Arterial blood gasses are prescribed for a client with chronic renal failure who has hypotension, cold and clammy skin, and dysrhythmias. The nurse should notify the HCP to report that the client is experiencing which imbalance? (Refer to values in the exhibit)
Respiratory acidosis
Respiratory alkalosis
(There were also 2 other answers but I wasn’t able to get them, if it’s not from the choices above) Thank you
| Scenario: Mr. Jack Charles owns and manages a Market Garden mainly producing celery and herbs. He and his son “Thomas” share this business together. Thomas has a wife and three young children aged 2, 4, and 6.
Mr. Jack Charles is a 78-year-old type 2 diabetic. He was first diagnosed in 1999 with hypertension then 2 years later as a type 2 diabetic. His wife Gladys has been managing his diet and medications until she died in 2010. He has hypercholesterolemia managed with Lipitor 40mg nocte, hypertension managed with Aldomet 50mg daily, his type 2 diabetes is managed with diet, and Metformin 500mg slow release BD. He has been struggling to manage his health and work on the Farm. Mr. Charles was admitted to a Private Hospital 65 days ago with unstable ischaemic heart disease. On admission, his BGL was 20 mmol/liter and he had polyuria, polydipsia, and polyphagia. He required emergency Quadruple Coronary Artery Bypass Grafts (CABGs)that were complicated post-operatively by a Right Cerebrovascular Accident (RCVA).
After ten (10) days he was transferred to a Private Rehabilitation Centre to receive specialized post-stroke management. He has L leg weakness, L arm weakness, and dysphasia as a result of his ischaemic stroke. Medications in Rehabilitation Hypertension is now managed by Captopril 50mg TDS Diabetes is now managed by TDS Actrapid Insulin 10 units Hypercholesterolaemia us managed by Lipitor 80mg Clexane 80mg BD subcutaneously He will require Oral warfarin on discharge, dosage to be determined.
|
| PART 1 – REHABILITATION HOSPITAL CARE | ||
| Q1.1 Identify 2 Priority chronic health problems and describe possible impacts of the conditions on body systems and Mr Charles’ ability to perform daily living activities. | ||
|
|
||
| Teacher Feedback: | MR | FER |
| Q1.2 Seek information from Mr Charles, and as appropriate, with family or carer to confirm their understandings of the condition and its impact.
What question/s would you ask Mr Charles and his son “Thomas “to determine if they have an understanding of one of Mr Charles’ chronic health conditions and its impact on their life and activities of daily living? |
||
|
|
||
| Teacher Feedback: | MR | FER |
| Q1.3 In the Post Stroke Rehabilitation Program,
identify the current treatments given by teach of the following members of the interdisciplinary health team Medical Doctor, Nurse , Physiotherapist , Occupational Therapist, Speech Therapist to Mr Charles in rehab and on discharge. |
||
|
|
||
| Teacher Feedback: | MR | FER |
| Q1.4 Identify community-based care services that are available for Mr Charles with a need for restorative or rehabilitation care. | ||
|
|
||
| Teacher Feedback: | MR | FER |
| Q1.5 Actively involve Mr Charles in the development of strategies to self-manage his condition. Describe the strategies, or design a program to help teach Mr Charles how to self-manage his Type 1 Diabetes and the introduction of insulin therapy.
Please make reference to:
|
||
|
|
||
| Teacher Feedback: | MR | FER |
| PART 2 – COMMUNITY CARE | ||
| Q2.1 Identify current contribution of other agencies and professionals in supporting Mr Charles. For the following agencies and professionals, determine their contribution in providing care for Mr Charles in hospital, or following discharge.
Please make reference to the following:
|
||
|
|
||
| Teacher Feedback: | MR | FER |
| Q2.2 Identify the level and type of contribution and support made by family or carer. | ||
|
|
||
| Teacher Feedback: | MR | FER |
| Q2.3 As a nurse, identify four (4) situations you will communicate with allied health professionals to describe Mr Charles progress. Provide an example for each situation of how and what is communicated. | ||
|
|
||
| Teacher Feedback: | MR | FER |
| Q2.4 Respond to variations in Mr Charles needs in the context of a coordinated service approach. Mr Charles is very sad and writes: “I can’t live like this. I just want to die- and I know how to do it.” As a nurse, how will you respond and what members of the health care team will you contact to help deal with this situation? | ||
|
|
||
| Teacher Feedback: | MR | FER |
Q2.5 After consultation with the Endocrinologist and Diabetic Nurse Educator, Mr Charles has been told he will need to manage his insulin injections to help control his Type 1 Diabetes. How will you as a nurse, educate and evaluate Mr Charles understanding of his diabetes and new management regime? Please make reference to the following:
|
||
Please explain the pathophysiologic processes of cardiovascular and cardiopulmonary systems that result from a week post-op patient experiencing shortness of breath, chest pain, new onset afib and inverted T waves on ECG.
Reflect on the importance of interoperability within healthcare delivery and the role that informatics technical standards play in the process. Now consider the role that an informatics nurse specialist plays in the development and adoption of, usability, and adoption of informatics technical standards. How relevant to nursing practice are these technical standards? How much does a clinical nurse need to know about these standards? Explain your reasoning. What are some key considerations for an informatics nurse specialist eg., what skills and knowledge are needed to best fulfill job/career roles?
