Case Study 18648325
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Please review the grading rubrics.Also attach some student works to read,I don’t have a book for this work.Please Read the works and make my own
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Case Study 18
Case Study, Chapter 18, Intraoperative Nursing Management
1. Pearl Richards, 69 years of age, is a female patient who is in the operating room for a repair of an abdominal aortic aneurysm. The patient has a history of hypertension controlled with medications, osteoporosis, chronic obstructive pulmonary disease, and has smoked two packs of cigarettes per day for 40 years.
- What nursing interventions are instituted to reduce the surgical risk factors related to the patient’s age?
- Explain the role of the nurse in providing patient safety measures during the intraoperative period.
2. Mr. Bond is a 32-year-old Caucasian man who plays professional football. He was admitted for repair of a rotator cuff injury sustained in a game. In excellent shape, Mr. Bond has a muscular build and his body fat is 18%. Mr. Bond is transferred to the operating room, and the anesthesiologist begins to administer general anesthesia. During the induction of anesthesia, Mr. Bond develops tachycardia and dysrhythmias. His condition continues to deteriorate and he becomes severely hypotensive and exhibits decreased cardiac output. The anesthesiologist states that Mr. Bond is developing malignant hyperthermia.
- What risk factor does Mr. Bond have for malignant hyperthermia?
- What clinical manifestations of malignant hyperthermia does Mr. Bond demonstrate?
- Based on the patient’s condition, the surgical procedure is stopped and 100% oxygen is started. Additionally, a muscle relaxant and sodium bicarbonate are administered. What are the rationales for these medications?
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Case Study 18823153
Case Scenario to be completed
–APA Format.-Introduction or abstract page-Summary or Conclusion page-Four pages minimum, no including Introduction or abstract, summary or conclusion, and Bibliography pages.
It is completely unacceptable to Copy and Paste from the Internet, or other resources-Bibliography has to be in APA Format, minimum 3, no more than 3 years old.
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Case Study 19024103
AB is a 72-year-old female who the nurse is admitting to a telemetry hospital bed. She stated: “I was feeling terrible—I had trouble breathing for a few days, but thought it would go away in awhile. But, I couldn’t sleep at night. I haven’t eaten much of anything for days, but I gained 10 pounds! We were going to church this morning, but I just couldn’t catch my breath, so my husband brought me to the hospital to get help.”
Physical assessment revealed an elderly woman with average body habitus, but an enlarged waist. She is alert, oriented x 4 and denies chest pain. Her facial expression is slightly anxious and she is breathing with some difficulty, although she can finish a complete sentence in one breath. The telemetry monitor reveals sinus tachycardia with no ectopic beats. The client is tachypneic. The nurse inspects the client’s chest, which reveals symmetric chest movement and intact skin. Lung sounds on the anterior chest reveal no adventitious sounds on the apices or the 2nd through 4th ICS on either sternal border. Abdomen is soft and slightly distended. Radial, brachial, post tibial pulses are 2+. Patient denies chest pain, but endorses feeling short of breath with a persistent nonproductive cough.
Assignment:
- Organize the information by subjective and objective data. (10%)
- List five priority questions the nurse should ask to obtain a more complete history focused on this client’s thorax and lungs, heart and great vessels, peripheral vascular and lymphatic system, and abdomen. (15%)
- What additional assessments should the nurse do to complete a focused physical assessment of this client’s thorax and lungs, heart and great vessels, peripheral vascular and lymphatic system, and abdomen? (60%)
- List three priority health problems the nurse should help this client with. (Use NANDA terminology) (15%)
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Case Study 19
Case Study, Chapter 19, Postoperative Nursing Management
1. Rita Schmidt, 74 years of age, is a female patient who was admitted to the surgical unit after undergoing removal of a section of the colon for colorectal cancer. The patient does not have a colostomy. The patient has several small abdominal incisions and a clear dressing over each site. The incisions are well approximated and the staples are dry and intact. There is a Jackson-Pratt drain intact with minimal serous sanguineous drainage present. The patient has a Salem sump tube connected to low continuous wall suction that is draining a small amount of brown liquid. The patient has no bowel sounds. The Foley catheter has a small amount of dark amber-colored urine without sediments. The patient has sequential compression device (SCD) in place. The nurse performs an assessment and notes that the patient’s breath sounds are decreased bilaterally in the bases and the patient has inspiratory crackles. The patient’s cardiac assessment is within normal limits. The patient is receiving O2 at 2 L per nasal cannula with a pulse oximetry reading of 95%. The vital signs include: blood pressure, 100/50 mm Hg; heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is afebrile. The patient is confused as to place and time.
