...Case Study 3 Unit 5 and Unit 6 AO is an 89-year-old woman with a long history of systolic heart failure secondary to a large left ventricular infarct when she was in her 70s. She had poor activity tolerance and required assistance with activities of daily living. Even minimal activity was associated with moderately severe dyspnea and exertional chest pain, which was relieved by rest. AO also exhibited marked pedal edema bilaterally. She is being treated with digitalis, furosemide (Lasix), KCl, (potassium chloride) and sublingual nitroglycerin. Discussion Questions 1. Which type of heart failure (left- or right-sided) is usually associated with dyspnea? What other clinical findings are likely to be present with left-sided heart failure? * The type of the heart failure that associated with dyspnea or difficult of breathing is the left-sided. The clinical findings that are more likely to be present in left-sided heart failure are pulmonary congestion, respiratory crackle (rale ), hypoxemia, high left atrial pressure, and acute cardiogenic pulmonary edema. 2. What compensatory mechanisms are likely to be operative in A.O. to enhance cardiac output? 3. What is the most likely cause of AO’s pedal edema? The most likely cause of AO’S pedal edema is heart failure specially the right side heart failure due left side heart failure which leads to much pressure to right side of heart. 4. What is the cause of AO’s exertional chest pain? What laboratory tests would...
Words: 366 - Pages: 2
...myostatin, a protein created by the gene GDF-8, or the MSTN gene. Myostatin determines exactly how large a muscle can become by inhibiting muscle growth and regulating muscle breakdown. This protein is part of the transforming growth factor beta superfamily, which is a group of proteins that help control the growth and development of tissues throughout the body. (MSTN, 2013) Myostatin is found almost exclusively in skeletal muscles, where it is active both before and after birth. Myostatin reduces protein synthesis and activates muscle protein breakdown, contributing to muscle regulation in two distinctly different ways. Studies have shown that when MSTN is overexpressed, muscle cells have reduced protein synthesis and smaller fibers. Research in healthy individuals showed an increase in human MSTN expression when not using the muscles, as seen with inactivity, bedrest, or spaceflight, and conversely, myostatin protein and its role in limiting muscle mass reduced with heavy resistance training. Myostatin gene expression seems to be higher in young men when compared to women or older individuals, but men also exhibited the greatest reductions following resistance training. As the muscles reach their limits the myostatin steps in to prevent any further growth by breaking down the muscle proteins. Natural mutations and knockouts in animals...
Words: 1230 - Pages: 5
...NURSING CARE PLAN COURSE: Basic Adult Health CLIENT INITIALS: DATE OF ADMISSION: AGE: GENDER: JL June 13, 2011 85 M HT: WT: ALLERGIES: 140 lbs. NKA CODE STATUS: FULL RACE/ETHNICITY: CULTURAL CONSIDERATIONS: Caucasian None RELIGION/SPIRITUAL CONSIDERATIONS: Unknown OCCUPATION/HOBBIES/RECREATIONAL ACTIVITIES: Retired LIVING SITUATION/WITH WHOM: (home, assisted living, LTC, etc) Lives with daughter. SOCIAL HISTORY: (tobacco, ETOH, illicit drugs, family dynamics) Quit smoking many years ago, no history of ETOH or drug use. NURSING CARE PLAN ADMITTING MEDICAL DIAGNOSIS: Client's principal admitting diagnosis was leukocytosis. Definition: (from Taber’s) “An increase in the number of leukocytes (usually above 10,000/mm3) in the blood. It occurs most commonly in disease processes involving infection, inflammation, trauma, or stress, but it also can result from the use of some medications” (Venes, 2009, p. 1327). Etiology/pathophysiology: ( NOT from Taber’s or Wikipedia) Etiology: Causes of leukocytosis are infection, inflammation, tissue damage, immune reaction, bone marrow problems, medications, and stress (Drug Information Online, 2011). Pathophysiology: “Leukocytosis can be a reaction to various infectious, inflammatory, and, in certain instances, physiologic processes (eg, stress, exercise). This reaction is mediated by several molecules, which are released or regulated in response to stimulatory events that include growth or survival factors (eg, granulocyte...