You are the nurse manager of a pediatric oncology unit. You are also the manager of the same day chemo unit that is attached to your inpatient unit. The strategy for delivering chemotherapy to children under the age of 18 is going to change in order to accommodate family schedules and school needs. Children will now be receiving their chemotherapy after 4 PM or on the weekend. This means that many of them will not be finished with their infusions until 10 PM or later and the unit will need to be staffed on the weekend which was not the case previously. This will greatly alter the staffing needs of the unit.
1. What is your course of action in the situation?
2. What is the fiscal impact of this change?
3. What data will drive this change?
4. Whose responsibility is it to provide education and support in the given situation?
5. How would you evaluate the outcome(s) of this change?
Donna and Darren have three children. Darren’s father has hypercholesterolemia, which is transmitted in an autosomal dominant pattern. Darren gets his cholesterol levels checked frequently, and they have remained within normal limits; however, two of Donna and Darren’s three children have high plasma levels of total and LDL cholesterol. Darren doesn’t understand why his children are affected when it is clear that he is healthy. 1. Do you see any risk factors or inheritance patterns (include family members in your response)? 2. What could explain why Darren is unaffected but two of his children are affected? 3. What are treatments for familial hypercholesterolemia? 4. When would children be treated?
Review the case study and identify 2 differential diagnoses (Asthma and Obstructive Sleep Apnea Syndrome) please provide rationales to support them. also discuss treatment plans for them.
Please use the two differential diagnoses provided
Please use and provide 3 peer review journals thank you
“My daughter has been coughing for the past 3 months. She cannot even play & run with her playmates.” HPI: 3 1/2 year old Shelly has been seen several times in the office for colds, cough and wheezing. She has been on Orapred 3 times in the past year for this. No other meds have been given.
PMH: She was a term baby delivered without complication. No feeding, growth issues and is developmentally on target for age. Mom does report 3 years ago Shelly was very sick in the hospital with an infection in New Jersey. Immunizations are up to date.
Review of Systems: (obtained from mom)
General: “A normal 3 year old, she just coughs all the time, and when she has a cold it settles in her chest!”
HEENT: She sometimes has very dark circles under her eyes. I think it is from her not sleeping and coughing all night.
Chest/Resp: Coughing, sometimes to the point of not catching her breath. Maybe she is out of shape but she can’t play like her friends, she just coughs and has to stop. Coughs every day & night, especially in the winter. (FMH of both parent with Asthma)
Chest/Card: No color changes
GI/GU: Eats well, no issues
MSK/Extremities: Walks without an issue
PE:
She is wheezing bilaterally, is unable to really take in a good breath, afebrile, and VSS.
————–
1. How can you apply the acquired knowledge in your role as a PSW in the Community Setting? Few weeks later, Grace saw John (Mrs. Cross son) who came to visit his mom. After his visit, Mrs. Cross appeared to be anxious and concerned. Two days after she shared her concerns with Grace. Apparently, John decided to move from BC to Toronto. John lost his job due to COVID and the family struggled financially.
Cross’sJohn has two kids. His wife didn’t work for many years. John lived in Barb’s house when they came from BC for the funeral.
He cannot stay there any longer. Mrs. Cross has a two-bedroom condo apartment. The apartment is rented. John is asking Mrs. Cross to allow his family to live there until they recover financially. He won’t be able to pay for the apartment, and asks Mrs.
Cross to support them money-wise. Mrs. Cross also mentioned that John asked her to change the Will, to make him her power of attorney (POA) and to write the apartment on his name. One day, you overheard their phone conversation. John was yelling at Mrs. Cross. You heard him saying, “Who do you want to leave this apartment to?
I am your son, and it belongs to me. You have to help me and my kids.” Mrs. Cross made John her POA, but refused to change the Will and to write the apartment on his name. She allowed them to live in the apartment until he finds a job. She agreed to pay for the condo bills.
Mrs. Cross still suffers from pain. Her arthritis got worse, and she needs to ambulate with a walker. Grace also noticed that Mrs. Cross got prescribed a new BP medication. During the last medical check-up, her BP was 178/97.
On Monday, Grace was scheduled to assist Mrs. Cross with a shower and laundry. She enters the apartment @ 8 am and finds Mrs. Cross on the floor. Grace noticed that the right leg is turned outwards and shorter than the other. Mrs. Cross is unconscious, and the right side of the face is not symmetrical to the left.
Considering the Policy Process (Chapter 7 – Berkowitz in Mason, Levitt, & Chaffee), appraise a recent healthcare policy change on your unit or in your organization using the Policy Process. This discussion may also present for you an opportunity to reflect back on a “burning question” that you may have as a nurse.
please put reference.
Alert & oriented X 3, speech clear, coherent, goal-directed, spontaneous. The self-reported mood is “sad”. The affect was somewhat blunted, but the child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes were noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation but does admit that he often thinks about himself being dead and what it would be like to be dead.
The PMHNP administers the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)
Writemynursingpaper.com provides custom papers such as Essays, Term papers, Research papers, Theses, and Dissertations to its global clientele. These papers are only deemed as reference materials meant for providing assistance to our customers.
Email:
support@writemynursingpaper.com
phone: +1 (617) 871 9964