Clinical judgment and diagnostic skills, As a Nurse Practitioner, write a Case study that demonstrates your critical thinking skills, diagnostic skills, utilization of evidence-based practice, clinical judgment, pharmacological management, follow-up plan, and how you would promote preventive care for this patient.
Describe in an essay your plan for continuing your education as a life-long learner.
Nurses often become motivated to change aspects within the larger healthcare system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger healthcare system. Identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation.
Discuss Strategies for better academic achievements in nursing; Academic achievements in nursing can be enhanced through building positive networks and applying the current technology techniques correctly. It is crucial to continuously advance skills, knowledge, and usage of technology and the internet for better academic achievements.
Emily is 11yrs old and has ASD (Autism Spectrum Disorder) and ADHD( Attention Deficit Hyperactivity Disorder).
Autism is a lifelong developmental disability that affects the way a person communicates and how they experience the world around them. ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood.
Children with ADHD may have trouble paying attention, control impulsive behaviors (may act without thinking about what the result will be), or be overly active. Autism and ADHD often coincide. An estimated 30 to 80 percent of children with autism also meet the criteria for ADHD.
Jennifer is a 16-year-old assessed in the school health clinic for flu-like symptoms> While obtaining her health history she admits her parents are unaware that she uses both control pills. Which of the following is an important part of establishing a therapeutic relationship with this client?
1-Maintaining confidentiality about non-life treatment issues
2-Letting her know she needs to talk to her parents about both control pills
3 Asking if she is sexually active
4-Promings that everything she shares with you is confidential
Review the Millie Larsen case update within this assignment, read the questions, and consult your resources–particularly the texts and National Patient Safety Goals website concerning Hospital Chapter, Goal 7, NPSG.07.01.01 and NSPG.07.03.01. Brainstorm ideas and formulate your responses. Use the Braden Scale form to score her skin risk; access the Braden Scale form through the link below.
Several weeks have passed since the clinic visit, and Millie is now re-admitted to the hospital with a diagnosis of urinary tract infection and dehydration. Her presentation is atypical, and she is confused. Upon the admission assessment, the nurse notices that Millie has a wound on her sacrum and asks her if it is painful. Millie states that “it does hurt, so I have just been lying down more.” The nurse places a gauze dressing over the wound and continues with the assessment.
She is now being cared for on a medical-surgical unit and because she is confused, she has a bed alarm for her safety. Millie needs much encouragement to get out of bed and walk to the bathroom so has become more incontinent and requires frequent bed changes. She is receiving intravenous fluids and medications for the urinary tract infection. Millie appears weak and underweight as she is only eating about one-quarter of her meals. She refuses to drink the supplements that she is offered and sometimes refuses to take her medications.
A few days later, it is noted that the wound has worsened and now has purulent drainage with a foul odor which will require referral to a wound nurse for additional care. Wound cultures are positive for methicillin-resistant staphylococcus aureus (MRSA).
Before responding to the questions, review the following videos:
Respond to the Following Questions
Oval wound on person with deep wound bed. Overall skin color is lightly pigmented. Yellow fatty tissue noted in part of wound bed. Remainder of wound bed is red.
Pathophysiology of acute renal failure in rhabdomyolysis; A 28-year-old male presents to the primary care office for evaluation of left calf pain, swelling, and redness. He reports that this started one day ago and worsened today. He ran a 27-mile marathon 2 days ago and traveled for 3 hours in a car today.
He reports slight pain on walking and a swollen red calf. He took Ibuprofen 600 mg twice today without relief. Patient reports being an experienced runner, running 3-5 miles daily. He trained for the marathon for 4 months. The patient also reports a history of exercise-induced asthma and uses albuterol sulfate HFA as needed.
On physical exam, the patient appears in good health T 99 P 68 R 18 BP 118/78 wt. 175 lb, height 72 in. BMI 23.1. Heart rate is regular without murmurs, rubs, or gallops. Lungs clear bilaterally. HEENT WNL. Strength lower extremities 5 and DTRs 2. Left calf erythematous, edematous, warm, and tender on palpation. Pulses 3
Quiz – Module 3 Knowledge Check
Knowledge Check: Gastrointestinal and Hepatobiliary Disorders
• In this exercise, you will complete five essay-type questions in the Knowledge Check to gauge your understanding of this module’s content.
• Each question will hold one to two parts asked to be addressed and each part will need at least one citation, at least two citations if asked two parts to the question from the textbook and/or current peer-reviewed journals.
• Each question is worth 4 points. I would expect substantive paragraphs per answer (a paragraph would include 6-10 sentences).
KC each essay needs a citation(s) and reference(s), if using textbook apply correct page(s)
Basic book citation format
The APA in-text citation for a book includes the author’s last name, the year, and (if relevant) a page number.
In the reference list, start with the author’s last name and initials, followed by the year. The book title is written in sentence case (only capitalize the first word and any proper nouns). Include any other contributors (e.g. editors and translators) and the edition if specified (e.g. “2nd ed.”).
Format Last name, Initials. (Year). Book title (Editor/translator initials, Last name, Ed. or Trans.) (Edition). Publisher.
Reference entry Anderson, B. (1983). Imagined communities: Reflections on the origins and spread of nationalism. Verso.
In-text citation (Anderson, 1983, p. 23)
Possible topics covered in this Knowledge Check include:
• Ulcers
• Hepatitis markers
• After HP shots
• Gastroesophageal Reflux Disease
• Pancreatitis
• Liver failure—acute and chronic
• Gall bladder disease
• Inflammatory bowel disease
• Diverticulitis
• Jaundice
• Bilirubin
• Gastrointestinal bleed – upper and lower
• Hepatic encephalopathy
• Intra-abdominal infections (e.g., appendicitis)
• Renal blood flow
• Glomerular filtration rate
• Kidney stones
• Infections – urinary tract infections, pyelonephritis
• Acute kidney injury
• Renal failure – acute and chronic
QUESTION 1
1. Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed urease.
The healthcare provider suspects the client has peptic ulcer disease.
Questions:
1. Explain what contributed to the development from this patient’s history of PUD?
QUESTION 2
1. Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed urease.
The healthcare provider suspects the client has peptic ulcer disease.
Question:
1. What is the pathophysiology of PUD/ formation of peptic ulcers?
QUESTION 3
1. Scenario 2: Gastroesophageal Reflux Disease (GERD)
A 44-year-old morbidly obese female comes to the clinic complaining of “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea.
PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m2)
FH:non contributary
Medications: Lisinopril 10 mg po qd, Bentyl 10 mg po, ibuprofen 800 mg po q 6 hr prn
SH: 20 PPY of smoking, ETOH rarely, denies vaping
Diagnoses: Gastroesophageal reflux disease (GERD).
Question:
1. If the client asks what causes GERD how would you explain this as a provider?
QUESTION 4
1. Scenario 3: Upper GI Bleed
A 64-year-old male presents the clinic with complaints of passing dark, tarry, stools. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper GI bleed which won’t be confirmed until further endoscopic procedures are performed.
Question:
1. What are the variables here that contribute to an upper GI bleed?
QUESTION 5
1. Scenario 4: Diverticulitis
A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning. She stated the first episode occurred last week. The episode today was accompanied by nausea, sweating, and weakness. She states she has had some LLQ pain for several weeks but described it as “coming and going”. She says she has had a fever and abdominal cramps that have worsened this morning.
Diagnosis is lower GI bleed secondary to diverticulitis.
Question:
1. What can cause diverticulitis in the lower GI tract?
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