Words: 3941 - Pages: 16
...Black women and pregnancy: Fibroids by Kimberly Seals-Allers, author of The Mocha Manual to a Fabulous Pregnancy Reviewed by the BabyCenter Medical Advisory Board Last updated: January 2010 What are fibroids? Fibroids are noncancerous tumors that grow from muscle tissue in the uterus. Fibroids, also called uterine leiomyomas or myomas, can grow on the outside of your uterine wall, within the uterine wall, or into the uterine cavity. Women can have fibroids in one or more of these locations. The growths can be as small as a pea or as large as a basketball. But they are almost always benign, no matter how large they get. If a fibroid or cluster of fibroids is particularly large or is growing on the outside of the uterine wall, it can push the uterus into an abnormal position. It can also put pressure on the bladder or intestine, causing symptoms such as frequent urination, constipation, pelvic pain, or backache. Fibroids may also cause heavy menstrual bleeding. Fibroids can interfere with fertility, and they occasionally cause complications during pregnancy. For example, if a large fibroid blocks the opening of a woman's uterus, she may have to deliver her baby by c-section. African American women are more likely than other women to get fibroids, but any woman of any race can get them. Why is it especially important for black women to know about fibroids? In the United States, African American women have the highest rates of fibroids. They're two to three times...
Words: 2214 - Pages: 9
...Nursing Program CLIENT INFORMATION FORM Student's Name Date of Care: Client Initials Room Number Sex: Age : Admission Date: Admitting Diagnosis: Rt. Lobe infiltrate, Breast & Bone Cancer Secondary Diagnosis if any): Respiratory Distress Surgery Type/Date (if any): Lumpectomy on Rt. Foot at 2002 Working Medical Diagnosis/Etiology (describe definition, pathophysiology, and sign/symptoms) Metastatic Breast Cancer Metastatic breast cancer is the term used to describe cancer that has spread from the original site in the breast to other organs or tissues in the body. Cancer cells can break away from the original cancer in the breast and the cancer cells that break away can spread to other parts of the body via blood vessels or lymphatic vessels. The original site where the cancer cells came from is called the primary cancer. When cancer cell travels from the breast around the body they can lodge themselves in various body organs or tissues. These cells can begin to form breast cancer in new place and this new cancer is called secondary or a metastasis. Breast cancer most commonly spreads to one or more sites: bone, liver, brain and lungs. The sign or symptoms that may experience will depend on where the cancer is in the body and the extent of the cancer. If its spread to the: Bone- pain is fairly constant, aching pain. It may...
Words: 5102 - Pages: 21
...Objectives: * Recognize common and potentially life-threatening postpartum complications * Postpartum Hemorrhage * Postpartum Endometritis * Peripartum Cardiomyopathy * Postpartum Thyroiditis * Postpartum Depression * Direct the initial management of the ill postpartum patient * Know the appropriate threshold for consultation with specialist Postpartum Hemorrhage * Be defined as a blood loss exceeding 500ml after delivery of the infant * Excessive bleeding that makes the patient symptomatic (lightheaded, syncope) and/or results in signs of hypovolemia (hypotension, tachycardia, oliguria) * PPH: occurs in 24 hour of delivery * the late PPH: occurs after 24 hour of delivery to 6 weeks * Obstetrical emergency that can follow vaginal or cesarean delivery * Incidence – 3% of births * 3rd most common cause of maternal death in US Causes of Postpartum Hemorrhage Four Ts | Cause | Approximate Incidence (%) | Tone | Atonic uterus | 70 | Trauma | Lacerations, Hematomas, Inversion, Rupture | 20 | Tissue | Retained tissue, Invasive placenta | 10 | Thrombin | Coagulopathies | 1 | Risk Factors * Prolonged 3rd stage of labor * Fibroids, placenta previa * Previous PPH * Overdistended uterus * Episiotomy * Use of magnesium sulfate, preeclampsia * Induction or augmentation of labor Management * Secondary steps * Will...
