GCU NRS410 Full Course

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GCU NRS410 Full Course

Week 1
Discussion

The case scenario provided will be used to answer the
discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital
with a cellulitis of her left lower leg. She has been applying heating pads to
the leg for the last 48 hours, but the leg has become more painful and she has
developed chilling.

Subjective Data

Complains of pain and heaviness in her leg.

States she cannot bear weight on her leg and has been in bed
for 3 days.

Lives alone and has not had anyone to help her with meals.

Objective Data

Round, yellow-red, 2 cm diameter, 1 cm deep, open wound
above medial malleolus with moderate amount of thick yellow drainage

Left leg red from knee to ankle

Calf measurement on left 3 in > than right

Temperature: 38.9 degrees C

Height: 160 cm; Weight: 83.7 kg

Laboratory Results

WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands

Wound culture: Staphylococcus aureus

Critical Thinking Questions

What clinical manifestations are present in Ms. G and what
recommendations would you make for continued treatment? Provide rationale for
your recommendations.

Identify the muscle groups likely to be affected by Ms. G’s
condition by referring to “ARC: Anatomy Resource Center.”

What is the significance of the subjective and objective
data provided with regard to follow-up diagnostic/laboratory testing,
education, and future preventative care? Provide rationale for your answer.

What factors are present in this situation that could delay
wound healing, and what precautions are required to prevent delayed wound
healing? Explain.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 2
Discussion

The American Cancer Society (ACS) is a nationwide,
community-based, voluntary health organization dedicated to eliminating cancer
as a major health problem. Together with its supporters, ACS is committed to
helping people stay well and get well by finding cures and by fighting back.

Critical Thinking Questions:

Imagine that a family friend or colleague has just been
diagnosed with cancer. Explain how the American Cancer Society might provide
education and support. What ACS services would you recommend and why?

According to statistics published by the American Cancer
Society, there will be an estimated 1.5 million new cancer cases diagnosed each
year over the next decade. What factors contribute to the yearly incidence and
mortality rates of various cancers in Americans? What changes in policy and
practice are most likely to affect these figures over time

Select a research program from among those funded by the
American Cancer Society. Describe the program and discuss what impact the
research will have on the prevention or treatment of cancer.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 3
Discussion

Use the following Case Scenario, Subjective Data, and
Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of
hypertension, chronic heart failure, and sleep apnea. She has been smoking two
packs of cigarettes a day for 40 years and has refused to quit. Three days ago,
she had an onset of flu with fever, pharyngitis, and malaise. She has not taken
her antihypertensive medications or her medications to control her heart
failure for 4 days. Today, she has been admitted to the hospital ICU with acute
decompensated heart failure.

Subjective Data

Is very anxious and asks whether she is going to die.

Denies pain but says she feels like she cannot get enough
air.

Says her heart feels like it is “running away.”

Reports that she is so exhausted she cannot eat or drink by
herself.

Objective Data

Height 175 cm; Weight 95.5 kg

Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58

Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS
and faint; all peripheral pulses are 1+; bilateral jugular vein distention;
initial cardiac monitoring indicates a ventricular rate of 132 and atrial
fibrillation

Respiratory: Pulmonary crackles; decreased breath sounds
right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%

Gastrointestinal: BS present: hepatomegaly 4 cm below costal
margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at
the time of her admission? Drug therapy is started for Mrs. J. to control her
symptoms. What is the rationale for the administration of each of the following
medications?

IV furosemide (Lasix)

Enalapril (Vasotec)

Metoprolol (Lopressor)

IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to
heart failure and what can be done in the form of medical/nursing interventions
to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults
take at least six prescription medications, discuss four nursing interventions
that can help prevent problems caused by multiple drug interactions in older
patients. Provide rationale for each of the interventions you recommend.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 4
Discussion

Use the image in “Discussion Question Resource: Chest
X-Ray” to answer the following Critical Thinking Questions.

Examine the x-ray of a patient diagnosed with pneumonia due
to infection with Mucor. Refer to the “Module 4 DQ Chest Xray”
resource in order to complete the following questions.

Critical Thinking Questions

Explain what Mucor is and how a patient is likely to become
infected with Mucor. Describe the pathophysiologic progression of the infection
into pneumonia and at least two medical/nursing interventions that would be
helpful in treating the patient.

Examine the laboratory blood test results and arterial blood
gases provided in “Discussion Question Resource: Laboratory Blood Test
Results.” What laboratory values are considered abnormal? Explain each
abnormality and discuss the probable causes from a pathophysiologic
perspective.

What medications and medical treatments are likely to be
prescribed by the attending physician on this case? List at least three
medications and three treatments. Provide rationale for each of the medications
and treatments you suggest.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 5
Discussion

Max Points: 20.0

The case scenario provided will be used to answer the discussion
questions that follow.

