Evaluating Patients

Instructions

It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format (6th Ed.).

Classroom Participation

Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.

All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation.

Discussion Prompt [Due Wednesday]

Case study:

Bana is a 24-year-old Muslim woman who was recently relocated to the United States as a refugee from Syria, along with her husband and three young children. She arrives at your office today for a physical with her children and a case manager. Her English is limited, and she relies on her case manager to explain the details of her situation, although the case manager does not speak Arabic and thus cannot interpret for her.

In interviewing Bana with the help of the case manager, you learn that her husband is currently looking for a job and that she works at night cleaning office buildings. Her last menstrual period was about 8 weeks ago, and she has been experiencing nausea and vomiting in the mornings recently. A pregnancy test proves positive, and you provide some prenatal education to the client.

During the physical, you notice recent bruises around her throat. She is embarrassed by them and indicates that she was assaulted in Syria before flying to the United States several weeks ago. On questioning further about the assault, Bana appears not to understand and looks at her case manager for help.

1. What is the biggest barrier you face in providing care to Bana at this point?
2. What is the priority action for you to take at this time?
3. What action is most important for you to take to ensure the health and safety of the fetus?
4. Given Bana’s financial situation, you are concerned about her and her family having adequate nutrition. Which intervention would best address this concern?

Online discussions are intended to be thoughtful exchanges among students that focus on the weekly readings and translating theory to practice. Initial postings are expected to be completed by Wednesday of each week. Response posts are due by Sunday of each week. Minimum expectations are to complete the initial posting and provide a substantive response to the initial posting of one other classmate who posted to a different question. Students earn points weekly for posts which meet (or exceed) minimum posting requirements. Points are deducted daily for late initial posts. Late response posts will not be accepted.

Complications of asthma can be sudden. Consider the case of Bradley Wilson, a young boy who had several medical conditions. He appeared in good health when he went to school, returned home, and ate dinner. However, when he later went outside to play, he came back inside wheezing. An ambulance took him to the hospital where he was pronounced dead (Briscoe, 2012). In another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the middle of the night and ran to her grandfather’s bedroom to tell him she couldn’t breathe. By the time paramedics arrived, she had passed out and was pronounced dead at the hospital (Glissman, 2012). These situations continue to outline the importance of recognizing symptoms of asthma and providing immediate treatment, as well as distinguishing minor symptoms from serious, life-threatening symptoms. Since these symptoms and attacks are often induced by a trigger, as an advanced practice nurse, you must be able to help patients identify their triggers and recommend appropriate treatment options. For this reason, you need to understand the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation.

To Prepare

· Review “Asthma” in Chapter 27 of the Huether and McCance text. Identify the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Consider how these disorders are similar and different.

· Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of both disorders. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

· Review the “Mind maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Consider the epidemiology and clinical presentation of both chronic asthma and acute asthma exacerbation.

ASSIGNMENT

Write a 2- to 3-page paper that addresses the following:

· Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.

· Explain how the factor you selected might impact the pathophysiology of both disorders. Describe how you would diagnose and prescribe treatment for a patient based on the factor you selected.

· Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Chapter 26, “Structure and Function of the Pulmonary System”

This chapter provides information relating to the structure and function of the pulmonary system to illustrate normal pulmonary function. It focuses on gas transport to build the foundation for examining alterations of pulmonary function.

Chapter 27, “Alterations of Pulmonary Function”

This chapter examines clinical manifestations of pulmonary alterations and disorders of the chest wall and pleura. It covers the pathophysiology, clinical manifestations, evaluation, and treatment of obstructive lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema.

Chapter 28, “Alterations of Pulmonary Function in Children”

This chapter focuses on alterations of pulmonary function that affect children. These alterations include disorders of the upper and lower airways.

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

Chapter 9, “Pulmonary Disease”

This chapter begins with an overview of normal structure and function of the lungs to provide a foundation for examining various lung diseases such as asthma and chronic obstructive pulmonary disease (COPD).

Required Media

Laureate Education, Inc. (Executive Producer). (2012e). Mid-course review. Baltimore, MD: Author.

This media is an interactive mid-course review covering course content.

Review the animations, case studies, and review questions on the evolve textbook support link. http://evolve.elsevier.com/huether

Optional Resources

American Lung Association. (2012). Retrieved from http://www.lung.org/

Asthma and Allergy Foundation of America. (2012). Retrieved from http://www.aafa.org

Develop and Concept Map, using the form provided, on the following patient. Include Diagnostic data and medical orders that you expect to be ordered on the patient.

T.J., a 30-year-old African American client, is in his last year of law school and is clerking for a prestigious law firm. He and his fiancé plan to marry as soon as he graduates. During the last week he has had four dizzy spells and a headache at the base of his skull upon awakening for the last 2 days. His father has a history of hypertension, so T.J. is aware that his symptoms may indicate high blood pressure. On his way home from work, T.J. stops by the clinic and asks the nurse to check his blood pressure. The nursing assessment yields the following data.

Subjective data: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication.

Objective data: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs.

People of French Canadian Heritage.

People of German Heritage.

Read chapter 14 and 29 of the class textbook and review the attached Power Point presentations.  Read content chapter 29 in Davis Plus Online Website.  Once done present a minimum of 600 words essay (excluding the first and reference page) explaining the evolution of health care beliefs of this these two heritage and explain if there is any similarity with the delivery of health care here in United States. Essay must have a minimum of three evidence based references excluding the class textbook and must be presented in an APA format, word document, Arial 12 font attached to the forum in the discussion tab of the blackboard title “Week 7 essay”.

You must post at least two replies to any of your peers essay sustained with the proper references.  Essay will not be accepted via email.