Asthma and significant fatigue

The patient presents with an exacerbation of their asthma and significant fatigue. Difficulty breathing and feeling of phlegm in their lungs that isn’t brought up by coughing. Symptoms are unresolved by her inhalers. Patient says they haven’t seen their primary physician in over a year.

Name: Smith, Sarah                    Allergies: Penicillin, Pollen                   DOB: 17/06/1990 
Medical Record #: 28-7665
Reason for Seeking Care Patient presents with an exacerbation of their asthma and significant fatigue. Difficulty breathing and feeling of phlegm in their lungs that isn’t brought up by coughing. Symptoms are unresolved by her inhalers. Patient says they haven’t seen their primary physician in over a year.
Client Details: Sex: Female        Age: 31           Height: 5’4              Weight: 140

 

Vital Signs (upon admission):

T: 36.5 C                         HR: 120 BPM                            RR: 24

BP: 149/95                      SpO2: 92% (room air)               Pain Scale: 5

 

Presented with wheezing upon inspiration bilaterally, fatigue, cough, dyspnea. Patient is anxious about entering the hospital and about finding a way to control her asthma.

Past Health: Asthma diagnoses in 2000. Diagnosed with a seasonal allergy to pollen in 2001. No other health issues or concerns at this time.
Current Medications: Proventil HFA (90mcg Albuterol) Inhaler PRN

Advair Discus (100mcg Fluticasone Propionate / 50mcg Salmeterol) q2d

Tylenol 650mg PRN (usually q3 week for headaches)

 

Patient states she doesn’t use her Advair inhaler because she “doesn’t think it does anything”. When asked about her medications, patient was unable to explain what they were specifically for. When asked to demonstrate using inhalers, patient used incorrect technique.

Family History Patient’s parents are both smokers, but mom quit smoking tobacco 3 years ago and took up vaping. Dad still smokes tobacco every day, he goes through a pack every couple of days.

Patient has 2 siblings both girls and they are both younger than the patient.

Patient is single with no children.

Occupation The patient has been working as a receptionist for the last 7 years.
Education Some college.
Activity & Mobility Fully independent. Patient says she used to play soccer on the weekends with a group at her local community center, but since her asthma has gotten worse is unable to play. The only exercise she gets now is walking around the house and office.
Sleep and Rest Reports no issues sleeping. Goes to bed around 2300 each night and wakes up at 0700 for work and 0900 on weekends. Although she gets 8-10 hours of sleep each night, she always feels fatigued. Also reports feeling very tired in the afternoons (1400-1600) and usually has a coffee around this time to keep her awake.
Nutrition and Elimination Patient is lactose intolerant, so she avoids eating milk products unless they are lactose free.

 

Patient has a coffee every morning and usually skips breakfast, the odd day she will pick something up from Tim Hortons. For lunch she normally has a salad that contain spring mix, kale, spinach, cucumber, tomatoes, peppers, feta with balsamic dressing. Sometimes shell make a sandwich with 3 layers of meat, lettuce, tomatoes, pickles, hot peppers, mayo and Italian dressing. The patient will normally have an apple or granola bar in the afternoon as a snack. The patient eats a large dinner, normally it contains a large portion of veggies, piece of meat and a portion of starch. Sometimes the patient will have a nice big bowl of pasta. When the patient relaxes on the couch before bed, she likes to treat herself by eating some of her favourites, candy, chocolate or chips with a pop.

Spirituality / Religion No religious/spiritual affiliations.
Coping & Stress Management  The patient will practice her breathing exercises to help cope with her stress and to reduce the symptoms of an asthma attack. Some other coping strategies the patient uses to prevent asthma attacks is taking her medication on a regular basis, getting her annual flu shot, practicing hand hygiene, and avoiding scented areas. All of these coping strategies help prevent triggering an attack and also help prevent triggering more stress because they more attacks she has, the more permanent damage that can be caused within her airways and this causes a lot of stress to her and her family.
Smoking History, Alcohol, Substance Abuse Patient reports that she does not smoke cigarettes. Patient reports having 2-3 drinks during the week and occasionally drinks in excess on the weekend with friends (1-2 times per month). Patient states that she does not use any recreational drugs.

