Population groups with differences determined by culture, religion or ethnicity also show differences in terms of illness behavior and beliefs.
Discuss a patient population that are at risk and apply evidence-based practice guidelines in management of their illnesses across the age continuum. 250 words not including title and reference page
Poor Patient Outcome
Relying solely on the classic features of a disease may be misleading. That’s because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.
Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs — is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.
This case portrays a poor patient outcome after a misdiagnosis.
Case scenario
A previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normal.
On physical examination the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.
The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.
Written Assignment:
Developing a list of possible conditions that might produce a patient’s symptoms and signs is an important part of clinical reasoning.
If a serious diagnosis comes to mind based on a patient’s symptoms:
The Interview:
The medical interview serves several functions. It is used to collect information to assist in diagnosis of the present illness, to understand the patient’s values, to assess and communicate prognosis, to establish a therapeutic relationship and to reach agreement with the patient about further diagnostic procedures and therapeutic options. The interview also offers an opportunity to influence patient behaviors.
Discuss the following:
Please answer the following questions and include your rationale and evidence-based research to support your written work.
500 words
Compare and contrast risk factors, age of onset, pathophysiology and clinical manifestations of Type 1 and Type 2 Diabetes. What do you think is the most important topic that must be taught to the diabetic patient and why? 300 words
What is the main issue for your organization in addressing a solution to evidence-based nursing practice? Discuss what might be the first step in addressing and resolving this issue. 200 words still following the capstone selected topic.
Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury. Jimmy is 10 years old. He was reaching for a ball that had gotten lodged into the gutter over the small balcony of his parent’s bedroom. He thought if he stood on the railing and reached with the badminton racket he could get it.
Currently he is 2 days postoperative from repair of the left femur. He is being transferred out of the pediatric ICU where the Neurologist has stated he is stable but needs continued neuro checks q2 hours. He has a full left leg cast. The Foley catheter is to be replaced today, or he can attempt to roll onto a bedpan if needed.
Please list the systems that are affected by this boy’s injuries.
List the nursing interventions now that he is on your nursing unit.
Start a list of nursing diagnosis match the system you are presenting. 300 words
Fill out the Alteration in Metabolism Exemplar Table. (Attached, so fill out the attached Metabolism Exemplar Table)
What is your personal worldview? Connect your worldview to cultural and spiritual competence. How will your worldview and cultural and spiritual competence affect your future practice and role as an advanced practice nurse? Consider both the provision of safe, quality care to diverse populations and interprofessional relationships. 300 words
Being able to articulate your personal worldview can help you formulate a personal philosophy of practice and enhance your influence on patients and the industry. In this assignment, you will have an opportunity to reflect on your current and future practice, and the ways worldview and nursing theory influence that practice.
Draft a 1,000-1,250 word paper in which you:
Address Questions 1 through 4
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Roslyn is complaining of severe pain. She is 6 years old and has been placed in public school for the first time. Now she is complaining of her legs hurting. She is so excited about being in school finally, but her parents report that she is not participating in play time, seems weaker, and is pale. She is diagnosed with sickle cell anemia, parents undergo genetic testing as well as all her siblings and it is found that she is the only child with the disease.
Once the crisis is over what education will you provide to Roslyn and her parents?
Discharge teaching should include?
Is it appropriate that Roslyn stay in school? What about activities?
300 words
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