Renal Case Study

Tea-Colored Urine

 

Case Scenario:

Carmelita Gomez, age 8, is brought to the Children’s Clinic by her mother because she is nauseated and has vomited three times in the past 24 hours. Her urine has turned “tea colored”. Carmelita is lethargic and she is complaining of diffuse abdominal pain. Ten days ago she had a sore throat and fever and stayed home from school for two days. She was not seen by a health care provider at that time. Upon questioning, Carmelita cannot remember needing to urinate in the past 12 hours. On exam, Carmelita is irritable and listless. She has slight periorbital edema. Carmelita has active bowel sounds with no palpable abdominal masses, but she is tender in all four quadrants. Carmelita is given a presumptive diagnosis of poststreptococcal glomerulonephritis (PSGN), pending laboratory tests.

Her laboratory values are:

Serum creatinine: 2.3 mg/dL

BUN 26.1 mg/dL

Serum sodium: 142 mEq/L

Potassium 4.2mEq

Specific gravity 1.025

Phosphorous: 6.3 mEq/dL

Calcium: 7 mEq/dL

UA: hematuria 4+, red cell casts

Antistreptococcal antibody titre: 800U

POINTS TO PONDER:

1. Which lab values are abnormal?
2. What clinical manifestations      correspond to the abnormal values?
3. Describe the changes      (pathophysiology) in the body causing each abnormal value and link the      value to a clinical manifestation present in the patient?
4. Which values are within normal      limits?
5. What nursing care needs to be      implemented?
6. Provide one nursing      diagnosis appropriate to this patient.

Reading

1. Urinalysis p.1146 (Leeuwen, pg.      546-552)
2. Culture p.230
3. Kidney      stone analysis p.696 (Leeuwen, pg. 61,265,426,444)

 

Case    Study Rubric

 

Criteria

 

Abnormal Values

What do the labs indicate specific to   this patient

 

values and signs and   symptoms

The relationship between the abnormal   Signs & Symptoms and lab values is clearly demonstrated. **Must be   specific**

 

Pathophysiology used to demonstrate connections between lab results, manifestations and disease process.

 

Expected care to be given for exhibited   s/s and lab values. Expected correction of lab values based on care given.   Patient education to prevent recurrence of abnormal lab values.

 

Quality

Grammar, spelling, APA…

Throughout this week, you read about managed care and third-party payers, the basic components of insurance.

Up until recent years the only options for the uninsured, if they qualified for it, were Medicare and Medicaid. With the passage of the Affordable Care Act, the landscape of insurance is changing.

For this week’s written assignment, read the following article:

Hamel, M.B., Blumenthal, D., Abrams, M., & Nuzum, R. (2015)

http://www.nejm.org/doi/full/10.1056/NEJMhpr1503614#t=article

.

The New England Journal of Medicine, 372, 2451-2458. Retrieved from

http://www.nejm.org

After reading the article, answer the following questions:

1. What are your initial thoughts from the article?
2. How do you think the Affordable Care Act improves health care for Americans?
3. Who do you think will benefit the most from the Affordable Care Act? Why?
4. Why are some states slower to participate than others?
5. If you could create a healthcare plan for the United States, what would it include, who would be covered?

Assignment: Application: Taking a Stand

Effective leaders have a high degree of self-awareness and know how to leverage their strengths in the workplace. Assessments are a valuable tool that professionals can use to learn more about themselves and consider how their temperament and preferences influence their interactions with others.

As you engage in this learning process, it is important to remember that everyone—regardless of temperament type or related preferences—experiences some challenges with regard to leadership. The key to success is being able to recognize and leverage your own strengths while honoring differences among your colleagues.

At some point in your leadership career, you will encounter an ethical or moral dilemma that requires you to take a stand and defend your position.

For this Assignment, you evaluate an issue and consider how you could act as a moral agent or advocate, facilitating the resolution of the issue for a positive outcome.

