Nursing questions – answers needed by thursday.
Complete each instance con-aggravate utilizing collegiate formatting (MLA or APA); kindd in Cambria or New Times Roman 12 subject-stuff font in ONE muniment. Citations exactd.
Case studies are instance restricted. Your answers should meditate the tribute and your anatomy of the instruction in the instance con-over... no generalized answers of all stuff affecting the procureing.
QUESTION 1: Healthcircumspection Delivery and Evidenced –Based Nursing Practice
The registered nurture afloat in the cardiac circumspection clinic is tasked followingcited a while utensiling peculiarity amendment metes. To ground the clinic staff, the nurture sketchs an in-service program to effect-known concepts of peculiarity amendment and evidence-naturalized exercise. Additionally, the role of the instance superintendent procure be comprised in the bestowal. The nurture sketchs on using circumspection of the resigned followingcited a while Congestive Courage Failure as a template, and prepares specimen clinical pathways, circumspection maps, and multidisciplinary operation sketchs. (Learning Objective 3)
a. Recount how clinical pathways are used to coordinate circumspection of instanceloads of resigneds.
b. What is the role of the instance superintendent in evaluating a resigned’s way?
c. What are examples of evidence-naturalized exercise tools used for sketchning resigned circumspection?
QUESTION 2: Community-Based Nursing Practice
Mrs. Johnson, a 67-year-old dowagerly resigned, has of-late been discharged from the hospital forthcoming an entrance for COPD. She has a spent medical fact of a colon reexception akin to sharp diverticulitis. She familiar a surgical harm corruption that exacts daily wet to dry harm packing and IV Zosyn. Mrs. Johnson was discharged followingcited a while abode oxygen. To manipulate her circumspection at abode, abode circumspection marks were adjusted. (Learning Objective 5).
a. What would be complicated in enhancement up the principal abode circumspection mark?
b. Recount the nursing tributes and manipulatement that would happen during the mark.
QUESTION 3: Instance Study, Chapter 3, Critical Thinking, Holy Decision Making, and the Nursing Process
1. Mrs. Elle, 80 years of age, is a dowagerly resigned who is diagnosed followingcited a while end-stage cancer of the inferior domestic. She is prevalently receiving self-approval metes merely in hospice. She has gangrene of her suitconducive foundation and has a fact of diabetes inferior followingcited a while unwritten deputys. She is involved and the physician has decided that she is unfitted to effect her own certified decisions. The hospice nurture, not realizing that the weekly adjust for CBC and renal profile had been discontinued, obtained the labs and sent them to the nearby laboratory for ruleing. The unnatural lab results obtained followingcitedcited that day biblical that the resigned scarcityed a race transfusion. The hospice nurture updated the resigned’s medical force of counsellor who was miserconducive at the news. The resigned’s wishes were to die peaceabundantly and to not enjoy to experience an pollarding of her suitconducive foundation. But if the resigned accepts the race transfusion, she may speed crave ample to scarcity the pollarding. The resigned’s physician had previously certified the medical force of counsellor that the resigned would most favorly not be conducive to survive the pollarding. The resigned’s medical force of counsellor had made the demand to demur all labs so that the resigned would accept self-approval metes until she died. The resigned has no remonstrance of deficiency of inspiration or annoyance. (Learning Objective 4)
What holy opposedy exists?
Who are the stakeholders and what gains or losses do each enjoy?
What strategies should the hospice nurture engage to sumeract the holy opposedy?
Chapter 4, Sanity Advice and Sanity Promotion
he nationality sanity nurture is sketchning a sanity furtherance completeanceshop for a eminent nurture PTSO (Parent-Teacher-Student Organization). The excellent of topics was allude-toed by the eminent nurture’s registered nurture who has observed a step-by-step acception in learner plumpness. The two nurtures enjoy collaborated to enlarge this completeanceshop to arrange parents, learners, and teachers followingcited a while instruction environing the conseries of sanity furtherance. (Learning Objectives 6, 8, and 9)
a. Recount the conseries of a rendezvous on sanity furtherance.
b. According to the sanity furtherance example familiar by Becker (1993), what lewd variables bias the segregation and use of sanity furtherance behaviors?
c. Describe lewd components of sanity furtherance.
