NRS410 Week 1 | Nursing in Health Care - Grand canyon university

NRS410 Week 1 Discussion Latest 2018 May The case scenario provided will be used to answer the discussion questions that follow. Case Scenario Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling. Subjective Data

Complains of pain and heaviness in her leg.
States she cannot bear weight on her leg and has been in bed for 3 days.
Lives alone and has not had anyone to help her with meals.

Objective Data

Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
Left leg red from knee to ankle
Calf measurement on left 3 in > than right
Temperature: 38.9 degrees C
Height: 160 cm; Weight: 83.7 kg

Laboratory Results

WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
Wound culture: Staphylococcus aureus

Critical Thinking Questions

What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
Identify the muscle groups likely to be affected by Ms. G's condition by referring to "ARC: Anatomy Resource Center."
What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

NRS410 Week 2 Discussion Latest 2018 May The American Cancer Society (ACS) is a nationwide, community-based, voluntary health organization dedicated to eliminating cancer as a major health problem. Together with its supporters, ACS is committed to helping people stay well and get well by finding cures and by fighting back.Critical Thinking Questions:

Imagine that a family friend or colleague has just been diagnosed with cancer. Explain how the American Cancer Society might provide education and support. What ACS services would you recommend and why?
According to statistics published by the American Cancer Society, there will be an estimated 1.5 million new cancer cases diagnosed each year over the next decade. What factors contribute to the yearly incidence and mortality rates of various cancers in Americans? What changes in policy and practice are most likely to affect these figures over time
Select a research program from among those funded by the American Cancer Society. Describe the program and discuss what impact the research will have on the prevention or treatment of cancer.

NRS410 Week 3 Discussion Latest 2018 May Case Scenario Mrs. J. 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

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 so exhausted she cannot eat or drink by herself.

Objective Data

Height 175 cm; Weight 95.5 kg
Vital signs: T 37.6 C, 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
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

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

IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
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. NRS410 Week 4 Discussion Latest 2018 May Use the image in "Discussion Question Resource: Chest X-Ray" to answer the following Critical Thinking Questions. Examine the x-ray of a patient diagnosed with pneumonia due to infection with Mucor. Refer to the "Module 4 DQ Chest Xray" resource in order to complete the following questions. Critical Thinking Questions

Explain what Mucor is and how a patient is likely to become infected with Mucor. Describe the pathophysiologic progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.
Examine the laboratory blood test results and arterial blood gases provided in "Discussion Question Resource: Laboratory Blood Test Results." What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.
What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and treatments you suggest.

NRS410 Week 5 Discussion Latest 2018 May The case scenario provided will be used to answer the discussion questions that follow. Case Scenario Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

Height: 68 inches; Weight 134.5 kg
BP: 172/96, HR 88, RR 26
Fasting Blood Glucose: 146/mg/dL
Total Cholesterol: 250mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL

Critical Thinking Questions What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not? Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
Ranitidine (Zantac) 300 mg PO at bedtime.
Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

Assess each of Mr. C.'s functional health patterns using the information given. (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance.)
What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

NRS410 Week 1 Assess your Knowledge of Foundational Concepts Latest 2018 May Student ADA Version of the Arterial Blood Gas Interpretation Pre-Assessment Anatomy

Backward effects of left-sided heart failure include:

A. Pulmonary congestion

B. Jugular vein distention

C. Dependent edema in the legs

D. Bounding pulses

Anatomy In performing a physical assessment, the nurse notes the patient has a “barrel” configuration to the chest. This is a consequence of:

A. Reduced intrapleural pressures

B. Bronchial airway expansion

C. Increased vital capacity

D. Increased residual lung volume

Anatomy Ausculation of the chest reveals bilateral fine crackles in the bases bilaterally, indicating:

A. Right-sided heart failure

B. Left-sided heart failure

C. Pneumonia

D. Acute respiratory distress syndrome

Biology The signs and symptoms of anemia are all related to what common pathophysiologic feature of the condition?