To prepare:

• Consider the examples of leadership demonstrated in this week’s media presentation and the other Learning Resources.
• To further your self-knowledge, you are required to complete the Kiersey Temperament as indicated in this week’s Learning Resources. Consider your leadership style, including your strengths for leading others and include your results from Kiersey Temperament Sorter to describe potential challenges related to your leadership style.
• Mentally survey your work environment, or one with which you are familiar, and identify a timely issue/dilemma that requires you to perform the leadership role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly).
• What ethical, moral, or legal skills, dispositions, and/or strategies would help you resolve this dilemma? Define the differences between ethical, moral, and legal leadership.
• Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your own values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is difficult to do so?

To complete:

By Day 7

Write a 4 to 5 page paper (page count does not include title and reference page) that addresses the following:

• Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the paper.
• Consider  an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.
• Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.
• Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma.

The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. .

 

Required Reading
Guide to Community Prevention Services (2016). 2016 Annual Report to Congress, Federal Agencies, and Prevention Stakeholders. Retrieved from http://www.thecommunityguide.org/annualreport/2016-congress-report-full.pdf

Guide to Community Preventive Services (2013). Increasing physical activity. Accessed on July 14, 2016 from http://www.thecommunityguide.org/pa/index.html

Kahn, E. B., Ramsey, L.T., Brownson R., Heath, G.W., Howze, E.H., Powell, K.E., Stone, E.J., Rajab, M.W., Corso, P. and the Task Force on Community Preventive Services (2002). The effectiveness of interventions to increase physical activity: a systematic review. American Journal of Preventive Medicine, 22(4S), 73-107. Retrieved from http://www.thecommunityguide.org/pa/pa-ajpm-evrev.pdf

Task Force on Community Preventive Services (2002). Recommendations to increase physical activity in communities. American Journal of Preventive Medicine, 22(4S), 67-72. Retrieved from http://www.thecommunityguide.org/pa/pa-ajpm-recs.pdf

Optional Readings
Committee on Health and Behavior: Research, Practice, and Policy, Board on Neuroscience and Behavioral Health (2001). Findings and recommendations. Health and behavior: The interplay between the biological, behavioral, and societal influences (pp. 329-350). Washington, DC: National Academy Press. Retrieved from http://books.nap.edu/openbook.php?record_id=9838&page=329

Optional Resources
Purdue Online Writing Lab. (2018). General format. Retrieved from https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/general_format.html

Purdue Online Writing Lab. (2018). In-text citations: The basics. Retrieved from https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/in_text_citations_the_basics.html

Purdue Online Writing Lab. (2018). Reference list: Basic rules. Retrieved from https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html

**HOMEWORK ASSIGNMENT**

The Task Force on Community Preventive Services recommends community-wide campaigns strategy to be effective in increasing physical activity and improving physical fitness among adults and children. Do you agree or disagree? Discuss your position in a 3-page paper.

The following items in particular will be assessed:

Discuss whether you agree or disagree with the findings that community-wide campaign strategies are effective in increasing physical activity and improving physical fitness among adults and children.
Defend your position by providing empirical evidence.
Based on your required readings and your own research, what strategies do you think are effective in increasing and maintaining a healthy, active lifestyle?

Week 2 Assignment Instructions

Tutor MUST have a good command of the English language

Tutor MUST have a good command of the English language

Sources need to be journal/scholarly articles.

Use only articles that are published between 2015-2018 (except for your theory articles which will be older as you must cite primary sources).

No textbook or direct quotes

Please follow the attached Rubric

The Quality and Sustainability Paper is a practice immersion assignment designed to be completed in three sections. This is part one of the assignment. Learners are required to analyze and apply quality and/or safety measures specific to contemporary nursing science.

General Guidelines:

Use the following information to ensure successful completion of the assignment:

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
This assignment requires that you support your position by referencing at least six to eight scholarly resources. At least three of your supporting references must be from scholarly sources other than the assigned readings.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Directions:

Write a 1,250-1,500 word paper discussing the role of quality and/or safety in nursing science. Include the following:

Define quality or safety measures and describe their relationship and role in nursing science today.
Provide a contemporary example of how quality or safety measures are applied in nursing science.
Identify the quality and/or components needed to analyze a health care program’s outcomes.