review a variety of research studies to answer their proposed research questions. What is the difference in the efficacy of randomized controlled trials, integrative reviews, or meta-analysis with practice-based evidence for continuous process improvement?3. The registered professional nurses must consider alternative support mechanisms when searching for the best evidence to support their clinical practice. What are possible mechanisms of support for evidence-based practice?4.  Describe the challenges that exist today for nurses in implementing evidence-based practice?

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

 CASE STUDY 3: Drooping of Face A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well. 

 

To Prepare

• By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
• Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

• Review this week’s Learning Resources, and consider the insights they provide about the case study.
• Consider what history would be necessary to collect from the patient in the case study you were assigned.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
• Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

 

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 7, “Mental Status”

  This chapter revolves around the mental status evaluation of an individual’s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.

• ·Chapter 23, “Neurologic System”

  The authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.

ZERO PLAGIARISM

FIVE REFERENCES NOT MORE THAN 5YEARS

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

 

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 850 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, and abstract is required.

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Please follow assignment rubric details and requirement

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"