Nursing Assignment Acers
NRS410V Case Study Mrs J
NRS410V Case Study Mrs J
Assessment Description
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mrs. J., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below. NRS410V Case Study Mrs J
Health History and Medical Information
Health History
Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.
Subjective Data
- Is very anxious and asks whether she is going to die.
- Denies pain but says she feels like she cannot get enough air.
- Says her heart feels like it is “running away.”
- Reports that she is exhausted and cannot eat or drink by herself.
Objective Data
- Height 175 cm; Weight 95.5kg.
- Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
- Cardiovascular: Distant S1, S2, S3 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. NRS410V Case Study Mrs J
- Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
- Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention
The following medications administered through drug therapy control her symptoms:
- IV furosemide (Lasix)
- Enalapril (Vasotec)
- Metoprolol (Lopressor)
- IV morphine sulphate (Morphine)
- Inhaled short-acting bronchodilator (ProAir HFA)
- Inhaled corticosteroid (Flovent HFA)
- Oxygen delivered at 2L/ NC
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:
- Describe the subjective and objective clinical manifestations present in Mrs. J.
- Describe four cardiovascular conditions in which Mrs. J is at risk, and that may lead to heart failure. What can be done in the form of medical/nursing interventions to prevent the development of heart failure in each of the presented conditions?
- By following the nursing process, were the interventions at the time of admissions beneficial for Mrs. J? Would you change any of the interventions to ensure patient independence and prevent readmission?
- Explain each of the seven medications listed in the scenario above. Include the classification, the action, and the rationale for each of these. Discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
- Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence and prevent readmission.
- Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. NRS410V Case Study Mrs J
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion
NRS410V Case Study Mrs J Rubric
Clinical Manifestations of Patient
12 points
Criteria Description
Description of subjective and objective clinical manifestations
- Target
12 points
Subjective and objective clinical manifestations are thorough.
- Acceptable
10.68 points
Subjective and objective clinical manifestations are detailed.
- Approaching
9.48 points
Subjective and objective clinical manifestations are present.
- Insufficient
9 points
Subjective and objective clinical manifestations are present but lack detail or are incomplete.
- Unsatisfactory
0 points
Subjective and objective clinical manifestations are omitted.
Cardiovascular Conditions Leading to Heart Failure and Interventions
18 points
Criteria Description
Description of four cardiovascular conditions in which the patient is at risk and may lead to heart failure. Explanation of what can be done in the form of medical/nursing interventions to prevent heart failure development in each of the presented conditions. NRS410V Case Study Mrs J
- Target
18 points
Description of four cardiovascular conditions in which the patient is at risk and may lead to heart failure, and an explanation of what can be done in the form of medical/nursing interventions to prevent heart failure development in each of the conditions are thorough.
- Acceptable
16.02 points
Description of four cardiovascular conditions in which the patient is at risk and may lead to heart failure is and an explanation of what can be done in the form of medical/nursing interventions to prevent heart failure development in each of the conditions are detailed.
- Approaching
14.22 points
Description of four cardiovascular conditions in which the patient is at risk and may lead to heart failure, and an explanation of what can be done in the form of medical/nursing interventions to prevent heart failure development in each of the conditions are present.
- Insufficient
13.5 points
Description of four cardiovascular conditions in which the patient is at risk and may lead to heart failure and/or explanation of what can be done in the form of medical/nursing interventions to prevent heart failure development in each of the conditions are present, but lack detail or are incomplete.
- Unsatisfactory
0 points
Description of four cardiovascular conditions in which the patient is at risk and may lead to heart failure and/or explanation of what can be done in the form of medical/nursing interventions to prevent heart failure development in each of the conditions are omitted.
Evaluation of Nursing Interventions at Admissions
12 points
Criteria Description
Description of the benefit of the intervention at the time of admission using the nursing process. Explanation of any changes to the interventions to ensure patient independence and prevent readmission.
- Target
12 points
Description of the benefit of the intervention at the time of admission using the nursing process and an explanation of any changes to the interventions to ensure patient independence and prevent readmission are thorough.
- Acceptable
10.68 points
Description of the benefit of the intervention at the time of admission using the nursing process and an explanation of any changes to the interventions to ensure patient independence and prevent readmission are detailed.
- Approaching
9.48 points
Description of the benefit of the intervention at the time of admission using the nursing process, and an explanation of any changes to the interventions to ensure patient independence and prevent readmission are present. NRS410V Case Study Mrs J
- Insufficient
9 points
Description of the benefit of the intervention at the time of admission using the nursing process and/or explanation of any changes to the interventions to ensure patient independence and prevent readmission are present, but lack detail or are incomplete.
- Unsatisfactory
0 points
Description of the benefit of the intervention at the time of admission using the nursing process and/or explanation of any changes to the interventions to ensure patient independence and prevent readmission are omitted.
Nursing Interventions for Older Patients to Prevent Problems Caused by Multiple Drug Interactions
18 points
Criteria Description
Explanation of seven medications listed in the scenario, including the classification, action, and rationale for each. Discussion of four nursing interventions to prevent problems caused by multiple drug interactions in older patients, including rationale for the recommended interventions.
