Read Chapter 36 from your Text Book and
PP
II. NCLEX Review Questions Chapter 36 from Evolve
Resources
III. Case Study: Mitral Stenosis
Patient Profile
L.S. is a 59-year-old female who goes to see her
primary care provider because of increasing fatigue and shortness
of breath with activity. She has a history of hypertension,
hypothyroidism, rheumatoid arthritis, and rheumatic fever as a
child. She is taking the following medications:
Triamterene/hydrochlorothiazide 37.5/25 mg PO
daily
Levothyroxine 150 mcg PO daily
Methotrexate 15 mg PO every Sunday
3. .How did the mitral valve stenosis contribute to
the development of left-sided heart failure?
4. What clinical manifestations of left-sided heart failure does
L.S. have?
5.What are the treatment options for L.S.?
6. What would be some pertinent nursing diagnoses and goals for L.S.?
7 What are the priority nursing interventions for
these nursing diagnoses?
Discussion Questions
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In: Nursing
What are some challenges facing healthcare institutions in relation to maintaining confidentiality of people’s medical information in the digital era? What are some solutions?
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LPN to RN Role Transition
Content Objectives:
Content:
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1. Define and differentiate among conflict, tension, and disputes.
2. In no less than 200 words summarize the Process of Resolution
3. Explain in detail the following:
* Active Listening
* Reframing
* Assertive versus Aggressive and Passive Aggressive Stances
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A school nurse notices bruises and scares on a child's body. The nurse suspects the child is being physically abused. What would be the next step for the nurse to take with this information and why?
In: Nursing
In: Nursing
11.) When assessing the client's lower extremities, which of the following symptoms would cause the nurse to believe the client has atherosclerotic occlusive disease (peripheral artery disease) rather than venous insufficiency?
Only one correct answer
1.) Edema
2.) Thickened skin
3.) Cool lower extremities
4.) Dark pigmentation
In: Nursing
1. What is the principle behind public health nursing?
2. How does a community health nurse promote health and prevent disease in the community?
3. What is the goal of Healthy People 2020?
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Discuss the relative importance of human biology, lifestyle, the environment, and medical care in contributing to the health of the population.
In: Nursing
I need to type up a story using either real life experience or simply make one up! use medical terminology in your story that tie in your tale (Examples: Pericardial, Pneumonia, and Hypothyroidism) where there is a suffix and prefix and combining forms) This assignment should be a minimum of 1 page as well as a minimum of 30 terms. Thank you in advance.
In: Nursing
I need to type up a story using either real life experience or simply make one up! use medical terminology in your story that tie in your tale (Examples: Pericardial, Pneumonia, and Hypothyroidism) where there is a suffix and prefix and combining forms) This assignment should be a minimum of 1 page as well as a minimum of 30 terms. Please make the 30 terms in a darker font or highlighted. Thank you in advance
In: Nursing
In: Nursing
I. Read Chapter 36 from your Text Book and
PP
II. NCLEX Review Questions Chapter 36 from Evolve
Resources
III. Case Study: Mitral Stenosis
Patient Profile
L.S. is a 59-year-old female who goes to see her
primary care provider because of increasing fatigue and shortness
of breath with activity. She has a history of hypertension,
hypothyroidism, rheumatoid arthritis, and rheumatic fever as a
child. She is taking the following medications:
Triamterene/hydrochlorothiazide 37.5/25 mg PO
daily
Levothyroxine 150 mcg PO daily
Methotrexate 15 mg PO every Sunday
Subjective Data
Does not exercise, but was always able to do daily
activities such as go up and down the stairs of her home and go
grocery shopping
The last few weeks has noticed that she gets short of
breath with her normal daily activities
Has been waking up at night short of breath
Denies any pain in her chest
Does not have any pain in her joints as long as she
takes her “arthritis medicine”
Objective Data
Physical
Examination
Temperature 98.5° F, pulse 88 and irregular,
respirations 24, blood pressure 134/82, O2 saturation
92%
Irregular heart rate with a grade III diastolic
murmur
Crackles in bilateral bases of lungs
No peripheral edema noted
Diagnostic
Studies
ECG shows atrial fibrillation with heart rate of
90
Echocardiogram reveals mitral valve stenosis with mild
left-sided heart failure
Laboratory Studies:
Hemoglobin 12
g/dL
Hematocrit
37%
T4
(total) 5.1
mcg/dL
Discussion Questions
What is mitral stenosis? What could be the possible
cause of L.S.’s mitral stenosis
What clinical manifestations of mitral valve stenosis
does L.S. have?
How did the mitral valve stenosis contribute to the
development of left-sided heart failure?
What clinical manifestations of left-sided heart
failure does L.S. have?
What are the treatment options for L.S.?
What would be some pertinent nursing diagnoses and
goals for L.S.?
What are the priority nursing interventions for these
nursing diagnoses?
In: Nursing
Miss C has been on your unit for one week and states "these medications are not working properly;the doctor chose the wrong one". When you ask her why she believes that, she states, '' I'm not feeling any better yet, I'm still feeling sad and pathetic''.
5a) how would you respond to Miss C's concern that her medication is not working?
Miss C is treated and released five weeks from her admission date. Five months later you are taking report on your evening shift and you hear a name that sounds familiar. Miss C has been admitted to the unit for monitoring. She was brought into the emergency department with the police after creating a disturbance at a mall in the city. She was verbally and physically abusive to staff in the emergency department and her boyfriend states she has been increasingly bizarre for the past few weeks. He reports that she believes that she has found the cure for cancer and has been sleeping very little. He is worried as she is spending all of her money on advertising her cure for cancer and has been drinking alcohol and taking street drugs to keep herself awake. He stats that she has been ''irritable'' and they ''have been arguing a lot.'' Two nights ago, Miss C left their home after an argument and he has not seen her since. Miss C is diagnosed with Bipolar Disorder.
5b) Miss C's family is upset about her diagnosis. Describes how you would explain bipolar disorder to Miss C's family.
6) Discuss three patient safety concerns as they relate to acute mania in the bipolar patient. Include your rationale for each concern.
Miss C's treatment progress well, and her mood stabilizes. She is ready for discharge but there is concern from the psychiatrist that she will not comply with the treatment upon discharge. Her family also shares this concern as Miss C states that she "doesn't need to keep taking the medication" that has been prescribed for her bipolar disorder once she is back home.
7) Discuss community treatment order (CTO) as it relates to bipolar disorder. In your own words describe why a patient may be issued a CTO.
Miss C is being discharged from hospital on your shift. She is going home on a therapeutic does of lithium as well as valproic acid.
8) In your own words, describe the priority teaching points related to the lithium and valproic acid you would discuss with Miss C during her discharge teaching.
9) Discuss why it is important to therapeutically end the nurse-patient relationship prior to discharge.
In: Nursing