 

hey there according to this patient profile the nursing diagnosis i have is patient is at risk for depression and social isolation due to feeling a negative self-image as evidenced by the patient report of low self-worth and withdrawal from social activities. please I would need help getting

3 goals

3 interventions

3 rationale so for each gaol there would be 3 interventions and 3 rationales.

I also would like a nice explanation of the rationale explaining why  and also the website for research for more reading

thank you. 🙂

The most recent version of the Prospectus template in the DC Network

Locate and download the most recent version of the prospectus template in the DC Network (http://dc.gcu.edu/dnp). This document has help and criteria information embedded to assist you in the completion of the prospectus.

  • Locate “The 10 Strategic Points” document (completed in previous courses). You will use information from this document to write the prospectus and attach this document as an appendix in the prospectus.
  • Review “DNP-830 Direct Practice Improvement (DPI) Project Guide,” (Chapters 1-3 only) for use in writing the prospectus.

Issues surrounding human Genetics and eugenics

Learning about issues surrounding human genetics and eugenics, including stem cell research, cloning, and genetic testing and treatment.

  • Choose and describe a scientific technique or practice related to genetics and eugenics. Provide the rationale behind the use of this technique or practice.

Congestive heart failure clients

You are a population health nurse working with congestive heart failure clients (greater than the age of 65) who receive services from your hospital. From a population health management perspective, identify services and interventions that address the health needs of this particular population.

Your exploration with this particular population should include cost-effective interventions that address health promotion and illness prevention, risk management, care coordination, and disease management.

Health Insurance Portability

Based on the research you completed in the previous slide, write a one-page summary (Four to Five thousand words) on the Health Insurance Portability and Accountability Act (HIPAA).

You may respond to one or more of the following questions as you write your report.

  • Why is HIPAA important to patients?
  • How does HIPAA provide security?
  • How does HIPAA help doctor’s offices with the standardization of patient records?
  • Who is required to follow HIPAA requirements?

Please review the information on this website, from the Department of Health and Human Services. 

 

Psychological Cultural and spiritual aspects

Explain why psychological cultural and spiritual aspects are important to consider for a patient who has been diagnosed with diabetes. Describe how support can be offered in these respective areas as part of a plan of care for the patient. Provide examples. NOTE: Please while writing, include intext citations and references published within the last 5 years. Thank you

Major or mild Neurocognitive disorders

Compare and contrast major or mild neurocognitive disorders with Lewy Bodies versus major or mild frontotemporal neurocognitive disorder. Place particular emphasis on how comprehensive assessment could help us to arrive at the correct diagnosis.

2- provide reference from 2018 to 2022

 

Board of nursing regulations in California

Post a comparison of at least two APRN board of nursing regulations in California with those of Florida. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice

Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

 Academic Success and Professional Development Plan

Using the “Module 3 | Part 3” section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:

  • Your topic of interest.
  • A correctly formatted APA citation of the article you selected, along with link or search details.
  • Identify a professional practice use of the theories/concepts presented in the article.
  • Analysis of the article using the “Research Analysis Matrix” section of the template
  • Write a 1-paragraph justification stating whether you would recommend this article to inform professional practice.
  • Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
    • Describe your approach to identifying and analyzing peer-reviewed research.
    • Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research.

Identify at least one resource you intend to use in the future to find peer-reviewed research

Focused Thyroid Exam

Focused Thyroid Exam. Kali, a 44-year-old female is in the office for a complete physical examination. She complains of proptosis and feeling fatigued. Her TSH levels are elevated, she has hyperlipidemia, her neck appears swollen, and is overweight.

 

question: Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition and identify at least five possible conditions that may be considered in a differential diagnosis for the patient.