COPD Case Study

Andy Portal is a 68-year-old retired construction worker with a 12-year history of COPD after a 35-pack-year history of smoking. He has not smoked in 9 years. He presents in the emergency department complaining of a sharp pain and redness at his posterior left calf, which is also hot and tender to the touch. The medical diagnosis of deep-vein thrombosis (DVT) is made by contrast venography. The nursing diagnosis is ineffective tissue perfusion: peripheral related to decreased venous circulation in the right leg.

When Andy’s wife asks, “What happens now?”, the nurse explains to them both that the goal is to prevent further clot formation and preventing the clot traveling as in pulmonary emboli. This is accomplished by anticoagulants, anti-embolitic stockings, and warm compresses. The nurse discusses the possible pharmacological treatments and side effects. When Andy’s wife asks, “Why did this happen?”, the nurse explains to them that COPD is one of the risk factors for DVT (Vesa et al., 2009).

Questions. Please answer with APA citations

What is the relationship between COPD and vascular effects?

Describe how COPD can cause pulmonary hypertension.

Describe a pulmonary function test (PFT). What finding is indicative of COPD?

Case Study - Pulmonary Edema

A 60-year-old man was admitted to intensive care unit because of dyspnea and pulmonary vascular congestion. The patient had reportedly been well until seven days earlier,when he began to have dyspnea during moderate exertion. Fourdays before admission, he felt a nonradiating, "heavy" discomfort in the lower retrosternal and epigastric areas when he stooped, bent over, or walked short distances. There was no orthopnea, sweating, nausea, or edema. Patient was admitted to the hospital. BP 150/80 mmHg HR 90-100 bpm. Inspiratory crackles were heard at both lung bases. The abdomen was normal, and there was no peripheral edema. Laboratory tests were performed, levels of CK and CK MB were normal, as was the level of troponin. The levels of urea nitrogen, creatinine,glucose, calcium, magnesium, electrolytes, LFT were normal.

Case study questions -Please answer with APA citations.

In YOUR OWN WORDS - explain the pathopysiology behind pulmonary edema. Pretend you were explaining it to another nursing student (correct terminology please)

What are some nursing interventions that can be directed to help this patient during his hospital stay (identify 3 goals for discharge)?

What is some patient / family education that is likely required for when he goes home?

From   this case study i need the SBAR

L.W., a 20-year-old college student, comes to the university health clinic for a pregnancy test. She has been sexually active with her boyfriend of 6 months, and her menstrual period is now “a few” weeks late. The pregnancy test result is positive. The patient begins to cry, saying, “I don't know what to do.”

1.What is ultrasound? How is it utilized in pregnancy (many reasons)? How often do low-risk women receive an ultrasound during pregnancy? Explain some reasons a woman may need to have more frequent ultrasounds.

2.What is a non-stress test? How is it performed; what equipment is needed? Why would this test be ordered for a pregnant client (numerous reasons)? What are the possible results and what do they mean?

3. What is a biophysical profile? How is it performed; what equipment is needed? What does it measure? Why would this test be ordered for a pregnant client (numerous reasons)? How are the various scores interpreted?

4. What are some referrals a prenatal care (OB) clinic may need to make to/for an antepartum (pregnant) client? Explain.

Objectives

1. Use effective communication techniques to delegate, supervise, and provide evaluative feedback to peers.
2. Maintain accurate and timely communication with clinical faculty and nursing staff on the unit.
3. Make and validate judgments about priorities of care.

As a nurse student in a clinical day your position would be leader in your group, what would be your ability to meet or struggles with meeting the above 3 objectives?

hi so im going to post a dicussion sooap note for a patient with chext pain and i would like you to respond to that discussion

i will also provide a sample answer use it as an example but please formulate your own thank you

here is the soap note discussion

HPI: Mr. C is a 56-year-old Asian male who presents to the clinic with chest pain x 2 days. He describes the chest pain as “a squeezing pressure” and states the pain has been intermittent. He notes the onset is gradual (over a few minutes) and it only occurs while he is performing strenuous activity such as sprinting but resolves within 5 minutes of resting. He has had a total of two episodes of chest pain since onset. The pain is localized to midsternal area and does not radiate. At its worse, he rates the pain as 7/10. Currently, he is not having any chest pain. He has taken ibuprofen with each episode of chest pain, minimal relief. He denies any diaphoresis, shortness of breath, nausea, vomiting, fatigue, palpitations, lightheadedness, or syncope. No previous history of similar chest pain. Denies any recent prolonged travel.

Past Medical/Surgical History: Hypertension (well-controlled) and type 2 diabetes. No history of coronary artery disease, cerebrovascular disease, DVT, PE, or GERD. No prior hospitalizations. History of appendectomy in 1984. No other surgeries.

Differential Diagnosis: acute coronary syndrome, myocardial infarction, acute pericarditis, acute thoracic aortic dissection, chest wall pain, costochondritis, acute congestive heart failure, cardiac tamponade, stress cardiomyopathy, pericarditis, pleuritis, pulmonary embolism, pneumonia, pneumothorax, esophageal perforation, peptic ulcer disease, GERD, pancreatitis, peptic ulcer disease, rib fracture, anxiety, herpes zoster, muscle strain (McConaghy, 2019).

