Grand Canyon – NRS 410V Week 3 Complete Work

NRS 410 Grand Canyon Week 3 Discussion

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. 3. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise.

She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

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 so exhausted she cannot eat or drink by herself. Objective Data
5. Height 175 cm; Weight 95.5 kg
6. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
   
7. Cardiovascular: Distant S1, 52, 53, 54 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
   
8. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; 5p02 82%
   
9. Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin
   

Critical Thinking Questions

What nursing interventions are appropriate for Mrs.]. at the time of her admission? Drug therapy is started for Mrs. 3. to control her symptoms. What is the rationale for the administration of each of the following medications?

1. IV furosemide (Lasix)
   
2. Enalapril (Vasotec)
   
3. Metoprolol (Lopressor)
   
4. IV morphine sulphate (Morphine)
   

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.

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 rationale for each of the interventions you recommend.

NRS 410 Grand Canyon Week 3 Case Study 1 Assignment Latest

Details:

In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.

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

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin.

Case Study 1

Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physician’s notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints.”

Laboratory values are as follows:

• Hemoglobin = 8 g/dl
  
• Hematocrit = 32%
  
• Erythrocyte count = 3.1 x 10/mm
  

RBC smear showed microcytic and hypochromic cells Reticulocyte count = 1.5%

Other laboratory values were within normal limits. Question

Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In an essay of 500-750 words, explain your answer and include rationale.

NRS 410 Grand Canyon Week 3 Case Study 2 Assignment Latest

Details:

In a short essay (500-750 words), answer the Question at the end of Case Study 2. Cite references to support your positions.

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

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin.

Case Study 2

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is ovenvhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:

• Describe your approach to care.
  
• Recommend a treatment plan.
  
• Describe a method for providing both the patient and family with education and explain your rationale.
  
• Provide a teaching plan (avoid using terminology that the patient and family may not understand).