QUESTION 5: Chapter 5, Adult Sanity and Nutritional Assessment
The registered nurture prepares to direct a nutritional tribute on Mrs. Varner, a 52-year-old Caucasian dowagerly who recounts herself as “overefficacy most of my adult society.” The client states that her sanity is cheerful. She completeances sever boundlessness as a receptionist and volunteers environing 10 hours per week in her habitation. The nurture obtains Mrs. Varner’s top as 64 inches and her efficacy as 165 pounds. (Learning Objective 8)
a. What is the rationale for computing concretion concretion index? What is Mrs. Varner’s BMI?
b. Calculate her spiritual concretion efficacy. What is your tribute of her BMI and efficacy?
c. Naturalized on Mrs. Varner’s BMI and efficacy, the nurture metes her waist periphery. Recount the adapted rule for this tribute.
d. Mrs. Varner’s waist periphery is 38 inches. What is your tribute?
e. What laboratory values would the nurture retrospect to evaluate Mrs. Varner’s protein razes?
QUESTION 6: Chapter 6, Individual and Source Homeostasis, Stress, and Adaptation
Mary Turner stepped on a nail 5 days ago and sustained a perfoscold environing 1 inch submerged. She delayout-delay cleaned the area followingcited a while soap and infiltscold and hydrogen peroxide, and applied triple antibiotic ointment to the office. Today she succeeds to the clinic followingcited a while remonstrances of acceptiond abstinence and turgescence in her foundation. On tribute, the nurture notes that the perfoscold office is red and edematous, and has a limited equality of yellowish parchage. (Learning Objective 9)
a. Recount the series of events that caused the national inflammation seen in Mary’s foundation.
b. What is the role of histamine and kinins in the aggravating rule?
c. Which of the five excellent signs of inflammation does Mary manifest?
d. Consequently Mary’s wear happenred 5 days ago, the nurture should assess for what systemic property?
Chapter 7, Overview of Transcultural Nursing
The nurture superintendent of an ambulatory circumspection clinic has eminent an acceptiond number of marks by resigneds from opposed sumries and humanizations, including resigneds from Mexico and other Latin American sumries. Concerned environing argueion the scarcitys of this culturally sundry population, the nurture superintendent convenes a staff argueion to argue this alter in resigned demographics, and to interrogation the staff environing any tuition scarcitys they enjoy akin to the circumspection of these resigneds. (Learning Objective 3)
a. What strategy to shirk stereotyping clients from other humanizations should the nurture apprehend in this argueion?
b. Identify culturally impressible issues to be argueed in the staff argueion.
c. One technician on the staff complains that some resigneds never effect eye adjunction, and this property it opposed for him to finished his completeance. How should the nurture correspond?
QUESTION 8: Chapter 8, Overview of Genetics and Genomics in Nursing
Mr. Wayne is a 38-year-old man followingcited a while a indicative source fact of proud cholesterol razes. His father died at age 42 from a concretionive courage invasion inferior to proud cholesterol and triglycerides, and two of his older siblings are prevalently portico medications to inferior their cholesterol razes. Mr. Wayne property an enactment to argue his destroy for hypercholesterolemia. The nurture recognizes that Mr. Wayne is at destroy for familial hypercholesterolemia consequently this is an autosomal dominant ancestral case. (Learning Objective 2)
a. Recount the precedent of autosomal dominant legacy.
b. Mr. Wayne asks what hazard his effect enjoy of enlargeing familial hypercholesterolemia. How should the nurture correspond?
c. Explain the phenomenon of penetrance observed in autosomal dominant legacy.
QUESTION 9: Chapter 9, Constant Illness and Disability
Mr. Edwards is 20-year-old manful resigned who is admitted for matter of recurring pyelonephritis (kinsfolk corruption) and surgical matter of a urinary criticism, which has decreased the urinary tendency. Mr. Edwards has paraplegia; he is superannuated from the waist down inferior to an automobile property when he was 16. He came by ambulance to the hospital, leaving his wheelchair and wheelchair urgency-relieving cushion at abode. According to the nursing fact, the resigned is a nonsmoker and he does not absorb alcohol or engage any unfair drugs. (Learning Objective 5)
a. What nursing considerations should be made for Mr. Edwards akin to his incapacity?
b. What sanity furtherance and interruption advice does Mr. Edwards scarcity?
QUESTION 10: Chapter 10, Principles and Practices of Rehabilitation
You are assigned to circumspection for David Ramsey, a 22-year-old manful resigned who sustained a end wear inferior to substance thrown from a motorcycle. He did not impairment the spinal outline, but the computed tomography biblical a compression disbandment at L-2 (lumbar area). David complains of afflictive inferior end abstinence followingcited a while insensibility and tingling in the inferior extremities. You identify the forthcoming nursing diagnosis: Impaired Physical Mobility.
(Learning Objective 4)
a. What tributes are indicated naturalized on this nursing diagnosis?
b. List other main nursing diagnoses naturalized on David’s clinical bestowal.
Chapter 11, Sanity Circumspection of the Older Adult
The nurture afloat at the main kernel notices Mrs. Jones, a 78-year-old, crying. The nurture approaches Mrs. Jones and asks if she scarcitys succor. Mrs. Jones states “I am so complex. I had another property and my pants are all wet. It’s favor I’m a baby. I never should enjoy succeed to the main kernel.” (Learning Objectives 3 and 4)
a. What factors may be contributing to the urinary intemperance?
b. How should the nurture corcorreply to Mrs. Jones?
Chapter 12, Abstinence Management
Mr. Rogers is 2 days postoperative of a thoracotomy for dissolution of a implacable concretion in his left chest. His abstinence is substance manipulated via an epidural catheter followingcited a while morphine (an opioid analgesic). As the nurture assumes circumspection of Mr. Rogers, he is prepared and abundantly oriented, and states that his prevalent abstinence is 2 on a 1-to-10 flake. His necessary signs are 37.8 – 92 – 12, 138/82. (Learning Objective 6)
What are benefits of epidural versus systemic administration of opioids?
b. The nurture advisers Mr. Rogers’ respiratory condition and necessary signs integral 2 hours. What is the rationale for these common tributes?
c. The nurture advisers Mr. Rogers for what other complications of epidural analgesia?
d. Mr. Rogers complains of a afflictive headache. What should the nurture do?
e. Mr. Rogers’ epidural morphine and decreased disturbance acception his hazards of constipation. What interventions should be comprised in his sketch of circumspection to minimize constipation?
Chapter 13, Flowing and Electrolytes: Balance and Disturbance
Mrs. Dean is 75-year-old dowager admitted to the hospital for a inferior bowel impediment. Her medical fact apprehends hypertension. Mrs. Dean is NPO. She has a nasogastric (NG) tube to low uniform suction. She has an IV of 0.9% NS at 83 mL/hr. Prevalent medications apprehend furosemide 20 mg daily and hydromorphone 0.2 mg integral 4 hours, as scarcityed for abstinence. The waking electrolytes unveil serum potassium of 3.2 mEq/L. (Learning Objective 4)
a. What are feasible causes of a low potassium raze?
b. What operation should the nurture engage in association to the serum potassium raze?
c. What clinical manifestations susceptibility the nurture assess in Mrs. Dean?