Assessment (Diagnosis): Stable angina

Plan:

• Medication/Therapy:
  • Rx: Nitroglycerin 0.4 mg sublingual tablets, as needed for chest pain; take 1 tablet sublingually every 5 minutes, up to 3 times, at first sign of angina. Disp #24. (Medscape, n.d.).
    • Allow tablet to dissolve under tongue or in buccal pouch, do not rinse mouth or spit for 5 minutes after administration
    • If chest pain remains unrelieved following nitroglycerin, call 911
  • Diagnostic tests:
    • 12-lead EKG to rule out acute myocardial infarction.
    • Labs: complete blood count with differential, complete metabolic panel, lipid panel, PT/INR/PTT, TSH, and cardiac enzymes (troponin, creatine kinase (CK) or CK-MB).
    • Chest x-ray (A/P and lateral).
    • Consider referral for exercise stress test.
  • Patient education:
    • Patient provided detailed instructions on how to take medications along with side effects. Store nitroglycerin in a dark bottle protected from light.
    • Provide patient education regarding the causes and symptoms of stable angina versus unstable angina.
    • Provide patient education regarding 12-lead EKG purpose/results and potential need for exercise stress test.
  • Follow-up:
    • Refer to cardiologist for stress test and possible echocardiogram.
    • Return to clinic in 2 weeks or sooner if needed for follow-up, review of lab results, and evaluation of symptoms.
    • Seek emergency medical care or call 911 if you are experiencing chest pain that is unresolved with rest, chest pain that is new or severe, back pain concurrent with chest pain, difficulty breathing, lightheadedness, fainting, dizziness, palpitations, weakness, nausea, vomiting

sample answer as a response to that soap note discusiion(this is only an example just to show you)

You wrote an excellent SOAP note assessment for this patient. Your use of the numbers scale for this patient's pain assessment was well done. You used OLDCARTS for the HPI and your prescription was exceptionally done. Also, your succinct ROS brought all of the most pertinent positive and negative subjective information to the forefront, correlating to the chief complaint seamlessly.

You had an excellent assessment, plan, education, and medication section to this SOAP note. Perhaps it would be important to include how his blood sugars have been. Indapamide combined with metformin may cause hyperglycemia (Epocrates, 2020). It was a good idea to include the CMP in your diagnostics. What are your thoughts on adding a routine BG test in the clinic given his recent change in condition?

Thank you so much for your thoughtful and informative post.

If you were a member of the NLRB, would you rule that HCR violated section 8(a)(1) of the NLRB by discharging the three nurses (assuming that they were covered by the NLRA)? Why or why not?

C.R. is a 42-year-old white male who fell from a 60-foot scaffold while working on the construction of a new building. He is admitted to the emergency department (ED) by ambulance and is strapped to a rigid backboard with cervical immobilization. At the site of the accident, C.R.'s co-workers immobilized his body until the ambulance arrived. His supervisor called his wife.

Question #1: Using the principles of prioritization that you have learned in this course, answer the question: what prioritization category does cervical immobilization fall under?

C.R.'s wife arrives at the emergency department (ED) at the same time the ambulance arrives. She is very agitated and crying. He sees her as he is wheeled into the ED, reassures her that he is okay, and tells her he fell at work. You take her to a waiting room, explaining that she can see her husband as soon as he is stabilized.

Question #2: Comment on your feelings about the wife being taken to the waiting room and told she will need to wait until the patient is stabilized.

Question #3: Using therapeutic communication, write what you could say to the patient at this point in the care of the patient/family.

Chapter 16 End Case Study
from Surgical Technology for the Surgical Technologist: A Positive Care Approach, 5th ed.

A 73-year-old male patient complains of progressive darkening and clouding across his entire left field of vision. The patient reports no pain or trauma, and the progression has taken place very gradually. He is diagnosed with a cataract in the left eye.

1. What surgical procedure will be performed in this case?
2. 
   
3. Describe how the microscope will be draped.
4. 
   
5. Why is it extremely important that all personnel in this procedure wear powder-free gloves?
6. 
   
7. What is the likely postoperative treatment plan for the patient?

How can hospitals use big data to improve on their policy and procedures

Body Pain:

Issue/Opportunity: Back pain caused by long durations of time bent on a computer.

Idea: Posture Corrector Write a power point presentation on Posture Corrector. Include its mission statement, opportunity, planning, give examples etc.

PLEASE TYPE THE ANSWERS and BE MORE SPECIFIC.

Read about the country context (Eastern Europe and Central Asia) and write about the laws/policies, stigma/discrimination, violence, expenditure, prevention of HIV/AIDS

1. Which of the following should be included when teaching a client newly diagnosed with diabetes about dietary management?

- Food intake should be decreased prior to exercise -

Consistency between food intake and exercise is important -

Carbohydrate are strictly limited before activity -

Sugar intake should be increased to prevent hypoglycemia

2. Significant risk factors for development of venous thrombosis include. Select all that apply?

- Altered blood coagulation

- Stasis of blood -

Vessel wall injury -

Arterial insufficiency

Good Samaritan laws, which protect the responder from financial liability, were developed to encourage people to help others in emergency situations. They assume a responder will do his or her best to save a life or prevent further injury. Good Samaritan laws require the responder to use common sense and a reasonable level of skill and to give only the type of emergency care for which he or she is trained. Good Samaritan laws usually protect responders who act the way a “reasonable and prudent person” would act if that person were in the same situation. For example, a reasonable and prudent person would:

■ Move a person only if the person’s life were in danger.

■ Ask a responsive person (or the parent or guardian of a minor) for permission to help (consent) before giving care.

■ Check the person for life-threatening conditions before giving further care.

■ Call 9-1-1 or the designated emergency number.

■ Continue to give care until more highly trained personnel take over. If a lay responder’s actions were grossly negligent or reckless, or if the responder abandoned the person after starting care, Good Samaritan laws may not protect the responder. For more information about your state’s Good Samaritan laws, conduct an Internet search or contact a legal professional.

Answer the following questions in your own words.

QUESTION:

1. What is the Good Samaritan Law?