Nursing Case Study

Nursing care is a dynamic field of practice. The way it looks today is far out greater intense and very structured. It advances itself by the use of nursing theories and evidence based practice. Policies and procedures constantly change with the advancement of technology and science. While caring for the patient in the given case studies, a nurse involved utilizes practical knowledge, a culture care model and transpersonal caring relationship to attain a caring environment (Smith & Parker, 2015).

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed.

1. The nurse is asked to implement a new, complex, and invasive procedure and is concerned that this may violate the state’s nurse practice act.

CHIEF COMPLAINT: This is a post op note from a procedure performed July 21, 2015 by David Lin, MD.

to as colitis, enteritis, ileitis, and proctitis. When you have this disease your body’s immune system begins attacking healthy cells in your digestive tract, and this is what causes the inflammation. Crohn’s disease is one of the fastest growing intestinal diseases in the United States. Although the condition can affect any part of the gut, the most commonly affected areas are the ileum or the large intestine, the colon. Crohn's disease may be mild, moderate, or severe. Most patients are able to lead full and productive lives when treated properly.

Mr. Brann is a 42-year-old male here today for followup from his left cerebellar stroke and left vertebral artery dissection, status post hospitalization in May of 2015

1. Monitor the patient's oxygen saturation frequently (once per hour) at rest and after exertion on room air

Respond to 11 questions to guide your description of the ethical challenge and prompt what you might say and do to make a values based decision. Follow the steps on the rubric to define the conflict, discuss what is at stake, define arguments you have to counter, and indicate responses that create a sound argument. The logistics of presenting your argument ask that you identify who, what time, allies, forum, communication style and support you will solicit when presenting your case.

Mr. Mustard fell down on his driveway three weeks ago. He has now presented to the clinic of Nurse Practitioner (NP) with chief complains of worsening left-sided headache, photophobia, unequal pupillary reaction, and dysphasia. Mr. Mustard takes Coumadin to lower the risk of stroke due to atrial fibrillation. Mr. Mustard’s presenting symptoms along with his higher age (70 years), history of hypertension and being on Coumadin regimen, should be considered as red flags and need urgent attention and evaluation. Based on the subjective interview, Mr. Mustard denies any previous history of brain injuries, which is also confirmed by the NP during physical examination. The NP considers that Mr. Mustard has suffered from traumatic brain injury likely

According to Walker and Avant (2011), model cases remain examples of concepts by containing all the defining attributes. Susie is a 77-year-old white woman, who was diagnosed with osteoporosis after suffering from a hip fracture. After her diagnosis, she read numerous articles about her condition. She arrives at the clinic today for her annual physical. She calculates the amount of calcium and vitamin D that she takes daily and agrees to continue to take the recommended dose. During her physical, Susie actively participates in discussions about her health, decisions about her plan of care, and asks questions appropriately. Her physician answers all of Susie’s questions and supplies her with additional information on diet and exercise. Furthermore, the physician offers her the phone number of a local gym that provides discounts to senior citizens. Susie enthusiastically reviews the information, verbalizes understanding of it, and schedules her dual energy X-ray absorptiometry (DEXA) scan.

This is a house call I made on this 94-year-old individual, multiple medical problems including chronic obstructive pulmonary disease, recurrent exacerbations of COPD with recurrent hospitalizations for pneumonia. Past medical history also includes that of recurrent hyponatremia intermittent atrial fibrillation,coronary disease, heart failure, pulmonary edema, hypertension, chronic constipation. The last time I saw her was in 01/2017. She had a previous hospitalization one year ago at Rex Hospital for respiratory failure from COPD. CPAP was used for rescue and family apparently got a CPAP machine at home for intermittent use. Since the last time I saw her in January, the patient has become non ambulatory. The last time I saw her

Glycation is a natural chemical reaction in the body that involves combining sugar molecules to protein molecules without the help of enzymes. In contrast to similar a chemical reaction that involves enzyme-directed processes called glycosylation, glycation disrupts normal metabolic pathways. This results in the production of advanced glycation end products (AGEs), which are assocated with oxidative damage that leads to pathological changes in various organ systems.

Glycogen phosphorylase is inhibited by glucagon and epinephrine. These two activate the G-proteins, and then trigger cAMP. The enzymes that are responsible for the production and mobilization of glycogen are glycogen phosphorylase. Glycogen phosphorylase is regulated by both allosteric factors and by covalent modification phosphorylation. Its regulation is consistent with the energy needs of the cell. High energy substrates like ATP, G6P, glucose inhibit GP, while low energy substrates like AMP activate it. If glycogen phosphorylase was inhibited then the liver couldn't make glucose for the body like it is suppose to and the whole body's system would be upset and could cease production. The inhibition of glycogen phosphorylase is also important

The proinflammatory cytokine TNF-a is released by activated white blood cells, triggering more inflammation, an immune system response and more damage to the mucosa of the colon in IBD patients, consequently inhibition of this cytokine is expected to be a powerful treatment strategy in patients with both CD and UC.

When glucose enters the cell, it is phosphorylated by an enzyme, hexokinase, and uses ATP to keep the glucose concentration low in order to continually transport glucose into the cell by the glucose transporters. This produces glucose 6-phosphate, which has a negative charge, preventing glucose from diffusing out of the cell [2]. Glucose 6-phosphate is then rearranged by phosphoglucose isomerase to form fructose 6-phosphate. Fructose 6-phosphate is catalyzed by phosphofructo-kinase-1 coupled with ATP, forming fructose 1,6-bisphosphate. Since the molecule is now destabilized, the fructose 1,6-bisphosphate is split by aldolase to form glyceraldehyde 3-phosphate and dihydroxyacetone phosphate [2]. Dihydroxyacetone phosphate is then converted into glyceraldehyde 3-phosphate by