Case Scenario

Mr. C., a 32-year-old single man, is seeking information at
the outpatient center regarding possible bariatric surgery for his obesity. He
reports that he has always been heavy, even as a small child, but he has gained
about 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 with sodium restriction. He current works
at a catalog telephone center.

Objective Data

Height: 68 inches; Weight 134.5 kg

BP: 172/96, HR 88, RR 26

Fasting Blood Glucose: 146/mg/dL

Total Cholesterol: 250mg/dL

Triglycerides: 312 mg/dL

HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have?
Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the
following medications have been ordered:

Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1
hour before bedtime and 3 hours after mealtime and at bedtime.

Ranitidine (Zantac) 300 mg PO at bedtime.

Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1
hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6
p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will
be most therapeutic and acceptable to the patient.

Assess each of Mr. C.’s functional health patterns using the
information given. (Hint: 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.)

What actual or potential problems can you identify? Describe
at least five problems and provide the rationale for each.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 1 Assignment

Assess your Knowledge of Foundational Concepts

Assess your knowledge of foundational concepts essential to
the nursing management of client health by taking the interactive quiz, located
in the media “Arterial Blood Gas Interpretation.”
http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_self-assessment-v1.1.php

The quiz is designed as a tool for self-assessment. When you
encounter questions that seem vaguely familiar, click on the media’s study
materials, which are organized by topic (e.g., anatomy, biology, chemistry,
pharmacology). This media will serve as a refresher for the concepts that build
upon one another in nursing practice.

You will have the opportunity to retake the quiz until you
achieve a passing score of 100%.

Once completed, please save your results and submit to the
instructor.

Student ADA Version

ofthe Arterial Blood Gas Interpretation Pre-Assessment

Anatomy

Backward effects of left-sided heart failure include:

A. Pulmonary
congestion

B. Jugular
vein distention

C. Dependent
edema in the legs

D. Bounding
pulses

Anatomy

In performing a physical assessment, the nurse notes the
patient has a “barrel” configuration to the chest. This is a consequence of:

A. Reduced
intrapleural pressures

B. Bronchial
airway expansion

C. Increased
vital capacity

D. Increased
residual lung volume

Anatomy

Ausculation of the chest reveals bilateral fine crackles in
the bases bilaterally, indicating:

A. Right-sided
heart failure

B. Left-sided
heart failure

C. Pneumonia

D. Acute
respiratory distress syndrome

Biology

The signs and symptoms of anemia are all related to what
common pathophysiologic feature of the condition?

A. Increased
oxygen consumption by tissues

B. Decreased
blood oxygen content

C. Vasodilation

D. A shift
in the oxyhemoglobin dissociation curve

Biology

In addition to hypertension, preeclampsia is characterized
by:

A. Nausea
and vomiting

B. Fatigue
and lower back pain

C. Protein
in the urine and edema

D. Retinal
changes and rates in the lungs

Biology

Common manifestations of bacterial pneumonia include all of
the following except:

A. Fever

B. Productive
Cough

C. Tachypnea

D. Hyperinflation

Biology

Closed drainage systems work to re-expand a lung after
pneumothorax by:

A. Re-establishing
the normal negative intrapleural pressure.

B. Creating
a positive pressure in the pleural space

C. Removing
excess fluid from the pleural space so that there is room for lung expansion.

D. Pulling
oxygen into distal air sacs to re-expand lung tissue

Biology

Patients with chronic renal failure usually exhibit:

A. Bradycardia

B. Hypokalemia

C. Hypocalcemia

D. Hematomas

Biology

The diet of a patient in end-stage kidney disease is
restricted in all of the following except:

A. Fluid

B. Potassium

C. Protein

D. Calories

Anatomy

Which of the following is true of the biological functions
of progesterone?

A. Progesterone
is the most important hormone associated with pregnancy.

B. Progesterone
directs male sexual characteristics.

C. Levels of
progesterone increases if the egg is not fertilized.

D. Levels of
progesterone remain stable if the egg is not fertilized.

Anatomy

Which of the following is true of the biological functions
of testosterone?

A. Testosterone
is not secreted by the ovaries.

B. Testosterone
is needed for development of female secondary sexual characteristics.

C. Testosterone
stimulates ovulation.

D. Testosterone
is needed for development of male secondary sexual characteristics.

Anatomy

Which of the following is true of the biological functions
of estrone?

A. Estrone
is required for proper development of male secondary sexual characteristics.

B. Level of
estrogen degreases if the egg is not fertilized.

C. Estrone
is required for proper development of female secondary sexual

characteristics.

D. Estrone
affects only the reproductive organs.

Biology

What is the function of hemoglobin?

