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what are the important developmental considerations for Casey? THE OLDER ADULT (GRADED) Jean is a 68-year-old female admitted for a total hip replacement.

what are the important developmental considerations for Casey? THE OLDER ADULT (GRADED) Jean is a 68-year-old female admitted for a total hip replacement.

week 1 HEALTHY PEOPLE INITIATIVE (GRADED) As the school nurse working in a college health clinic, you see many opportunities to promote health. [http://www.bezern.com/] Maria is a 40-year-old Hispanic woman who is in her second year of nursing school. [http://www.bezern.com/] She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. [http://www.bezern.com/] After doing her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. [http://www.bezern.com/] She is married with two school-age children. [http://www.bezern.com/] She is in class a total of 15 hours per week, plus 12 hours of labs and clinical. [http://www.bezern.com/] She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. [http://www.bezern.com/] She states that she is lucky to get 6 hours of sleep per night, but that is okay with her. [http://www.bezern.com/] She lives 1hour from campus and commutes each day. [http://www.bezern.com/] Using . [http:style=]healthypeople. [http://www.bezern.com/]gov/”>Healthy People 2020as a guide: * What additional information would you like to gather from Maria? * What are Maria’s real and potential health risks? * Pick one of Maria’s health risks. [http://www.bezern.com/] What would be one reasonable short-term goal for this risk? CULTURAL BIAS (GRADED) Understanding cultural phenomena is essential to the completion of an accurate health assessment. [http://www.bezern.com/] Please choose a cultural group from Table 4. [http://www.bezern.com/]1 from your text and describe the cultural differences pertinent to that group. [http://www.bezern.com/] Remember, the table may not include all cultural groups. [http://www.bezern.com/] Let’s try to include all the groups listed in the discussion, so please do not choose a group that has already been done. [http://www.bezern.com/] To expedite this, please use the group name in the title of your post. [http://www.bezern.com/] week 2 PAIN ASSESSMENT (GRADED) John, a 46-year-old African-American male presents for admission to your hospital for hemi-colectomy for colon polyps. [http://www.bezern.com/] He is complaining of chronic back pain. [http://www.bezern.com/] Patient is on disability from work related injury. [http://www.bezern.com/] History of two (2) previous back surgeries with relief of numbness in RLE but pain has not been relieved. [http://www.bezern.com/] His current medications include Methadone, Neurontin and Norco. [http://www.bezern.com/] John states he takes Benadryl PM every night in addition to his prescribed medications. [http://www.bezern.com/] John is a smoker and smokes 1 PPD. [http://www.bezern.com/] John confides in you that he is considering a spinal cord stimulator for the chronic pain. [http://www.bezern.com/] * What risk factors does John have for risk of opioid withdrawal during this hospitalization? * Is there a stigma connected to being disabled and or methadone? * Does the nurse need to be concerned about acetaminophen use? * What are the differences in acute and chronic pain? * NUTRITIONAL ASSESSMENT (GRADED) Yulang Lei, an 82-year-old Vietnamese man, was admitted to your floor with dehydration and a urinary tract infection following a fall at home. [http://www.bezern.com/] He is alert and oriented, but weak. [http://www.bezern.com/] He appears frail. [http://www.bezern.com/] His admission history includes the following. [http://www.bezern.com/] * He lives alone; his wife died 6 months ago. [http://www.bezern.com/] * He states he ran a traditional Vietnamese family, unlike his children, who are married and have now moved away. [http://www.bezern.com/] * His wife did all the cooking and he hasn’t had much of an appetite since she died. [http://www.bezern.com/] He eats rice and some vegetables, but rarely “bothers to cook meat for just one person. [http://www.bezern.com/]” * Usual daily activity is reading the Vietnamese community newspaper with his morning tea for breakfast. [http://www.bezern.com/] He says he usually eats lunch, but can’t remember what he usually eats. [http://www.bezern.com/] He has rice and a few vegetables for dinner. [http://www.bezern.com/] * You notice that his clothes fit very loosely. [http://www.bezern.com/] He states he weighed 140 pounds at his doctor’s office 5 months ago. [http://www.bezern.com/] When you weigh him, he weighs 123 pounds and is 5’8″ tall. [http://www.bezern.com/] Look at the list of nursing diagnoses in Appendix A of your text. [http://www.bezern.com/] What nursing diagnoses would you choose for Mr. [http://www.bezern.com/] Lei? * What additional questions would you ask to confirm your diagnosis? * What physical examination and laboratory findings would you expect Mr. [http://www.bezern.com/] Lei to have? * What psychosocial and cultural factors should you consider when assessing Mr. [http://www.bezern.com/] Lei? GENERAL SURVEY AND HEALTH HISTORY (GRADED) Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained falling at the local skateboard park while practicing for a national competition. [http://www.bezern.com/] He has never been hospitalized before. [http://www.bezern.com/] His mother has been notified and is on her way. [http://www.bezern.com/] The EMTs gave him morphine and he reports his pain level as “okay. [http://www.bezern.com/]” * What part of the interview and examination can be done prior to his mother’s arrival? * As you enter the room for the first time, what should you observe as part of the general survey? * As you complete his history, what areas are especially important? * What are the important developmental considerations for Casey? THE OLDER ADULT (GRADED) Jean is a 68-year-old female admitted for a total hip replacement. [http://www.bezern.com/] In her interview you learn that she has a history of obstructive sleep apnea (OSA) with a neck circumference of 16 inches and snores much of the night. [http://www.bezern.com/] She is 5’7” and weighs 265 pounds. [http://www.bezern.com/] She states she is sleepy throughout the day. [http://www.bezern.com/] Her other medical history includes: hypertension treated with angiotensin II receptor