A. Increased oxygen consumption by tissues

B. Decreased blood oxygen content

C. Vasodilation

D. A shift in the oxyhemoglobin dissociation curve

Biology

In addition to hypertension, preeclampsia is characterized by:

A. Nausea and vomiting

B. Fatigue and lower back pain

C. Protein in the urine and edema

D. Retinal changes and rates in the lungs

Biology Common manifestations of bacterial pneumonia include all of the following except:

A. Fever

B. Productive Cough

C. Tachypnea

D. Hyperinflation

Biology

Closed drainage systems work to re-expand a lung after pneumothorax by:

A. Re-establishing the normal negative intrapleural pressure.

B. Creating a positive pressure in the pleural space

C. Removing excess fluid from the pleural space so that there is room for lung expansion.

D. Pulling oxygen into distal air sacs to re-expand lung tissue

Biology

Patients with chronic renal failure usually exhibit:

A. Bradycardia

B. Hypokalemia

C. Hypocalcemia

D. Hematomas

Biology The diet of a patient in end-stage kidney disease is restricted in all of the following except:

A. Fluid

B. Potassium

C. Protein

D. Calories

Anatomy Which of the following is true of the biological functions of progesterone? A. Progesterone is the most important hormone associated with pregnancy. B. Progesterone directs male sexual characteristics. C. Levels of progesterone increases if the egg is not fertilized. D. Levels of progesterone remain stable if the egg is not fertilized. Anatomy Which of the following is true of the biological functions of testosterone? A. Testosterone is not secreted by the ovaries. B. Testosterone is needed for development of female secondary sexual characteristics. C. Testosterone stimulates ovulation. D. Testosterone is needed for development of male secondary sexual characteristics. Anatomy Which of the following is true of the biological functions of estrone? A. Estrone is required for proper development of male secondary sexual characteristics. B. Level of estrogen degreases if the egg is not fertilized.

C. Estrone is required for proper development of female secondary sexual

characteristics. D. Estrone affects only the reproductive organs. Biology What is the function of hemoglobin? A. Hemoglobin is the protein in red blood cells that is responsible for carrying oxygen to the cells of the body. B. Hemoglobin is a lipid in red blood cells that is responsible for carrying oxygen to the cells of the body. C. Hemoglobin is a protein in white blood cells that is responsible for carrying oxygen to the cells of the body. D. Hemoglobin is a protein in red blood cells that is not responsible for carrying carbon dioxide to the cells of the body. Biology Why is heat an effective means of sterilization? A. Heat is an effective means of sterilization because it destroys the proteins of microbial lifeforms, including fungi, bacteria, and viruses. B. Heat is an effective means of sterilization because it destroys the proteins of anaerobic microbial lifeforms, including fungi, bacteria, and viruses. C. Heat is an effective means of sterilization because it destroys the lipids of microbial lifeforms, including fungi, bacteria, and viruses. D. Both (B) and (C).

Chemistry:

List the enzymes whose levels are elevated in the blood serum following an MI.

A. CPK, LDH, AST, and SGOT

B. LDH, AST, and SGOT

C. CRE, AST, and ALT

D. None of the above

Chemistry What is the physiological function of gluconeogenesis? A. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel. B. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are high. This ensures proper function of brain and white blood cells, which only use glucose as fuel. C. Gluconeogenesis is production of glucose from carbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel.

D. None of the above

Chemistry What effect does glycogen metabolism have on glucose levels? A. Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels. B. Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes increase blood glucose levels. C. Glycogen metabolism releases glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels.

D. None of the above

Chemistry Carbon monoxide binds tightly to the heme groups of hemoglobin and myoglobin. How does this affinity reflect the toxicity of carbon monoxide? A. Since carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen enhancement result in what divers call the “bends.” B. Because carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation. C. Because carbon monoxide binds tightly to the heme groups of hemoglobin, it is not easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation.