Chapter 14, Astound and Multiple Organ Dysfunction Syndrome
Adam Smith, 77 years of age, is a manful resigned who was admitted from a nursing abode to the intensive circumspection ace followingcited a while septic astound inferior to urosepsis. The resigned has a Foley catheter in situate from the nursing abode followingcited a while doltish greenish, yellow-colored urine followingcited a while sediments. The nurture removes the catheter followingcited obtaining a urine humanization and replaces it followingcited a while a condom catheter established to a parchage bag gone the resigned has a fact of urinary and bowel intemperance. The resigned is involved, afebrile, and hypotensive followingcited a while a race urgency of 82/44 mm Hg. His respiratory scold is 28 inspirations/min and the pulse oximeter lection is at 88% vestibule air, so the physician adjusted 2 to 4 L of oxygen per nasal cannula titrated to binder SaO2 greater than 90%. The resigned corresponded to 2 L of oxygen per nasal cannula followingcited a while a SaO2 of 92%. The resigned has diarrhea. His race glucose raze is proud at 160 mg/dL. The lucid race sum is 15,000 and the C-reactive protein, a marker for inflammation, is proud. The resigned is substance treated followingcited a while broad-spectrum antibiotics and norepinephrine (Levophed) threshold at 2 mcg/min and titrated to binder systolic race urgency greater than 100 mm Hg. A subclavian triple lumen catheter was inserted and identified by chest x-ray for rectify situatement. An arterial length was situated in the suitconducive radial artery to air-tight adviser the resigned’s race urgency during the exercise of the vasopressor therapy. (Learning Objectives 6 and 7)
a. What predisposed the resigned to enlarge septic astound?
b. What possible findings would allude-to that the resigned’s septic astound is worsening from the subject-stuff of entrance?
c. The norepinephrine concentration is 16 mg in 250 mL of typical salength (NS). Explain how the nurture should direct the medication. What nursing implications are akin to the exercise of a vasoactive medication?
d. Explain why the efficiency of a vasoactive medication decreases as the septic astound worsens. What matter should the nurture forecast to be obtained to succor the resigned?
Chapter 15, Oncology: Nursing Superintendence in Cancer Care
The oncology clinical nurture specificist (CNS) is asked to enlarge a staff enlargement program for registered nurtures who procure be directing chemotherapeutic deputys. Consequently the nurtures procure be directing a multiformity of chemotherapeutic drugs to oncology resigneds, the CNS sketchs on introduceing an aggravateview of deputys, classifications, and specific precautions akin to the sure handling and administration of these drugs. (Learning Objectives 6 and 8)
a. What does the CNS recount as the goals of chemotherapy?
b. How should the CNS corcorreply to the forthcoming question: “Why do resigneds exact rounds of chemotherapeutic drugs, including opposed drugs and varying intervals?”
c. In training environing the administration of chemotherapeutic deputys, what signs of extravasation should the nurture apprehend?
d. What clinical manifestations of myelosuppression, inferior to chemotherapy administration, should the CNS apprehend in this program?
Chapter 16, End-of-Life Care
Joe Clark, 79 years of age, is a manful resigned who is receiving hospice circumspection for his ultimate illnesses that apprehend lung cancer and constant unconducive pulmonary complaint (COPD). He familiar bilateral pleural speech (flowing that accumulates in the pleural boundlessness of each lung), which has concerned his lung comment. He states that he is less of inspiration and feels concerned that the proximate inspiration procure be his ultimate. The resigned is admitted to the hospital for a thoracentesis (an invasive rule used to parch the flowing from the pleural boundlessness so the lung can swell). The thoracentesis is substance used as a palliative mete to help the disself-approval he is experiencing. Low dose morphine is adjusted to arrange deliverance from dyspnea or annoyance. The resigned is prescribed Proventil (albuterol) inhaler 2 puffs per day, as scarcityed, and Flovent (fluticasone propionate) inhaler 2 puffs twice a day. The resigned has 2 L/min of oxygen adjusted per nasal cannula as scarcityed for self-approval. (Learning Objective 9)
a. What nursing metes should the nurture use to manipulate the resigned’s dyspnea?
b. The resigned complains that he has no propensity and struggles to eat and inspiratione. What nursing metes should the nurture utensil to manipulate this physiologic defense to the ultimate illnesses?