- Target
18 points
Explanation of seven medications listed in the scenario, including the classification, action, and rationale for each, and discussion of four nursing interventions to prevent problems caused by multiple drug interactions in older patients, including rationale for the recommended interventions are thorough.
- Acceptable
16.02 points
Explanation of seven medications listed in the scenario, including the classification, action, and rationale for each, and discussion of four nursing interventions to prevent problems caused by multiple drug interactions in older patients, including rationale for the recommended interventions are detailed.
- Approaching
14.22 points
Explanation of seven medications listed in the scenario, including the classification, action, and rationale for each and discussion of four nursing interventions to prevent problems caused by multiple drug interactions in older patients, including rationale for the recommended interventions are present.
- Insufficient
13.5 points
Explanation of seven medications listed in the scenario, including the classification, action, and rationale for and/or discussion of four nursing interventions to prevent problems caused by multiple drug interactions in older patients, including rationale for the recommended interventions is present, but lacks detail or are incomplete.
- Unsatisfactory
0 points
Explanation of seven medications listed in the scenario, including the classification, action, and rationale for each, and/or discussion of four nursing interventions to prevent problems caused by multiple drug interactions in older patients, including rationale for the recommended interventions are omitted.
Health Promotion and Restoration Teaching Plan
18 points
Criteria Description
Health promotion and restoration teaching plan is provided for patient including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications. Explanation of how the rehabilitation resources and modifications will assist the patient’s transition to independence and prevent readmission.
- Target
18 points
Health promotion and restoration teaching plan is provided for patient including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications, and explanation of how the rehabilitation resources and modifications will assist the patient’s transition to independence and prevent readmission are thorough. NRS410V Case Study Mrs J
- Acceptable
16.02 points
Health promotion and restoration teaching plan is provided for patient including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications, and explanation of how the rehabilitation resources and modifications will assist the patient’s transition to independence and prevent readmission are detailed.
- Approaching
14.22 points
Health promotion and restoration teaching plan is provided for patient including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications, and explanation of how the rehabilitation resources and modifications will assist the patient’s transition to independence and prevent readmission are present.
- Insufficient
13.5 points
Health promotion and restoration teaching plan is provided for patient including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications and/or explanation of how the rehabilitation resources and modifications will assist the patient’s transition to independence and prevent readmission are present, but lack detail or are incomplete.
- Unsatisfactory
0 points
Health promotion and restoration teaching plan is provided for patient including multidisciplinary resources for rehabilitation and any modifications that may be needed, including maintenance of medications and/or explanation of how the rehabilitation resources and modifications will assist the patient’s transition to independence and prevent readmission are omitted.
COPD Triggers and Options for Smoking Cessation
18 points
Criteria Description
Discussion of options for smoking offered considering patient’s current and long-term tobacco use. Outline of COPD triggers that can increase exacerbation frequency, resulting in readmission.
- Target
18 points
Discussion of options for smoking cessation offered considering patient’s current and long-term tobacco use, and outline of COPD triggers that can increase exacerbation frequency, resulting in readmission are thorough.
- Acceptable
16.02 points
Discussion of options for smoking cessation offered considering patient’s current and long-term tobacco use, and outline of COPD triggers that can increase exacerbation frequency, resulting in readmission are detailed.
- Approaching
14.22 points
Discussion of options for smoking cessation offered considering patient’s current and long-term tobacco use, and outline of COPD triggers that can increase exacerbation frequency, resulting in readmission are present.
- Insufficient
13.5 points
Discussion of options for smoking cessation offered considering patient’s current and long-term tobacco use and/or outline of COPD triggers that can increase exacerbation frequency, resulting in readmission are present, but lack detail or are incomplete. NRS410V Case Study Mrs J
- Unsatisfactory
0 points
Discussion of options for smoking cessation offered considering patient’s current and long-term tobacco use is omitted and/or outline of COPD triggers that can increase exacerbation frequency, resulting in readmission are omitted.
Thesis, Position, or Purpose
6 points
Criteria Description
Communicates reason for writing and demonstrates awareness of audience.
- Target
6 points
The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.
- Acceptable
5.34 points
The thesis, position, or purpose is adequately presented. An awareness of the appropriate audience is demonstrated.
- Approaching
4.74 points
The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.
- Insufficient
4.5 points
The thesis, position, or purpose is unfocused or confused. There is very little awareness of the intended audience.
- Unsatisfactory
0 points
The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.
Development, Structure, and Conclusion
6 points
Criteria Description
Advances position or purpose throughout writing; conclusion aligns to and evolves from development.
- Target
6 points
The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose.
- Acceptable
5.34 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.
- Approaching
4.74 points
Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.
- Insufficient
4.5 points
Writing lacks logical progression of the thesis, position, or purpose. Some organization is attempted, but ideas are disconnected. Conclusion is unclear and not supported by the overall development of the purpose.
