FIRST PAPER

Case Study: Mr. M.

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 Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

1. Temperature:      37.1 degrees C
2. BP      123/78 HR 93 RR 22 Pox 99%
3. Denies      pain
4. Height:      69.5 inches; Weight 87 kg

Laboratory Results

1. WBC:      19.2 (1,000/uL)
2. Lymphocytes      6700 (cells/uL)
3. CT      Head shows no changes since previous scan
4. Urinalysis      positive for moderate amount of leukocytes and cloudy
5. Protein:      7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

1. Describe      the clinical manifestations present in Mr. M.
2. Based      on the information presented in the case scenario, discuss what primary      and secondary medical diagnoses should be considered for Mr. M. Explain      why these should be considered and what data is provided for support.
3. When      performing your nursing assessment, discuss what abnormalities would you      expect to find and why.
4. Describe      the physical, psychological, and emotional effects Mr. M.’s current health      status may have on him. Discuss the impact it can have on his family.
5. Discuss      what interventions can be put into place to support Mr. M. and his family.
6. Given      Mr. M.’s current condition, discuss at least four actual or potential      problems he faces. Provide rationale for each.

You are required to cite to a minimum of two 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. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

SECOND PAPER

Case Study: Mr. C.

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 Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 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 by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height:      68 inches; weight 134.5 kg
2. BP:      172/98, HR 88, RR 26
3. 3+      pitting edema bilateral feet and ankles
4. Fasting      blood glucose: 146 mg/dL
5. Total      cholesterol: 250 mg/dL
6. Triglycerides:      312 mg/dL
7. HDL:      30 mg/dL
8. Serum      creatinine 1.8 mg/dL
9. BUN 32      mg/dl

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe      the clinical manifestations present in Mr. C.
2. Describe      the potential health risks for obesity that are of concern for Mr. C.      Discuss whether bariatric surgery is an appropriate intervention.
3. Assess      each of Mr. C.’s functional health patterns using the information given.      Discuss at least five actual or potential problems can you identify from      the functional health patterns and provide the rationale for each.      (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.)
4. Explain      the staging of end-stage renal disease (ESRD) and contributing factors to      consider.
5. Consider      ESRD prevention and health promotion opportunities. Describe what type of      patient education should be provided to Mr. C. for prevention of future      events, health restoration, and avoidance of deterioration of renal      status.
6. Explain      the type of resources available for ESRD patients for nonacute care and      the type of multidisciplinary approach that would be beneficial for these      patients. Consider aspects such as devices, transportation, living      conditions, return-to-employment issues.

You are required to cite to a minimum of two 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. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.