D. None of the above

Pathophysiology Which of the following may be a reason to order an ABG on a patient?

A. The patient suddenly develops shortness of breath

B. An asthmatic is starting to show signs of tiring

C. A diabetic has developed Kussmaul’s respirations

D. All of the above

Pharmacology How do sulfa drugs selectively kill bacteria while causing no harm to humans? A. Folic acid is a vitamin required for the synthesis of a coenzyme needed to make the amino acid methionine and the purine and pyrimidine nitrogenious bases for DNA and RNA and folic acid is produced by humans. B. Sulfa drug binds to the enzyme, no product is formed, folic acid is made and the biosynthesis of methionine and nitrogenous bases increases. C. Humans are not harmed because they do not synthesize their own folic acid. It is obtained in the diet.

D. None of the above

Pharmacology What occurs when glycogen metabolism is stimulated by insulin? A. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. B. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates removal of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase. C. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates uptake of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase.

D. All of the above

Pharmacology

What is the medical application of cortisone? Cortisone is used to treat:

A. Rheumatoid arthritis, asthma, gastrointestinal disorders, and a variety of skin conditions. B. Kidney disease, high blood pressure, and osteoporosis. C. Muscle disorders, tuberculosis, and thyroid disorder.

D. All of the above

Anatomy Oxygen saturation is likely to be lowest when an asthmatic with a diagnosis of pneumonia is positioned:

A. In a high Fowler position

B. Lying on the left side

C. Lying on the right side

D. Lying supine with the head of the bed flat

Chemistry Laboratory test results indicative of thrombocytopenia, in addition to a low platelet count, would be:

A. Increased PT

B. Prolonged bleeding time and poor clot retraction.

C. Increased aPTT

D. Decreased RBC count. Pharmacology

The purposes of epinephrine injection include all of the following except:

A. Stabilizing mast cell membranes. B. Relaxing bronchial smooth muscle. C. Supporting arterial blood pressure. D. Blocking histamine receptors. Pharmacology Therapeutic interventions focused on increasing the oxygen supplied to the heart and decreasing the heart’s demand for oxygen include:

A. Antiplatelet drugs

B. Anticoagulants

C. Morphine sulphate

D. Thrombolytic drugs

Pharmacology

An intervention that would contribute toward the healing of a peptic ulcer is:

A. Steroid administration

B. Blocking or neutralizing of acid secretion

C. Surgical removal of the ulcer

D. Intravenous nutritional support

Pharmacology Aspirin and NSAIDs are causative factors for the development of peptic ulcer disease because they:

A. Increase acid secretion

B. Allow proliferation of H. pylori

C. Damage the mucosal barrier

D. Alter platelet aggregation

Pharmacology Your patient is interested in trying medication to improve low mood/depression. All of the following medications might be appropriate except:

A. Selective serotonin reuptake inhibitors

B. Amitriptyline

C. Serotonin and norepinephrine reuptake inhibitors

D. Benzodiazepines

NRS410 Week 2 Approach to Care Latest 2018 May

Details:

Write a paper (1,250-1,750 words) describing the approach to care of cancer. In addition, include the following in your paper:

Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
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. NRS410 Week 3 Case Study 1 Latest 2018 May

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. 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. 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. NRS410 Week 3 Case Study 2 Latest 2018 May

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. 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 overwhelmed 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). NRS410 Week 4 CLC - Home Visit with Sallie Mae Fisher Latest 2018 May

Details:

This is a CLC assignment. As a group, observe the simulated "Home Visit With Sallie Mae Fisher" video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php). Refer to "Sallie Mae Fisher's Health History and Discharge Orders" for specifics related to the case study used to inform the assignment. Using "Home Visit With Sallie Mae Fisher" and "Sallie Mae Fisher's Health History and Discharge Orders," complete the following components of this assignment: Essay Portion After viewing the home visit, write an essay of 500-750-words in which you do the following: