Neurologic Function Case Study

Part 1:

Compare and contrast the 3 conditions (pain) in the chart. (I attached the chart)

Part 2:

Choose a pain syndrome to explore (pick one of them).

Present a hypothetical case that includes the following:

1. 1. Vital information about a person who might be predisposed to this condition (I.e., a person who may have risk factors for this condition).
2. 2. The pathophysiology of the disease, including clinical manifestations.
3. 3. Which diagnostic tests you’d recommend and a rationale for the one(s) you choose.
4. 4. How this condition compares to other differentials. (use differential chart)
5. 5. The evidence-based recommendations from the AHRQ guidelines (https://www.ahrq.gov/gam/index.html) or guidelines recommended from a professional organization. Based on these recommendations, discuss how  to manage the condition best.
6. 6. A patient safety issue that could be associated with the condition presented in this case.

Part 3:

Answer these reflection questions:

1. 1. What information would a master’s prepared nurse gather from a patient with this condition?
2. 2. How could the master’s prepared nurse use this information to design a patient education session for someone with this condition?
3. 3. What was the most confusing or challenging information presented in this case?

Expectations: 

• -Use medical terminology and appropriate graduate level writing.
• -Your resources must include research articles and reference to non-research evidence-based.
• -AHRQ guidelines
• -Use APA format to style your paper and to cite your sources. Your source(s) should be integrated into the paragraphs. Use internal citations pointing to evidence in the literature and supporting your ideas. You will need to include a reference page listing those sources. Cite a minimum of three resources.

Purpose

The purpose of this assignment is to apply hypersensitivity pathophysiological concepts to explain assessment findings of a patient with Allergic Rhinitis. Students will examine all aspects of the patient’s assessment including: Chief Complaint (CC), History of Present Illness (HPI), Past Medical History (PMH), Family History (FH), Social History (SH), Review of Systems (ROS), and Medications and then answer the questions that follow on the provided Comprehensive Case Study template.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

1. Analyze the case to arrive at the type of hypersensitivity reaction that the patient is exhibiting. (CO1)
2. Explain the pathophysiology of the identified hypersensitivity reaction. (CO1)
3. Identify all subjective and objective information provided in the case. (CO3)
4. Explain, using pathophysiology, the rationale for each subjective and objective finding. (CO1, CO3)
5. Identify two types of medications that are strongly recommended for the treatment of allergic rhinitis according to the clinical practice guidelines on the management of allergic rhinitis. (CO2, CO5)
6. Explain the mechanism of action of the two medication classifications and include how the symptoms of allergic rhinitis are alleviated when taken. (CO2, CO5)

Due Date

Sunday by 11:59 PM MT of Week 1

Total Points Possible

This assignment is worth 100 points.

Preparing the Assignment

Content Criteria:

1. Read the case study listed below.
2. Refer to the rubric for grading requirements.
3. Utilizing the Week 1 Case Study TemplateLinks to an external site., provide your responses to the case study questions listed below.
4. You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
5. You must use the Clinical Practice Guideline (CPG) for the management of allergic rhinitis to answer the treatment recommendation questions. The guideline can be found at the following web address: https://journals.sagepub.com/doi/10.1177/0194599814561600Links to an external site..You may also use a medication administration reference such as Epocrates to provide medication names.
6. Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.

Case Study Scenario

A 35-year-old woman presents to the primary care office with a history of nasal congestion that has worsened over time and recurrent sinus infections. She considered herself healthy until about 12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that “seems to never go away”. She noticed that her rhinorrhea greatly improved when she attended her family reunion on a two-week Caribbean cruise but returned after being home a few days. She lives with her husband and 5- year-old child. They have two household pets: a dog that has lived with them for the last 4 years and a cat who joined the family 1 year ago. Upon exam, the NP observed eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners (lower lid venous swelling), Allergic crease (lateral crease on the nose) and inflamed nares.

Case Study Questions

Pathophysiology & Clinical Findings of the Disease

1. Identify the correct hypersensitivity reaction.
2. Explain the pathophysiology associated with the chosen hypersensitivity reaction.
3. Identify at least three subjective findings from the case.
4. Identify at least three objective findings from the case.

Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

1. Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each.
2. Describe the mechanism of action for each of the medication classes identified above.
3. Identify two treatment options that are NOT recommended (I.e., recommended against).

ASSIGNMENT CONTENTCategoryPoints%Description

Pathophysiology & Clinical Findings of the Disease

45

45%

The student:

• Identifies the correct hypersensitivity reaction.
• Explains the pathophysiology associated with the chosen hypersensitivity reaction.
• Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).
• Identifies at least three subjective findings from the case.Identifies at least three objective findings from the case.

(5 Required Elements)

Management of the Disease 

45

45%

The student:

• Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.
• Identifies two strongly recommended medication classes for the treatment of the condition and provides an example (drug name) for each.
• Describes the mechanism of action for each of the medications identified.Identifies two treatment options that are NOT recommended (I.e.,recommended against).

90

90%

Total CONTENT Points = 90 pts

ASSIGNMENT FORMAT

CategoryPoints%DescriptionOrganization, spelling, grammar & APA format

10

10%

The student:

• Uses the week 1 case study template for case study responses.
• Provides correct in-text citations for responses which match the reference page.
• Has minimal spelling, grammar & APA format errors.

1010%Total FORMAT Points = 10 pts100100%ASSIGNMENT TOTAL = 100 points

Rubric

NR507 Week 1 Case Study

NR507 Week 1 Case Study

CriteriaRatingsPts

This criterion is linked to a Learning OutcomePathophysiology & Clinical Findings of the Disease

The student:- Identifies the correct hypersensitivity reaction.- Explains the pathophysiology associated with the chosen hypersensitivity reaction.- Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).- Identifies at least three subjective findings from the case.- Identifies at least three objective findings from the case.(5 Required Elements)

45 pts

All 5 required elements are present

41 pts

1 required element is missing.

37 pts

2 required elements are missing

23 pts

3-4 required elements are missing.

0 pts

All 5 required elements are missing.

45 pts

This criterion is linked to a Learning OutcomeManagement of the Disease

The student:- Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.- Identifies two strongly recommended medication classes for the treatment of the condition and provides an example (drug name) for each.- Describes the mechanism of action for each of the medications identified.- Identifies two treatment options that are NOT recommended (I.e., recommended against).

45 pts

All 4 elements are present

41 pts

1 required element is missing

37 pts

2 required elements are missing

23 pts

3 required elements are missing

0 pts

All 4 required elements are missing

45 pts

This criterion is linked to a Learning OutcomeOrganization, spelling, grammar & APA format

The student:- Uses the week 1 case study template for case study responses.- Provides correct in-text citations for responses which match the reference page.- Has minimal spelling, grammar & APA format errors.

10 pts

Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 0-2 errors in spelling, grammar or APA format.

9 pts

Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 3-5 errors in spelling, grammar or APA format.

8 pts

Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 6-8 errors in spelling, grammar or APA format.

5 pts

Case study template is not used for responses OR In-text citations are incorrect or do not match the reference page AND There are 0-5 errors in spelling, grammar or APA format.

0 pts

Case study template is not used for responses AND/OR In-text citations are incorrect or do not match the reference page AND There are 6 or more errors in spelling, grammar or APA format.

10 pts

This criterion is linked to a Learning OutcomeLate penalty deductions

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

0 pts

Manual Deductions

0 pts

Manual Deductions

0 pts

Total Points: 100

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Hi writer please see attach document for the  case study with instructions including rubric 

References no later than 5 years please. 

40 yo Asia woman comes into the clinic complaining of red rash all down her back but more noted under her bra strap, noted 14 days ago, painful, and used Tylenol with no real relief. Ms. Kim has not been to the doctor for over 2 years, with no insurance in the past. She has a medical card now. Ms. Kim is married, Last menstrual period not sure, maybe 1 month ago, g2 para 2l living 1, no real medical problems, no medications other than women vitamins but can’t afford now, business slow at her restaurant. It is located on the south side of Chicago, and lots of renovations are causing her to lose business. She also stated she couldn’t see out of her peripheral vision. This is a new issue for her too. She stated she sometimes has a blurry vision with headaches. No glasses, no eye exam in years

