Comparison of Cardiovascular Exemplars
|
Angina |
Acute Myocardial Infarction |
|
|
Pathophysiology |
||
|
Etiology |
||
|
Assessment Findings (including Diagnostics) |
||
|
Nursing Diagnosis |
||
|
Interventions (including meds and Surgical interventions) |
The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.
When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.
To Prepare:
Write a 1-page narrative in APA format that addresses the following:
Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient. Three (3) resources after 2008 are required along with APA format.
A 70 year old black American female who has the following
preexisting conditions;
Hypertension (HTN): longterm
Heart failure (CHF) : 2 months
Coronary artery disease (CAD) : longterm
Myocardial infarction (MI) : five years ago
Ejection (EF) of 55% : 2 months ago
Socioeconomic data:
Widow, Lives alone, independent ADL’s, Nonsmoker, Nondrinker
Pharmacologic data:
Aspirin (acetylsalicylic acid, ASA)
Clopidogrel bisulfate (Plavix)
Lisinopril (Prinivil, Zestril)
Carvedilol (Coreg)
Furosemide (Lasix)
Potassium chloride (KCL)
Client Profile:
70 year old woman originally from Alabama. She lives alone and is able to manage herself independently. She is active in her community and church. Diagnosed with heart failure 2 months age and is followed up at home with a visiting nurse every other week for to assist is managing her heart failure symptoms. She is being referred to the nurse practitioner for follow up of changes in her symptoms.
Assessment:
At the office the following subjective and objective data was supplied:
“I noticed my legs were getting a bit bigger and they are achy, too.”
She has gained 10 pounds over the last 5 days.
She gets short of breath when ambulating from one room to the other (approximately 20 feet) and must sit down to catch her breath.
Her oxygen saturation is 95% on room air. Bibasilar crackles are heard when auscultating her lung sounds.
She denies any chest, arm, or jaw pain or nausea.
She denies any back pain, stomach pain, confusion, dizziness, or a feeling faint.
She admits only to feeling a little more tired than usual.
Eats Southern Cooking when at home.
Vital signs :
T= 97.6 F (36.4C), BP 140/70, P 93, R 22.
Labs ordered:
complete blood count (CBC), basic metabolic panel (BMP), brain natriuretic peptide (B-type natriuretic peptide assay or BNP), troponin, creatine kinase (CPK), creatine kinase-MB (CKMB), and albumin. The APN also prescribes oral (PO) Furosemide and arranges an outpatient electrocardiogram (ECG, EKG), chest X-ray, and echocardiogram.
Questions
1. Which assessment findings during this visit are consistent with heart failure?
2. Why did the APN ask about back pain, stomach pain, confusion, dizziness or a feeling that she might faint?
3. Explain what the following terms indicate and include the normal values: cardiac output, stroke volume, afterload, preload, ejection fraction and central venous pressure. Is an ejection fraction of 55% significant. Provide rationale.
5. Discuss the body’s compensatory mechanisms during hear failure. Include an explanation of the Frank-Starling law in your discussion.
6. Heart failure can be classified as left or right ventricular failure, systolic versus diastolic, according to the New York Heart Association (NYHA) and using the ACC/AHA (American Heart Association) guidelines. Explain these four classification systems and the signs and symptoms that characterize each. Which Classification fits this patient?
7. Provide a rationale for why each of the following medications have been prescribed: Aspirin, Clopidogrel bisulfate (Plavix), Lisinopril(Prinivil/Zestril) , and Carvedilol (Coreg).
8. What information will each of the following tests provide: CBC, BMP, BNP, Troponin, CPK, CKMB, and albumin, EKG, CXR, and Echocardiogram
Assistance please.
This is the temple for a Psych Soap note, please follow the template and complete, need less than 20% plagiarism, I have completed Bipolar Disorder, and Generalized Anxiety Disorder, pick a different diagnosis on an adult patient. Thank you!
Please respond to each discussion post with 4 to 5 sentences with apa references for each
1) Watch the entire scenario. In the scenario assignment, you are asked to reflect on responses to the presented scenario.
2) Fill out the template attached below
3) Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:
*Why do you feel the way you do about the issue presented?
*Of the four responses offered in the scenario, which do you think is the most ethical and why?
*Which ethical theory would you use to support your stance? Why does this theory work?
4) Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.
Health Promotion Proposal, Part 1 Content
1.
Top of Form
Health Promotion Proposal, Part 1
For this assignment you will submit
Part One of your proposal, detailing a health problem that is
prevalent within
your selected group and demonstrating your
research of health promotion strategies for
addressing this specific health problem. At this point you already developed in your discussions the core ideas of the topic contained on this assignment. You will use the same information, but it won’t be a copy and paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluation.
Directions
1. Introduction. Describe the health problem. Don't type “Introduction”. (1 paragraph).
Using data and statistics, support your claim that the issue you selected is a problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measurable.
Bottom of Form
2. Describe the vulnerable population. (1-2 paragraph).
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraph, one for each article).
After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (1-2 paragraph).
4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal. (1-2 paragraph).
For this assignment a conclusion paragraph is not required.
Writing Assignment Requirements
Three to five pages in length (excluding title page, references, and appendices)
Follow APA format
Cite a minimum of five research articles
Please review rubric prior to submission.
Sample APA paper for your reference:
Resources
In your Case Study Analysis related to the scenario provided, explain the following:
Please follow all directions