A. Hemoglobin
is the protein in red blood cells that is responsible for carrying oxygen to
the cells of the body.

B. Hemoglobin
is a lipid in red blood cells that is responsible for carrying oxygen to the
cells of the body.

C. Hemoglobin
is a protein in white blood cells that is responsible for carrying oxygen to
the cells of the body.

D. Hemoglobin
is a protein in red blood cells that is not responsible for carrying carbon
dioxide to the cells of the body.

Biology

Why is heat an effective means of sterilization?

A. Heat is
an effective means of sterilization because it destroys the proteins of
microbial lifeforms, including fungi, bacteria, and viruses.

B. Heat is
an effective means of sterilization because it destroys the proteins of
anaerobic microbial lifeforms, including fungi, bacteria, and viruses.

C. Heat is
an effective means of sterilization because it destroys the lipids of microbial
lifeforms, including fungi, bacteria, and viruses.

D. Both (B)
and (C).

Chemistry:

List the enzymes whose levels are elevated in the blood
serum following an MI.

A. CPK, LDH,
AST, and SGOT

B. LDH, AST,
and SGOT

C. CRE, AST,
and ALT

D. None of
the above

Chemistry

What is the physiological function of gluconeogenesis?

A. Gluconeogenesis
is production of glucose from noncarbohydrate molecules in times when blood
glucose levels are low. This ensures proper function of brain and red blood
cells, which only use glucose as fuel.

B. Gluconeogenesis
is production of glucose from noncarbohydrate molecules in times when blood
glucose levels are high. This ensures proper function of brain and white blood
cells, which only use glucose as fuel.

C. Gluconeogenesis
is production of glucose from carbohydrate molecules in times when blood
glucose levels are low. This ensures proper function of brain and red blood
cells, which only use glucose as fuel.

D. None of
the above

Chemistry

What effect does glycogen metabolism have on glucose levels?

A. Glycogen
metabolism traps glucose within liver cells and increases storage of glucose in
the form of glycogen. These processes decrease blood glucose levels.

B. Glycogen
metabolism traps glucose within liver cells and increases storage of glucose in
the form of glycogen. These processes increase blood glucose levels.

C. Glycogen
metabolism releases glucose within liver cells and increases storage of glucose
in the form of glycogen. These processes decrease blood glucose levels.

D. None of
the above

Chemistry

Carbon monoxide binds tightly to the heme groups of
hemoglobin and myoglobin. How does this affinity reflect the toxicity of carbon
monoxide?

A. Since
carbon monoxide binds the heme groups of hemoglobin, it is easily removed or
replaced by oxygen. As a result, the effects of oxygen enhancement result in
what divers call the “bends.”

B. Because
carbon monoxide binds the heme groups of hemoglobin, it is easily removed or
replaced by oxygen. As a result, the effects of oxygen deprivation result in
suffocation.

C. Because
carbon monoxide binds tightly to the heme groups of hemoglobin, it is not
easily removed or replaced by oxygen. As a result, the effects of oxygen
deprivation result in suffocation.

D. None of
the above

Pathophysiology

Which of the following may be a reason to order an ABG on a
patient?

A. The
patient suddenly develops shortness of breath

B. An
asthmatic is starting to show signs of tiring

C. A
diabetic has developed Kussmaul’s respirations

D. All of
the above

Pharmacology

How do sulfa drugs selectively kill bacteria while causing
no harm to humans?

A. Folic
acid is a vitamin required for the synthesis of a coenzyme needed to make the
amino acid methionine and the purine and pyrimidine nitrogenious bases for DNA
and RNA and folic acid is produced by humans.

B. Sulfa
drug binds to the enzyme, no product is formed, folic acid is made and the
biosynthesis of methionine and nitrogenous bases increases.

C. Humans
are not harmed because they do not synthesize their own folic acid. It is
obtained in the diet.

D. None of
the above

Pharmacology

What occurs when glycogen metabolism is stimulated by
insulin?

A. Insulin
stimulates glycogen synthase, the first enzyme in glycogen synthesis.

B. Insulin
stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also
stimulates removal of glucose from the bloodstream into cells and
phosphorylation of glucose by the enzyme glucokinase.

C. Insulin
stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also
stimulates uptake of glucose from the bloodstream into cells and
phosphorylation of glucose by the enzyme glucokinase.