Chapter 17, Preoperative Nursing Management
The nurture in a gynecology clinic is completing preoperative training for a resigned scheduled for an abdominal hysterectomy proximate week. The resigned states that she is prevalently portico 325 mg of aspirin daily for constant articulation abstinence, acrave followingcited a while a multivitamin. The resigned has kind 2 diabetes; she air-tight advisers her race glucose razes. Currently, she is portico an unwritten hypoglycemic deputy. The nurture advises her to ask the anesthesiologist whether she should engage this medication the waking of surgery. (Learning Objectives 2 and 4)
a. The nurture instructs the resigned to plug portico the aspirin. What is the rationale for this operation?
b. Why is it main to assess the resigned for use of herbal products earlier to surgery?
c. The resigned asks how surgery could favor her race glucose; how should the nurture correspond?
QUESTION 18: Chapter 18, Intraoperative Nursing Management
Pearl Richards, 69 years of age, is a dowagerly resigned who is in the playing vestibule for a retrieve of an abdominal aortic aneurysm. The resigned has a fact of hypertension inferior followingcited a while medications, osteoporosis, constant unconducive pulmonary complaint, and has smoked two packs of cigarettes per day for 40 years. (Learning Objectives 2, 6, and 9)
a. What nursing interventions are inaugurated to subdue the surgical destroy factors akin to the resigned’s age?
b. Explain the role of the nurture in providing resigned surety metes during the intraoperative bound.
QUESTION 19: Chapter 19, Postoperative Nursing Management
1. Rita Schmidt, 74 years of age, is a dowagerly resigned who was admitted to the surgical ace followingcited experienceing dissolution of a exception of the colon for colorectal cancer. The resigned does not enjoy a colostomy. The resigned has sundry inferior abdominal incisions and a lucid surroundings aggravate each office. The incisions are polite approximated and the staples are dry and uncontaminated. There is a Jackson-Pratt parch uncontaminated followingcited a while minimal serous sanguineous parchage introduce. The resigned has a Salem sump tube united to low uniform glacis suction that is parching a inferior equality of brown soft. The resigned has no bowel sounds. The Foley catheter has a inferior equality of sombre amber-colored urine followingcited a whileout sediments. The resigned has sequential compression invention (SCD) in situate. The nurture completes an tribute and notes that the resigned’s inspiration sounds are decreased bilaterally in the bases and the resigned has inspiratory crackles. The resigned’s cardiac tribute is followingcited a whilein typical limits. The resigned is receiving O2 at 2 L per nasal cannula followingcited a while a pulse oximetry lection of 95%. The necessary signs apprehend: race urgency, 100/50 mm Hg; courage scold 110 bpm; respiratory scold 16 inspirations/min; and the resigned is afebrile. The resigned is involved as to situate and boundlessness. (Learning Objectives 4 and 7)
a. Explain the tribute parameters used to arrange clues to discover postoperative problems present and the interventions scarcityed.
b. What gerontological postoperative considerations should the nurture effect?
2. Mr. John Smith is admitted to the hospital for surgical incision and parchage (I&D) of an abscess on his suitconducive calf, which resulted from a farm machinery property. The suitconducive calf has an area 3 cm × 2.5 cm, which is red, genial and inexplicable to affect, and edematous. (Learning Objective 5)
a. Explain the harm nutritious rule according to the side of Mr. Smith’s harm?
b. The surgeon adjusts for wet-to-dry unfruitful salength surroundings twice a day followingcited a while iodoform gauze to the harm, tried followingcited a while the wet-to-dry surroundings. Explain how to complete this surroundings alter
Fundamentals of Nursing Second Edition Theory, Concepts and Applications by Judith M. Wilkinson, Leslie S Treas .