blockers (ARB), Diabetic with an Hgb A1c over 8%. [http://www.bezern.com/] Hypercholesteremia treated with a Statin drug. [http://www.bezern.com/] Coronary Artery Disease (CAD) with a history of a drug eluting cardiac stent placed 14 months ago and currently on Plavix and ASA. [http://www.bezern.com/] History of gastroesophageal reflux disease (GERD) and is on Prilosec. [http://www.bezern.com/] Her husband has a history of cerebral vascular accident (CVA) several years ago. [http://www.bezern.com/] * What medications should she take pre-op and what should she hold? * Should Jean be allowed to continue ASA pre-operatively? * Should cardiology be consulted on this matter? * What are Jean’s risks for diabetes complications? What concerns do you have about her social support system? * week 4 ASSESSMENT OF THE SKIN (GRADED) Describe a patient with an abnormal skin symptom or group of symptoms such as a rash, an itch, redness, a lesion, or wounds. [http://www.bezern.com/] Do not limit yourself to these examples. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history might be associated with the symptom, if any? * What are the known risk factors for this condition? * What physical examination techniques would you use? * What patient education would you give the patient? * Find a nursing journal article about these symptoms. [http://www.bezern.com/] ASSESSMENT OF THE HEAD AND NECK (GRADED) Choose one area of the head and neck and then select a common complaint (symptom or group of symptoms) patients may have in that area. [http://www.bezern.com/] For example, you may select headaches, earaches, ringing in the ears (tinnitus), sinus drainage and pain, sore throat and cough, and so on. [http://www.bezern.com/] Do not limit yourself to these examples. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history would be associated with the symptom? * What are the risk factors for this condition? * What physical examination techniques would you use? * What patient education would you give the patient? * Find a nursing journal article about this symptom or condition. [http://www.bezern.com/] * * unit 5 ASSESSMENT OF THE ABDOMEN (GRADED) Describe a patient with an abdominal symptom or group of symptoms, such as bloating, flatus, and eructation; constipation; nausea and vomiting; diarrhea; or abdominal pain. [http://www.bezern.com/] Do not limit yourself to these examples. [http://www.bezern.com/] Remember that there are different types and locations of abdominal pain. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history might be associated with the symptom, if any? * What are the known risk factors for this condition? * What physical examination techniques would you use? * What patient education would you give the patient? * Find a nursing journal article about these symptoms. [http://www.bezern.com/] ASSESSMENT OF THE GENITOURINARY SYSTEM (GRADED) Describe a patient with a genitourinary symptom or group of symptoms; such as incontinence, burning on urination, irregular menses, pain in the scrotum, erectile dysfunction, and so on. [http://www.bezern.com/] Do not limit yourself to these; for example, there are different types of incontinence. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history might be associated with the symptom, if any? * What are the known risk factors for this condition? * What physical examination techniques would you use? * What patient education would you give to the patient? * Find a nursing journal article about these symptoms. [http://www.bezern.com/] unit 6 ASSESSMENT OF CARDIAC STATUS (GRADED) Describe a patient with a cardiac symptom or group of symptoms, such as palpitations, hypertension, hypotension, tachycardia, or bradycardia. [http://www.bezern.com/] Do not limit yourself to these examples. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history might be associated with the symptom, if any? * What are the known risk factors for this condition? * What physical examination techniques would you use? * What patient education would you give to the patient? * Find a nursing journal article about this symptom or condition. [http://www.bezern.com/] * ASSESSMENT OF RESPIRATORY STATUS (GRADED) Choose one area of the respiratory system and then select a common complaint (symptom or group of symptoms) patients may have in that area. [http://www.bezern.com/] For example, you may select wheezes, pulmonary congestion, absence of breath sounds on one side, productive cough, and so on. [http://www.bezern.com/] Do not limit yourself to these examples. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history would be associated with the symptom? * What are the risk factors for this condition? * What physical examination techniques would you use? What patient education would you give the patient? * Find a nursing journal article about this symptom or condition. [http://www.bezern.com/] * unit 7 ASSESSING THE MUSCULOSKELETAL SYSTEM (GRADED) Describe a patient with a musculoskeletal symptom or group of symptoms, such as joint pain, back pain, neck pain, and so on. [http://www.bezern.com/] Do not limit yourself to these examples. [http://www.bezern.com/] Remember: There are different types and locations of joint pain. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history might be associated with the symptom, if any? * What are the known risk factors for this condition? * What physical examination techniques would you use? * What patient education would you give the patient? * Find a nursing journal article about these symptoms. [http://www.bezern.com/] unit 7 ASSESSING THE NERVOUS SYSTEM (GRADED) Choose one common complaint (symptom or group of symptoms) related to the neurological system. [http://www.bezern.com/] For example, you may select syncope, hand tremors, seizures, right/left-sided weakness or paralysis, abnormalities of gait or posture, changes in mental status, and so on. [http://www.bezern.com/] Do not limit yourself to these examples. [http://www.bezern.com/] * What questions would you ask as part of your focused assessment? * What history would be associated with the symptom? * What are the risk factors for this condition? * What physical examination techniques would you use? * What patient education would you give to the patient? * Find a nursing journal article about this symptom or condition. [http://www.bezern.com/] *

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