Words: 5443 - Pages: 22
...------------------------------------------------- Clinical Preparation Worksheet- Information Necessary for Care ------------------------------------------------- ------------------------------------------------- Your Name _ Date of Care_3/17/2014_____ Pt. Initials__M.A.____________ ------------------------------------------------- Pt. age__51_______ Code Status _Full Code______________Braden /SKIN Score __K_____ ------------------------------------------------- Fall Risk- Fall risk with high injury probability __Level 2________________ ------------------------------------------------- ------------------------------------------------- Admitted from: Home/extended care facility? __Home___________________ ------------------------------------------------- ------------------------------------------------- Reason for admission - also called CC or Chief complaint: (This is in the pt.’s words. Ask them why they came to the hospital and record what they say as a direct quote.) ------------------------------------------------- Fell in the shower and became unconscious, tried to call girlfriend but couldn’t move left side ------------------------------------------------- ------------------------------------------------- Admitting Medical Diagnosis/Diagnoses: ------------------------------------------------- Stroke ------------------------------------------------- ------------------------------------------------- Medical and Surgery History:...
Words: 3603 - Pages: 15
...Darren & Jenny’s Nursing Study Guide Darren & Jenny Nursing Study Guide Nursing Formulas and Conversions Drugs and Dosage Formulas and Conversions Volume 60 minims = 1 dram = 5cc = 1tsp 4 drams = 0.5 ounces = 1tbsp 8 drams = 1 ounce 16 ounces = 1pt. 32 ounces = 1qt. Weight 60 grains = 1dram 8 drams = 1 ounce 12 ounces = 1 lb. (apothecaries') Household 1tsp = 1tsp = 3tsp = 1tbsp = Household 1tsp=5cc 3tsp=1tbsp 1tbsp=0.5oz or 15cc 2tbsp=1oz or 30cc 1pt.=16oz or 480cc 1qt=32oz or 960cc 1/60 grain=1mg 15 grains=1g 2.2 lbs.=1kg Apothecary 1 dram 60 gtts (drops) 0.5 ounce 0.5 ounce Metric 5cc=1tsp 15cc=1tbsp 30cc=2tbsp(1oz) 1cc=16minims Apothecary 1fl.dram=4cc 4drams=0.5oz 8drams=2tbsp(1oz) 16minims=1cc 500cc=0.5L or 1pt. 1000cc=1L or 1qt. Temp. Conversion C= F-32/1.8 F= 1.8*C-32 2 Darren & Jenny Nursing Study Guide NOTES CARDIOVASCULAR Arterial Ulcer – Pale, deep base, surrounded by tissue that is cool with trophic changes such as dry, soluble skin and loss of hair. Cause by ischemia from inadequate arterial blood supply of oxygen and nutrients . Venous stasis Ulcer – Dark, red base, surrounded by skin that is brown in color with edema. Caused by the accumulation of waste products of metabolism that are not cleared due to venous congestion. Stage I Ulcer – Reddened area with intact skin surface. Management of DVT – Bed rest, limb elevation , relief of discomfort with warm, moist, heat and analgesics (Tylenol, not narcotics) prn. Ambulation is contraindicated...