1.List 3 Differential Diagnosis for Ms. Kim’s complaints

2. What system or systems should be addressed with this patient?

3. What other questions need to be asked? If any, what do gravida para and living mean in this case? explain in details

4. What would be the plan for this patient? Please include education, referral, recommendations

5 What guidelines were used to come to the final diagnosis? What is the diagnosis(es)?

A 38 -year-old morbidly obese Caucasian woman inquires about bariatric surgery, a treatment option for patients with a body-mass index of 40 or more (or 35 or more when there are coexisting medical conditions). Bariatric surgery has been shown to result in substantial weight loss and resolution of associated conditions. A successful clinical outcome requires an experienced multidisciplinary management team and an informed patient who will follow a long-term management plan and self-care plan.

Questions

Please discuss who would be included in the multidisciplinary team.

What are the updated guidelines for bariatric surgery?

Please discuss the various types of bariatric surgeries available.

Discuss cost and insurance coverage

Discuss a minimum of 3 complications related to Bariatric Surgery

Discuss the global approach to obesity includes 2 countries. 

Discuss obesity in your clinical setting( gender, race, age, etc.). How is it addressed, if at all?  As a future APN, what will be your approach? What resources are available?

Don’t forget to use a minimum of  3 scholarly references, no later than 2016, and  7th edition APA

Thank you

Mr. Baxter is an 86 year-old gentleman who just returned to the surgical floor after having a left below-the knee amputation.   He is a nonverbal patient with a history of noncompliant diabetes management.   The family is at the bedside, and they have expressed their concern about how his pain will be managed. 

Please answer the following questions regarding the Case Study.

1.            Since this patient is non-verbal, how can the nurse recognize symptoms of pain?

2.            What assessments need to be conducted before pain medication is administered, and why?

3.            Vicki administers IV pain medication at 11:00am.  What does Vicki need to do next, and why?

RUBRIC

Each question is worth 2 points and will be graded with the following rubric.

EXCELLENT = 2 points

ACCEPTABLE = 1 point

POOR = 0 points

Clear, direct & concise. Writing free of grammatical & spelling errors.

Few grammatical and/or spelling errors. Clear & concise writing.

Numerous grammatical and/or spelling errors. Confusing content.

Ms. M is 42 years old and has had rheumatoid arthritis for six years. At baseline, her fingers are stiff and show slight ulnar deviation. She has come to see you as she is currently experiencing an exacerbation, and her wrists are red and swollen. She finds it to be painful when something such as clothing touches the skin over her wrists. Her elbows and knees are also stiff and painful, especially after she has been resting. She is feeling extremely tired and depressed and has not been eating well.

1. Describe the pathophysiologic process that leads to the appearance and the pain occurring at her wrists. Is this an acute or chronic process? Could it be both?
2. Describe the pathophysiology contributing to the stiff, deformed fingers. What terms can be used to describe this?
3. Explain why some activity relieves the pain and stiffness of rheumatoid arthritis and why the pain tends to be worse with immobility. Is this true for other inflammatory or musculoskeletal conditions?
4. Describe several factors contributing to Ms. M’s systemic symptoms. Is this an acute or chronic process?
5. Explain how each of the following medications interact with the pathophysiology of rheumatoid arthritis and help return Ms. M to a more homeostatic state.
   1. NSAIDs
   2. Glucocorticoids
   3. Disease-modifying agents
   4. Biologic agents.
6. If we didn’t already know that Ms. M had rheumatoid arthritis, what other conditions would be on the differential for this patient? Think about what other conditions can present with erythematous, painful, swollen joints. Identify two such conditions and describe the most common signs and symptoms.
7. What are some possible long-term effects of chronic inflammation in conditions such as rheumatoid arthritis and other inflammatory conditions?

Case Study: Mrs. J.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Case Study on Biomedical Ethics in the Christian Narrative

This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.

Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:

Part 1: Chart

This chart will formalize the four principles and four boxes approach and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.

Part 2: Evaluation

This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.

Remember to support your responses with the topic study materials.

APA style is not required, but solid academic writing is expected.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Attachments PHI-413V-RS-T3T5CaseStudyHealingAndAutonomy.docx PHI-413V-RS-T3ApplyingFourPrinciplesCaseStudy.docx