- Explain the assessment parameters used to provide clues to detect postoperative problems early and the interventions needed.
- What gerontological postoperative considerations should the nurse make?
2. Mr. John Smith is admitted to the hospital for surgical incision and drainage (I&D) of an abscess on his right calf, which resulted from a farm machinery accident. The right calf has an area 3 cm × 2.5 cm, which is red, warm and hard to touch, and edematous.
- Explain the wound healing process according to the phase of Mr. Smith’s wound?
- The surgeon orders for wet-to-dry sterile saline dressing twice a day with iodoform gauze to the wound, covered with the wet-to-dry dressing. Explain how to perform this dressing change.
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Case Study 18983861
Case Study.
APA 6th ed format.
Work supported by at least 3 peer reviewed references.
One document is the case study, the other is an example.
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Case Study 18969639
Case Study
Read the following case study:
A small community hospital in the Midwest has used a homegrown information system for years. The system began in the early 1970s with a financial module. Over time, additional modules were added. A limited number of departments selected a commercial system and interfaces were used to integrate these into the overall functionality of the hospital information system. Except for physicians, most in-house clinical or care-related documentation is online. However, about 15% to 20% of this documentation is done by free text and is not effectively searchable. In addition, the screens, including the drop-down and default values, were built using terms selected by the in-house development team in consultation with clinical staff; thus there is no data dictionary or specific standard language. In the last few years, the hospital has purchased two outpatient clinics (obstetrics and mental health) and a number of local doctor practices. The clinics and doctors’ offices are now being converted to the hospital administrative systems. A few of the clinical applications that are tied directly to the administrative systems such as order entry and results reporting are also being installed.
A major change is being planned. A new chief information officer (CIO) was hired last year and she has appointed a chief medical information officer (CMIO) and a chief nursing information officer (CNIO). No other significant staff changes were made. With her team in place, one of the CIO’s first activities was to complete an inventory of all applications. Rather than continue to build, a decision was made to switch to a commercial vendor and the hospital selected a commercial system.
As a member of the clinical staff with informatics education, the CIO has requested that you develop a training and information presentation for the clinical staff that will:
1· Identify two or more issues with the existing system
2· Provide staff with appropriate “work-around” for using the existing system
3· Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps
– One standard language should pertain only to nursing
– One standard language should be multidisciplinary.
4· Obtain clinical staff input, using a five-question survey, of specific methods to support transition to the new system; questions should be open-ended.
PowerPoint Presentation
Directions:
1. Review the case study.
2. Download the provided PowerPoint template to create a presentation that includes:
· Your name on the title slide of the presentation
· Identification of two or more issues with existing system
· Identification of “work-a-round” solutions when using existing system
· Overview of standard language used only in nursing
· Overview of multidisciplinary standard language
· Set of five (5) open-ended survey questions for staff input on transitioning to the new system
Presentation is free of spelling and grammar errors.
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Case Study 18957547
In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
You are required to submit this assignment to Turnitin.
Case Study 1
Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physician’s notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints.”
Laboratory values are as follows:
Hemoglobin = 8 g/dl
Hematocrit = 32%
Erythrocyte count = 3.1 x 10/mm
RBC smear showed microcytic and hypochromic cells
Reticulocyte count = 1.5%
Other laboratory values were within normal limits.