Words: 7141 - Pages: 29
...Darren & Jenny’s Nursing Study Guide Darren & Jenny Nursing Study Guide Nursing Formulas and Conversions Drugs and Dosage Formulas and Conversions Volume 60 minims = 1 dram = 5cc = 1tsp 4 drams = 0.5 ounces = 1tbsp 8 drams = 1 ounce 16 ounces = 1pt. 32 ounces = 1qt. Weight 60 grains = 1dram 8 drams = 1 ounce 12 ounces = 1 lb. (apothecaries') Household 1tsp = 1tsp = 3tsp = 1tbsp = Household 1tsp=5cc 3tsp=1tbsp 1tbsp=0.5oz or 15cc 2tbsp=1oz or 30cc 1pt.=16oz or 480cc 1qt=32oz or 960cc 1/60 grain=1mg 15 grains=1g 2.2 lbs.=1kg Apothecary 1 dram 60 gtts (drops) 0.5 ounce 0.5 ounce Metric 5cc=1tsp 15cc=1tbsp 30cc=2tbsp(1oz) 1cc=16minims Apothecary 1fl.dram=4cc 4drams=0.5oz 8drams=2tbsp(1oz) 16minims=1cc 500cc=0.5L or 1pt. 1000cc=1L or 1qt. Temp. Conversion C= F-32/1.8 F= 1.8*C-32 2 Darren & Jenny Nursing Study Guide NOTES CARDIOVASCULAR Arterial Ulcer – Pale, deep base, surrounded by tissue that is cool with trophic changes such as dry, soluble skin and loss of hair. Cause by ischemia from inadequate arterial blood supply of oxygen and nutrients . Venous stasis Ulcer – Dark, red base, surrounded by skin that is brown in color with edema. Caused by the accumulation of waste products of metabolism that are not cleared due to venous congestion. Stage I Ulcer – Reddened area with intact skin surface. Management of DVT – Bed rest, limb elevation , relief of discomfort with warm, moist, heat and analgesics (Tylenol, not narcotics) prn. Ambulation is contraindicated...
Words: 7141 - Pages: 29
...Makati Medical Center - College of Nursing SY 2011 – 2012 A Case Study Presentation on the Care of a Mother with Preeclampsia Superimposed on Chronic Hypertension In Partial Fulfillment of the Course Requirement of NCM102 – Related Learning Experience Submitted To: Submitted By: Leader: Knight, Catherine P. Members: Iglesias, Pauleen Itliong, Juliane B. Javier, Reniccia Janel Joaquin, Gian Denise M. Kwek, Michael Angelo L. La Sangre, Anne Gabrielle B. Lacerna, Iruel Victor III Leynes, Sofia Antonniette M. Lindawan, Ma. Kristine S. BSN II – B Group 2 December 17, 2011 Table of Contents Chapter I - Introduction A. Description of the Case………................................................................. 4 B. Purpose and Objectives........................................................................... 5 C. Significance and Justification....................
Words: 13388 - Pages: 54
...ACUTE GLOMERULONEPHRITIS DISCLOSED _________________________ A Case Study Presented to The Clinical Instructors AUP College of Nursing Adventist University of the Philippines __________________________ In Partial Fulfillment of the Requirements for the Course NMCN 244, Care of Mother, Child, Family and Population at Risk ___________________________ TABLE OF CONTENTS I. Introduction Significance of the Study II. Patient DataBase A. Demographic Data B. Nursing History 1. Developmental Tasks 2. Health History 3. Medical Diagnosis & Chief Complaints III. The Disease Entity A. Review of Normal Physiology B. Theoretical Background C. Statistical Report D. Risk/Aggravating Factors E. Pathophysiology Narrative w/ Documentation F. Pathophysiology Diagram G. Prognosis of Disease IV. Assessment A. Gordon’s or Head to Toe Assessment B. Book Picture vs Patient’s Manifestations V. The Management A. Diagnostic Test Result and Significant B. Therapeutic/Medical Interventions 1. Surgeries/Treatment 2. Drugs C. Nursing Initiated Interventions 1. Nursing Care Plan 2. Discharge Plan VI. General Evaluation of the Study A. Summary B. Recommendation VII. Bibliography I. Introduction Acute glomerulonephritis is a disease that affects glomerular capillaries. Etiologic factors are many and varied; they include immunologic reactions, vascular injury, metabolic...