- Unsatisfactory
0 points
No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.
Evidence
6 points
Criteria Description
Selects and integrates evidence to support and advance position/purpose; considers other perspectives.
- Target
6 points
Specific and appropriate evidence is included. Relevant perspectives of others are clearly considered.
- Acceptable
5.34 points
Relevant evidence that includes other perspectives is used.
- Approaching
4.74 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.
- Insufficient
4.5 points
Evidence is limited or irrelevant. The interpretation of other perspectives is superficial or incorrect.
- Unsatisfactory
0 points
Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.
Mechanics of Writing
3.6 points
Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.
- Target
3.6 points
No mechanical errors are present. Appropriate language choice and sentence structure are used throughout. NRS410V Case Study Mrs J
- Acceptable
3.2 points
Few mechanical errors are present. Suitable language choice and sentence structure are used.
- Approaching
2.84 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.
- Insufficient
2.7 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.
- Unsatisfactory
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.
Format/Documentation
2.4 points
Criteria Description
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.
- Target
2.4 points
No errors in formatting or documentation are present.
- Acceptable
2.14 points
Appropriate format and documentation are used with only minor errors.
- Approaching
1.9 points
Appropriate format and documentation are used, although there are some obvious errors.
- Insufficient
1.8 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.
- Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided.
Case Study: Mrs. J. Resources
- Pathophysiology: Clinical Applications for Client Health
Read Chapter 1 in Pathophysiology: Clinical Applications for Client Health.
Pathophysiology: Clinical Applications for Client Health (Second Edition)
Editor: Grand Canyon University
© 2022 Grand Canyon University. All Rights Reserved. No part of this eBook may be
reproduced, in any form or by any means, without permission in writing from the publisher.
Photography credits and illustrations: Grand Canyon University, Copyright © 2022.
Authors: Angel Falkner, Sue Z. Green, Andrea Johnson, Jeannie Randall, and Stacey Whitney
PDF ATTACHED
- Acute Myocardial Infarction
Read “Acute Myocardial Infarction,” by Reed, Rossi and Cannon, from The Lancet (2017).
PDF ATTACHED
- Congestive Heart Failure and Congenital Defects
Read “Congestive Heart Failure and Congenital Defects,” located on the American Heart Association website.
- Evaluating the Effectiveness of an Online Cardiac Rehabilitation Resource (www.svhhearthealth.com.au) in Improving Knowledge and Confidence for Patients With Newly Diagnosed Cardiac Conditions: A Pre-Experimental Pilot Study
Read “Evaluating the Effectiveness of an Online Cardiac Rehabilitation Resource (www.svhhearthealth.com.au) in Improving Knowledge and Confidence for Patients With Newly Diagnosed Cardiac Conditions: A Pre-Experimental Pilot Study,” by Molan, Emmanuel, Langley and Holloway, from Heart, Lung and Circulation, 2019. NRS410V Case Study Mrs J
PDF ATTACHED
- GOLD Initiative for Chronic Obstructive Lung Disease
Explore the Global Initiative for Chronic Obstructive Lung Disease (GOLD) website.
- Identifying Self-Care Practices in Heart Failure Patients
Read “Identifying Self-Care Practices in Heart Failure Patients”, by Koster, J, from The Nursing Voice, 9(1) (2021).
PDF ATTACHED
- Patient Perceived Impact of Nurse-Led Self-Management Interventions for COPD: A Systematic Review of Qualitative Research
Read “Patient Perceived Impact of Nurse-Led Self-Management Interventions for COPD: A Systematic Review of Qualitative Research,” by Baker and Fatoye, from International Journal of Nursing Studies (2019).
PDF ATTACHED
- Nurseslabs-For All Your Nursing Needs
Refer to the nurseslabs.com website for pharmacology support in completing the assignment for the topic 1 case study.
- Optional- A Nursing Care of Patients After Cardiac Arrest in the Course of Myocardial Infarction
For additional information, the following is recommended:
“A Nursing Care of Patients After Cardiac Arrest in the Course of Myocardial Infarction,” by Kaminska and Krzeminska, from Journal of Education, Health and Sport (2018).
https://doaj.org/article/39ac6a139c46478997596aa30cf17811?
- Optional- Atrial Fibrillation Symptom Perception
For additional information, the following is recommended:
“Atrial Fibrillation Symptom Perception,” by Streur, from Journal for Nurse Practitioners (2019).
PDF ATTACHED
- Optional- Exploring New Pathways and Emerging Data for Better Control and Management in the Personalized Treatment of Severe Asthma
For additional information, the following is recommended:
“Exploring New Pathways and Emerging Data for Better Control and Management in the Personalized Treatment of Severe Asthma,” by Bernstein, D.I., Journal of Managed Care Medicine, 23(1) (2020).
PDF ATTACHED
- Optional- Ludwig’s Angina: a Multidisciplinary Concern
For additional information, the following is recommended:
“Ludwig’s Angina: A Multidisciplinary Concern,” by Parker and Mortimore, from British Journal of Nursing (2019).
PDF ATTACHED