D. All of
the above

Pharmacology

What is the medical application of cortisone? Cortisone is
used to treat:

A. Rheumatoid
arthritis, asthma, gastrointestinal disorders, and a variety of skin
conditions.

B. Kidney
disease, high blood pressure, and osteoporosis.

C. Muscle
disorders, tuberculosis, and thyroid disorder.

D. All of
the above

Anatomy

Oxygen saturation is likely to be lowest when an asthmatic
with a diagnosis of pneumonia is positioned:

A. In a high
Fowler position

B. Lying on
the left side

C. Lying on
the right side

D. Lying
supine with the head of the bed flat

Chemistry

Laboratory test results indicative of thrombocytopenia, in
addition to a low platelet count, would be:

A. Increased
PT

B. Prolonged
bleeding time and poor clot retraction.

C. Increased
aPTT

D. Decreased
RBC count.

Pharmacology

The purposes of epinephrine injection include all of the
following except:

A. Stabilizing
mast cell membranes.

B. Relaxing
bronchial smooth muscle.

C. Supporting
arterial blood pressure.

D. Blocking
histamine receptors.

Pharmacology

Therapeutic interventions focused on increasing the oxygen
supplied to the heart and decreasing the heart’s demand for oxygen include:

A. Antiplatelet
drugs

B. Anticoagulants

C. Morphine
sulphate

D. Thrombolytic
drugs

Pharmacology

An intervention that would contribute toward the healing of
a peptic ulcer is:

A. Steroid
administration

B. Blocking
or neutralizing of acid secretion

C. Surgical
removal of the ulcer

D. Intravenous
nutritional support

Pharmacology

Aspirin and NSAIDs are causative factors for the development
of peptic ulcer disease because they:

A. Increase
acid secretion

B. Allow
proliferation of H. pylori

C. Damage
the mucosal barrier

D. Alter
platelet aggregation

Pharmacology

Your patient is interested in trying medication to improve
low mood/depression. All of the following medications might be appropriate
except:

A. Selective
serotonin reuptake inhibitors

B. Amitriptyline

C. Serotonin
and norepinephrine reuptake inhibitors

D. Benzodiazepines

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 2 Assignment

Approach to Care

Write a paper (1,250-1,750 words) describing the approach to
care of cancer. In addition, include the following in your paper:

Describe the diagnosis and staging of cancer.

Describe at least three complications of cancer, the side
effects of treatment, and methods to lessen physical and psychological effects.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the

rubric to grade the assignment; therefore, students should
review the rubric prior to beginning the assignment to become familiar with the
assignment criteria and expectations for successful completion of the
assignment.

You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center. Only Word documents can
be submitted to LopesWrite.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 3 Assignment

Case Study 1

In a short essay (500-750 words), answer the Question at the
end of Case Study 1. Cite references to support your positions.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the rubric to grade the assignment; therefore, students should review the
rubric prior to beginning the assignment to become familiar with the assignment
criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

Ms. A. is an apparently healthy 26-year-old white woman.
Since the beginning of the current golf season, Ms. A has noted increased
shortness of breath and low levels of energy and enthusiasm. These symptoms
seem worse during her menses. Today, while playing in a golf tournament at a high,
mountainous course, she became light-headed and was taken by her golfing
partner to the emergency clinic. The attending physician’s notes indicated a
temperature of 98 degrees F, an elevated heart rate and respiratory rate, and
low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a
problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for
6 days during menstruation.” During the summer months, while playing golf, she
also takes aspirin to avoid “stiffness in my joints.”

Laboratory values are as follows:

Hemoglobin = 8 g/dl

Hematocrit = 32%

Erythrocyte count = 3.1 x 10/mm

RBC smear showed microcytic and hypochromic cells

Reticulocyte count = 1.5%

Other laboratory values were within normal limits.

Question

Considering the circumstances and the preliminary workup,
what type of anemia does Ms. A most likely have? In an essay of 500-750 words,
explain your answer and include rationale.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 3 Assignment

Case Study 2

In a short essay (500-750 words), answer the Question at the
end of Case Study 2. Cite references to support your positions.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the rubric to grade the assignment; therefore, students should review the
rubric prior to beginning the assignment to become familiar with the assignment
criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

Case Study 2

Mr. P is a 76-year-old male with cardiomyopathy and
congestive heart failure who has been hospitalized frequently to treat CHF
symptoms. He has difficulty maintaining diet restrictions and managing his
polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields,
and labored breathing. He has no family other than his wife, who verbalizes
sadness over his declining health and over her inability to get out of the
house. She is overwhelmed with the stack of medical bills, as Mr. P always took
care of the financial issues. Mr. P is despondent and asks why God has not
taken him.

Question

Considering Mr. P’s condition and circumstance, write an
essay of 500-750 words that includes the following:

• Describe
your approach to care.

• Recommend
a treatment plan.

• Describe
a method for providing both the patient and family with education and explain
your rationale.

• Provide a
teaching plan (avoid using terminology that the patient and family may not
understand).

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 4
Assignment

Collaborative Learning Community: Home Visit with Sallie Mae
Fisher

This is a CLC assignment.

As a group, observe the simulated “Home Visit With
Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and
Discharge Orders” for specifics related to the case study used to inform
the assignment.