Question
Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In an essay of 500-750 words, explain your answer and include rationale
Case Study 2
Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.
Question
Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:
· Describe your approach to care.
· Recommend a treatment plan.
· Describe a method for providing both the patient and family with education and explain your rationale.
· Provide a teaching plan (avoid using terminology that the patient and family may not understand).
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Case Study 18934133
Jessica is a 32 y/old math teacher who presents to the ER with a friend for evaluation of sudden decrease of vision in the left eye. She denies any trauma or injury. It started this morning when she woke up and has progressively worsened over the past few hours. She had some blurring of her vision 1 month ago and thinks that may have been related to getting overheated, since it improved when she was able to get in a cool, air-conditioned environment. She has some pain if she tries to move her eye, but none when she just rests. She is also unable to determine colors. She denies tearing or redness or exposure to any chemicals. Nothing has made it better or worse.
She is normally healthy. She had chickenpox at age 10 and a tonsillectomy/adenoidectomy at age 11. She has no medical problems. She has never been hospitalized. She has four children, all spontaneous vaginal deliveries. She completed a bachelor’s degree in mathematics and a master’s degree in education. She quit smoking 10 years ago (two packs daily for 5 years); she drinks an occasional wine cooler, and she denies illicit drug use. Her father has a coronary artery disease (he had a stent placed at age 67) and a mother with hypertension.
She denies fever, chills, night sweats, weight loss, fatigue, headache, changes in hearing, sore throat, nasal or sinus congestion, neck pain or stiffness, chest pain or palpitations, shortness of breath or cough, abdominal pain, diarrhea, constipation, dysuria, vaginal discharge, swelling in the legs, polyuria, polydipsia, and polyphagia.
Patient is alert; she appears anxious. BP 135/85 mm Hg; HR 64bpm and regular, RR 16 per minute, T: 98.5F. Visual acuity 20/200 in the left eye and 20/30 in the right eye. Sclera white, conjunctivae clear. Unable to assess visual fields in the left side; visual fields on the right eye are intact. Pupil response to light is diminished in the left eye and brisk in the right eye. The optic disc is swollen. Full range of motions; no swelling or deformity. Mental status: Oriented x 3. Cranial nerves: I-XII intact; horizontal nystagmus is present. Muscles with normal bulk and tone; Normal finger to nose, negative Romberg. Intact to temperature, vibration, and two-point discrimination in upper and lower extremities. Reflexes: 2+ and symmetric in biceps, triceps, brachioradialis, patellar, and Achiles tendons; no Babinski.
Instructions:
Make a whole history and physical examination in a comprehensive manner with all its elements included: CC, HPI, PMH, FH, SH, MEDICATIONS, ALLERGIES, ROS PER APPARATUS OR SYSTEMNS, HEAD TO TOE PHYSIACL EXAMINATION PER SYSTEMS ( write your presentation in H&P format no paragraph format).
Based on this information, what is your presumptive nursing diagnosis? All nursing diagnosis that apply to the case written in NANDA format related to … and evidence by…., NO MEDICAL DIAGNOSIS.
Teaching plan and nursing care plan per each nursing diagnosis on this case.
Requirements.
1- All written assignment and documentations must be in APA 6th edition format.
2- Double spaces, minimum 4 pages long , minimum 3 up to date bibliography. (UP to date means last 3 years.), Note: have to be written in APA format.
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Case Study 18930701
Individually Authored CSA #3
Instructions
In this module, you will write an individually authored case study analysis. The case study for this module’s writing assignment is “A Small Healthcare Clinic Confronts Health Insurance Problems,” which appears on pages 441-443 of the textbook.
The paper should address the three discussion questions that appear at the end of the case.
The length of the case analysis should be approximately 1,000 words (excluding the reference list at the end of the paper). The paper should also apply and cite at least three external references above and beyond the textbook. APA format is required.
Submit the individually authored case study analysis to the Assignment box no later than Sunday 11:59 PM EST/EDT. (The Assignment box is linked to Turnitin.)
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