Words: 11884 - Pages: 48
...AND II IN SPECIALTY AREA COURSE CODE: NUR 822S and NUR 829S PATIENT / FAMILY CASE STUDY (A NURSING PROCESS APPROACH) ON A CLIENT WITH GESTATIONAL TROPHOBLASTIC NEOPLASM BY: CHARLOTTE LAMPTEY SN/ADN/15/0030 AUGUST, 2016 CONTENTS * PREFACE * ACKNOWLEDGEMENT * INTRODUCTION CHAPTER ONE: OVERVIEW OF CLIENT SITUATION I. Literature review of gestational trophoblastic neoplasm CHAPTER TWO: COMPREHENSIVE HOLISTIC ASSESSMENT OF PATIENT/FAMILY I. Patient’s medical and personal history including review of the systems II.Physical examination III.Diagnostic evaluation IV.Nutritional assessment V. Psychosocial history VI. Patient developmental assessment VII.Spiritual assessment VIII.Quality of life assessment IX.Admission of patient CHAPTER THREE: ANALYSIS OF DATA CHAPTER FOUR: COLLABORATIVE PLAN OF CARE I. Presumptive medical diagnosis II.Nursing diagnosis III.Evidence-based interventions IV.Additional diagnostic procedures warranted but not done Medication to be ordered CHAPTER FIVE: DISCHARGE PLAN I. Community service and resource needed II.Client education plan III.Plans for follow-up of care CHAPTER SIX: EVALUATION PLAN Termination of care * SUMMARY * CONCLUSION * REFERENCE PREFACE The patient / family care study is an essential and relevant study undertaken on the patient and the family by a final year nursing student as part of the required curriculum...
Words: 17052 - Pages: 69
...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
Words: 72133 - Pages: 289
...Advance concept of nursing I Unit 1 Nursing process The nursing process is an organized sequence of problem solving steps used to identify and to manage the health problems of clients .The nursing process is the framework for nursing care in all health care settings.When nursing practice follows the nursing process, clients receive quality care in minimal time with maximal efficiency. The steps of nursing process 1)Assesment 2)Diagnosis 3)Planning 4)Implementation 5)Evaluation Assessment An RN uses a systematic, dynamic way to collect and analyze data about a client, the first step in delivering nursing care. Assessment includes not only physiological data, but also psychological, sociocultural, spiritual, economic, and life-style factors as well. For example, a nurse’s assessment of a hospitalized patient in pain includes not only the physical causes and manifestations of pain, but the patient’s response—an inability to get out of bed, refusal to eat, withdrawal from family members, anger directed at hospital staff, fear, or request for more pain mediation. Diagnosis The nursing diagnosis is the nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs. The diagnosis reflects not only that the patient is in pain, but that the pain has caused other problems such as anxiety, poor nutrition, and conflict within the family, or has the potential to cause complications—for example, respiratory infection is a potential hazard...
Words: 28659 - Pages: 115
...Restorative Care Training for the Certified Nursing Assistant Trainer Manual TABLE OF CONTENTS Introduction Making the Most of the Training Making the Most of the Lesson Plans Making the Most of the Activities Trainer Preparation Welcome Module Activity T1 Welcome to the training Activity T2 Common Rules to Follow Activity T3 Successful Completion Activity T4 You will learn Trainer Preparation Module one Module one Trainer Preparation Module two Module two Trainer Preparation Module three Module three Trainer Preparation Module four Module four Appendix A Feeding Assistance Appendix B Fall Prevention Page T3 Page T3 Page T3 Page T4 Page T5 Page T7 Page T7 Page T8 Page T8 Page 7a Page 8 Page 27a Page 28 Page 35a Page 37 Page 104a Page 105 Page 114 Page 123 T2 Restorative Care; Training for the Certified Nursing Assistant Introduction Welcome to the program Restorative Care. This is the trainer manual used by trainers to teach nurse assistants and home health aides about caring for the person with Restorative issues. This manual accompanies the student manual, Restorative Care. This training is activity based. Participants are encouraged to share in the training process, to talk about relevant experiences if they choose and to ask questions. Making the Most of the Training Program Use this training manual as a guide for training individually or in groups. If you train on an individual basis it will be more effective to brainstorm with them than to use the...
Words: 59692 - Pages: 239
