Category: nursing

A 65-year-old woman was just been diagnosed with Stage 3 non-Hodgkin’s lymphoma. She was informed of this diagnosis in her primary care physician’s office. She leaves her physician’s office and goes home to review all of her tests and lab results with her family. She goes home and logs into her PHR. She is only able to pull up a portion of her test results. She calls her physician’s office with this concern. The office staff discussed that she had part of her lab work completed at a lab not connected to the organization, part was completed at the emergency room, and part was completed in the lab that is part of the doctor’s office organization. The above scenario might be a scenario that you have commonly worked with in clinical practice. For many reasons, patients often receive healthcare from multiple organizations that might have different systems. As you review this scenario, reflect and answer these questions for this discussion. What are the pros and cons of the situation in the case study? What safeguards are included in patient portals and PHRs to help patients and healthcare professionals ensure safety? Do you agree or disagree with the way that a patient obtains Personal Health Records (PHRs)? What are challenges for patients that do not have access to all of the PHRs?

1. Why is HDL considered the “good” cholesterol?

 

2. Questions: Explain the role inflammation has in the development of atherosclerosis.

Scenario for question 3 A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.

3. Question: What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?

 

Scenario for question 4 A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sent home. He says the Tamiflu didn’t seem to work. States had a slight sore throat a couple weeks ago and attributed it to the flu. Physical exam revealed thin young man who appears to be uncomfortable but not acutely ill. Posterior pharynx reddened and tonsils 3+ without exudate. + anterior and posterior cervical lymphadenopathy. Tachycardic and a new onset 2/6 high-pitched, crescendo-decrescendo systolic ejection murmur auscultated at the left sternal border. Rapid strep +. The patient was diagnosed with acute rheumatic heart disease (RHD).

 

 

4. Question: Explain how a positive strep test has caused the patient’s symptoms.

 

5. Question: Describe the factors that could have contributed to the development of a DVT in this patient explain how each of the factors could cause DVT.

Scenario for question 5 The APRN sees a 74-year-old obese female patient who is 2 days post-op after undergoing left total hip replacement. The patient has had severe post op nausea and vomiting and has been unable to go to physical therapy. Her mucus membranes are dry. The patient says she feels like the skin on her left leg is too tight. Exam reveals a swollen, tense, and red colored calf. The patient has a duplex ultrasound which reveals the presence of a deep venous thrombosis (DVT).

 

 

 

6. Question: Explain why a large pulmonary embolus interferes with oxygenation.

Elaine Goodwin is a 38-year-old G5 P5 LC 6presenting to your clinic today to discuss contraceptive options.She states that she is not interested in having more children but her new partner has never fathered a child.Her medical history is remarkable for exercise-induced asthma, migraines, and IBS.¯Her surgical history is remarkable only for tonsils as a child. Her social history is negative for alcohol, tobacco, and recreational drugs. She has no known drug allergies and takes only vitamin C.Hospitalizations were only for childbirth ¯Family history¯reveals that her maternal grandmother is alive with dementia, while her maternal grandfather is alive with COPD. Her paternal grandparents are both deceased due to an automobile accident. Her mother is alive with osteopenia and fibromyalgia, and her dad is alive with a history of skin cancer (basal cell)¯Elaine has one older sister with no medical problems and one younger brother with no reported medical problems

When taking care of patients, why do you think it is important to utilize the appropriate resources? How do you think evidence from nursing journals affects patient care? What role does using the right evidence play in being a professional nurse? What role does understanding plagiarism and academic integrity play in being a professional nurse? Research online and find a recent medical error that made the news. Answer the following questions. What happened in the incident? Who was involved? What were the ramifications for the patient and/or staff?

According to economic principles, what forces go into play as demand for nursing goes up?