Using “Home Visit With Sallie Mae Fisher” and
“Sallie Mae Fisher’s Health History and Discharge Orders,” complete
the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of
500-750-words in which you do the following:

Identify, prioritize, and describe at least four problems.

Provide substantiating evidence (assessment data) for each
problem identified.

Identify and describe at least four medical and/or nursing
interventions.

Discuss your rationale for the interventions identified.

Prepare this step of the assignment according to the APA
guidelines found in the APA Style Guide, located in the Student Success Center.
An abstract is not required.

Scripted Dialogue Portion

Utilizing the information learned from the home visit,
health histories, and discharge orders, write a scripted dialogue in which you
provide Sallie Mae with education that describes her problems and the
interventions identified to improve her condition. Consider Sallie Mae’s
physiological, psychosocial, educational, and spiritual needs when developing
your dialogue.

Your dialogue should resemble a script. The following is an
example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and
I will be your nurse today. I understand you are experiencing problems with
________.”

APA format is not required for this part of the assignment,
but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading
Criteria.”

Entire Assignment

You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center. Only Word documents can
be submitted to LopesWrite.

Sallie Mae Fisher’s Health History

and Discharge Orders

Sallie Mae Fisher Health History

Ms. Fisher is an 82-year-old female with a history of
chronic congestive heart failure (CHF), atrial fibrillation, and hypertension.
During the last 6 months, she has been hospitalized four times for exacerbation
of her CHF. She was discharged home last Saturday from the hospital after a
3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.

Ms. Fisher is recently widowed and lives alone. She has a
daughter, Thelma Jean, who lives in town but works full time and has family
issues of her own. Therefore, family support is limited.

Hospital Discharge Instructions

• Mountain
Top Home Health to evaluate cardio-pulmonary status, medication management, and
home safety.

• Medical
Equipment Company to deliver oxygen concentrator and instruct patient in use.
O2 at 2 liters per nasal prongs PRN.

• Prescriptions
given at discharge:

o Digoxin
0.25 mg once a day

o Lasix 80
mg twice a day

o Calan 240
mg once a day

• Order written
to continue other home meds.

Sallie Mae’s Home Medication List

• Zocar 50
mg once a day

• Minipres
1 mg once a day

• Vasotec
10 mg twice a day

• Prilosec
20 mg once a day

• Furosemide
40 mg once a day

• Effexor
37.5 mg at bedtime

• Lanoxin
0.125 mg every other day

• Multivitamin
once a day

• Potassium
40 mEq once a day

• Ibuprofen
400 mg q 4 hours as needed for pain

• Darvocet
N 100 mg q 4 hours as needed for pain

• Nitroglycerin
ointment, apply 1 inch every day

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 5 Assignment

Benchmark – Evidence-Based Practice Project—Paper on
Diabetes

Identify a research or evidence-based article that focuses
comprehensively on a specific intervention or new diagnostic tool for the
treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of
the research findings for a specific patient population. Research must include
clinical findings that are current, thorough, and relevant to diabetes and the
nursing practice.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the rubric to grade the assignment; therefore, students should review the
rubric prior to beginning the assignment to become familiar with the assignment
criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center. Only Word documents can
be submitted to LopesWrite.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 5 Assignment

Evidence-Based Practice Project—Intervention Presentation on
Diabetes

Based on the summary of research findings identified from
the Evidence-Based Project—Paper on Diabetes that describes a new diagnostic
tool or intervention for the treatment of diabetes in adults or children,
complete the following components of this assignment:

Develop a PowerPoint presentation (a title slide, 6-12
slides, and a reference slide; no larger than 2 MB) that includes the
following:

A brief summary of the research conducted in the
Evidence-Based Project – Paper on Diabetes.

A descriptive and reflective discussion of how the new tool
or intervention may be integrated into practice that is supported by sound
research.

While APA format is not required for the body of this
assignment, solid academic writing is expected, and in-text citations and
references should be presented using APA documentation guidelines, which can be
found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to
LopesWrite, unless otherwise directed by your instructor. If so directed, refer
to the Student Success Center for directions. Only Word documents can be
submitted to LopesWrite.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 1
Discussion

The case scenario provided will be used to answer the
discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital
with a cellulitis of her left lower leg. She has been applying heating pads to
the leg for the last 48 hours, but the leg has become more painful and she has
developed chilling.

Subjective Data

Complains of pain and heaviness in her leg.

States she cannot bear weight on her leg and has been in bed
for 3 days.

Lives alone and has not had anyone to help her with meals.

Objective Data

Round, yellow-red, 2 cm diameter, 1 cm deep, open wound
above medial malleolus with moderate amount of thick yellow drainage

Left leg red from knee to ankle

Calf measurement on left 3 in > than right

Temperature: 38.9 degrees C

Height: 160 cm; Weight: 83.7 kg

Laboratory Results

WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands

Wound culture: Staphylococcus aureus

Critical Thinking Questions

What clinical manifestations are present in Ms. G and what
recommendations would you make for continued treatment? Provide rationale for
your recommendations.

Identify the muscle groups likely to be affected by Ms. G’s
condition by referring to “ARC: Anatomy Resource Center.”

What is the significance of the subjective and objective
data provided with regard to follow-up diagnostic/laboratory testing,
education, and future preventative care? Provide rationale for your answer.

What factors are present in this situation that could delay
wound healing, and what precautions are required to prevent delayed wound
healing? Explain.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 2
Discussion

The American Cancer Society (ACS) is a nationwide,
community-based, voluntary health organization dedicated to eliminating cancer
as a major health problem. Together with its supporters, ACS is committed to
helping people stay well and get well by finding cures and by fighting back.

Critical Thinking Questions:

Imagine that a family friend or colleague has just been
diagnosed with cancer. Explain how the American Cancer Society might provide
education and support. What ACS services would you recommend and why?

According to statistics published by the American Cancer
Society, there will be an estimated 1.5 million new cancer cases diagnosed each
year over the next decade. What factors contribute to the yearly incidence and
mortality rates of various cancers in Americans? What changes in policy and
practice are most likely to affect these figures over time

Select a research program from among those funded by the
American Cancer Society. Describe the program and discuss what impact the
research will have on the prevention or treatment of cancer.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 3
Discussion

Use the following Case Scenario, Subjective Data, and
Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of
hypertension, chronic heart failure, and sleep apnea. She has been smoking two
packs of cigarettes a day for 40 years and has refused to quit. Three days ago,
she had an onset of flu with fever, pharyngitis, and malaise. She has not taken
her antihypertensive medications or her medications to control her heart
failure for 4 days. Today, she has been admitted to the hospital ICU with acute
decompensated heart failure.

Subjective Data

Is very anxious and asks whether she is going to die.

Denies pain but says she feels like she cannot get enough
air.

Says her heart feels like it is “running away.”

Reports that she is so exhausted she cannot eat or drink by
herself.

Objective Data

Height 175 cm; Weight 95.5 kg

Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58

Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS
and faint; all peripheral pulses are 1+; bilateral jugular vein distention;
initial cardiac monitoring indicates a ventricular rate of 132 and atrial
fibrillation

Respiratory: Pulmonary crackles; decreased breath sounds
right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%

Gastrointestinal: BS present: hepatomegaly 4 cm below costal
margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at
the time of her admission? Drug therapy is started for Mrs. J. to control her
symptoms. What is the rationale for the administration of each of the following
medications?

IV furosemide (Lasix)

Enalapril (Vasotec)

Metoprolol (Lopressor)

IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to
heart failure and what can be done in the form of medical/nursing interventions
to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults
take at least six prescription medications, discuss four nursing interventions
that can help prevent problems caused by multiple drug interactions in older
patients. Provide rationale for each of the interventions you recommend.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 4
Discussion

Use the image in “Discussion Question Resource: Chest
X-Ray” to answer the following Critical Thinking Questions.

Examine the x-ray of a patient diagnosed with pneumonia due
to infection with Mucor. Refer to the “Module 4 DQ Chest Xray”
resource in order to complete the following questions.

Critical Thinking Questions

Explain what Mucor is and how a patient is likely to become
infected with Mucor. Describe the pathophysiologic progression of the infection
into pneumonia and at least two medical/nursing interventions that would be
helpful in treating the patient.

Examine the laboratory blood test results and arterial blood
gases provided in “Discussion Question Resource: Laboratory Blood Test
Results.” What laboratory values are considered abnormal? Explain each
abnormality and discuss the probable causes from a pathophysiologic
perspective.

What medications and medical treatments are likely to be
prescribed by the attending physician on this case? List at least three
medications and three treatments. Provide rationale for each of the medications
and treatments you suggest.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 5
Discussion

Max Points: 20.0

The case scenario provided will be used to answer the discussion
questions that follow.

Case Scenario

Mr. C., a 32-year-old single man, is seeking information at
the outpatient center regarding possible bariatric surgery for his obesity. He
reports that he has always been heavy, even as a small child, but he has gained
about 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 with sodium restriction. He current works
at a catalog telephone center.

Objective Data

Height: 68 inches; Weight 134.5 kg

BP: 172/96, HR 88, RR 26

Fasting Blood Glucose: 146/mg/dL

Total Cholesterol: 250mg/dL

Triglycerides: 312 mg/dL

HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have?
Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the
following medications have been ordered:

Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1
hour before bedtime and 3 hours after mealtime and at bedtime.

Ranitidine (Zantac) 300 mg PO at bedtime.

Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1
hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6
p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will
be most therapeutic and acceptable to the patient.

Assess each of Mr. C.’s functional health patterns using the
information given. (Hint: 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.)

What actual or potential problems can you identify? Describe
at least five problems and provide the rationale for each.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 1 Assignment

Assess your Knowledge of Foundational Concepts

Assess your knowledge of foundational concepts essential to
the nursing management of client health by taking the interactive quiz, located
in the media “Arterial Blood Gas Interpretation.”
http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_self-assessment-v1.1.php

The quiz is designed as a tool for self-assessment. When you
encounter questions that seem vaguely familiar, click on the media’s study
materials, which are organized by topic (e.g., anatomy, biology, chemistry,
pharmacology). This media will serve as a refresher for the concepts that build
upon one another in nursing practice.

You will have the opportunity to retake the quiz until you
achieve a passing score of 100%.

Once completed, please save your results and submit to the
instructor.

Student ADA Version

ofthe Arterial Blood Gas Interpretation Pre-Assessment

Anatomy

Backward effects of left-sided heart failure include:

A. Pulmonary
congestion

B. Jugular
vein distention

C. Dependent
edema in the legs

D. Bounding
pulses

Anatomy

In performing a physical assessment, the nurse notes the
patient has a “barrel” configuration to the chest. This is a consequence of:

A. Reduced
intrapleural pressures

B. Bronchial
airway expansion

C. Increased
vital capacity

D. Increased
residual lung volume

Anatomy

Ausculation of the chest reveals bilateral fine crackles in
the bases bilaterally, indicating:

A. Right-sided
heart failure

B. Left-sided
heart failure

C. Pneumonia

D. Acute
respiratory distress syndrome

Biology

The signs and symptoms of anemia are all related to what
common pathophysiologic feature of the condition?

A. Increased
oxygen consumption by tissues

B. Decreased
blood oxygen content

C. Vasodilation

D. A shift
in the oxyhemoglobin dissociation curve

Biology

In addition to hypertension, preeclampsia is characterized
by:

A. Nausea
and vomiting

B. Fatigue
and lower back pain

C. Protein
in the urine and edema

D. Retinal
changes and rates in the lungs

Biology

Common manifestations of bacterial pneumonia include all of
the following except:

A. Fever

B. Productive
Cough

C. Tachypnea

D. Hyperinflation

Biology

Closed drainage systems work to re-expand a lung after
pneumothorax by:

A. Re-establishing
the normal negative intrapleural pressure.

B. Creating
a positive pressure in the pleural space

C. Removing
excess fluid from the pleural space so that there is room for lung expansion.

D. Pulling
oxygen into distal air sacs to re-expand lung tissue

Biology

Patients with chronic renal failure usually exhibit:

A. Bradycardia

B. Hypokalemia

C. Hypocalcemia

D. Hematomas

Biology

The diet of a patient in end-stage kidney disease is
restricted in all of the following except:

A. Fluid

B. Potassium

C. Protein

D. Calories

Anatomy

Which of the following is true of the biological functions
of progesterone?

A. Progesterone
is the most important hormone associated with pregnancy.

B. Progesterone
directs male sexual characteristics.

C. Levels of
progesterone increases if the egg is not fertilized.

D. Levels of
progesterone remain stable if the egg is not fertilized.

Anatomy

Which of the following is true of the biological functions
of testosterone?

A. Testosterone
is not secreted by the ovaries.

B. Testosterone
is needed for development of female secondary sexual characteristics.

C. Testosterone
stimulates ovulation.

D. Testosterone
is needed for development of male secondary sexual characteristics.

Anatomy

Which of the following is true of the biological functions
of estrone?

A. Estrone
is required for proper development of male secondary sexual characteristics.

B. Level of
estrogen degreases if the egg is not fertilized.

C. Estrone
is required for proper development of female secondary sexual

characteristics.

D. Estrone
affects only the reproductive organs.

Biology

What is the function of hemoglobin?

A. Hemoglobin
is the protein in red blood cells that is responsible for carrying oxygen to
the cells of the body.

B. Hemoglobin
is a lipid in red blood cells that is responsible for carrying oxygen to the
cells of the body.

C. Hemoglobin
is a protein in white blood cells that is responsible for carrying oxygen to
the cells of the body.

D. Hemoglobin
is a protein in red blood cells that is not responsible for carrying carbon
dioxide to the cells of the body.

Biology

Why is heat an effective means of sterilization?

A. Heat is
an effective means of sterilization because it destroys the proteins of
microbial lifeforms, including fungi, bacteria, and viruses.

B. Heat is
an effective means of sterilization because it destroys the proteins of
anaerobic microbial lifeforms, including fungi, bacteria, and viruses.

C. Heat is
an effective means of sterilization because it destroys the lipids of microbial
lifeforms, including fungi, bacteria, and viruses.

D. Both (B)
and (C).

Chemistry:

List the enzymes whose levels are elevated in the blood
serum following an MI.

A. CPK, LDH,
AST, and SGOT

B. LDH, AST,
and SGOT

C. CRE, AST,
and ALT

D. None of
the above

Chemistry

What is the physiological function of gluconeogenesis?

A. Gluconeogenesis
is production of glucose from noncarbohydrate molecules in times when blood
glucose levels are low. This ensures proper function of brain and red blood
cells, which only use glucose as fuel.

B. Gluconeogenesis
is production of glucose from noncarbohydrate molecules in times when blood
glucose levels are high. This ensures proper function of brain and white blood
cells, which only use glucose as fuel.

C. Gluconeogenesis
is production of glucose from carbohydrate molecules in times when blood
glucose levels are low. This ensures proper function of brain and red blood
cells, which only use glucose as fuel.

D. None of
the above

Chemistry

What effect does glycogen metabolism have on glucose levels?

A. Glycogen
metabolism traps glucose within liver cells and increases storage of glucose in
the form of glycogen. These processes decrease blood glucose levels.

B. Glycogen
metabolism traps glucose within liver cells and increases storage of glucose in
the form of glycogen. These processes increase blood glucose levels.

C. Glycogen
metabolism releases glucose within liver cells and increases storage of glucose
in the form of glycogen. These processes decrease blood glucose levels.

D. None of
the above

Chemistry

Carbon monoxide binds tightly to the heme groups of
hemoglobin and myoglobin. How does this affinity reflect the toxicity of carbon
monoxide?

A. Since
carbon monoxide binds the heme groups of hemoglobin, it is easily removed or
replaced by oxygen. As a result, the effects of oxygen enhancement result in
what divers call the “bends.”

B. Because
carbon monoxide binds the heme groups of hemoglobin, it is easily removed or
replaced by oxygen. As a result, the effects of oxygen deprivation result in
suffocation.

C. Because
carbon monoxide binds tightly to the heme groups of hemoglobin, it is not
easily removed or replaced by oxygen. As a result, the effects of oxygen
deprivation result in suffocation.

D. None of
the above

Pathophysiology

Which of the following may be a reason to order an ABG on a
patient?

A. The
patient suddenly develops shortness of breath

B. An
asthmatic is starting to show signs of tiring

C. A
diabetic has developed Kussmaul’s respirations

D. All of
the above

Pharmacology

How do sulfa drugs selectively kill bacteria while causing
no harm to humans?

A. Folic
acid is a vitamin required for the synthesis of a coenzyme needed to make the
amino acid methionine and the purine and pyrimidine nitrogenious bases for DNA
and RNA and folic acid is produced by humans.

B. Sulfa
drug binds to the enzyme, no product is formed, folic acid is made and the
biosynthesis of methionine and nitrogenous bases increases.

C. Humans
are not harmed because they do not synthesize their own folic acid. It is
obtained in the diet.

D. None of
the above

Pharmacology

What occurs when glycogen metabolism is stimulated by
insulin?

A. Insulin
stimulates glycogen synthase, the first enzyme in glycogen synthesis.

B. Insulin
stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also
stimulates removal of glucose from the bloodstream into cells and
phosphorylation of glucose by the enzyme glucokinase.

C. Insulin
stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also
stimulates uptake of glucose from the bloodstream into cells and
phosphorylation of glucose by the enzyme glucokinase.

D. All of
the above

Pharmacology

What is the medical application of cortisone? Cortisone is
used to treat:

A. Rheumatoid
arthritis, asthma, gastrointestinal disorders, and a variety of skin
conditions.

B. Kidney
disease, high blood pressure, and osteoporosis.

C. Muscle
disorders, tuberculosis, and thyroid disorder.

D. All of
the above

Anatomy

Oxygen saturation is likely to be lowest when an asthmatic
with a diagnosis of pneumonia is positioned:

A. In a high
Fowler position

B. Lying on
the left side

C. Lying on
the right side

D. Lying
supine with the head of the bed flat

Chemistry

Laboratory test results indicative of thrombocytopenia, in
addition to a low platelet count, would be:

A. Increased
PT

B. Prolonged
bleeding time and poor clot retraction.

C. Increased
aPTT

D. Decreased
RBC count.

Pharmacology

The purposes of epinephrine injection include all of the
following except:

A. Stabilizing
mast cell membranes.

B. Relaxing
bronchial smooth muscle.

C. Supporting
arterial blood pressure.

D. Blocking
histamine receptors.

Pharmacology

Therapeutic interventions focused on increasing the oxygen
supplied to the heart and decreasing the heart’s demand for oxygen include:

A. Antiplatelet
drugs

B. Anticoagulants

C. Morphine
sulphate

D. Thrombolytic
drugs

Pharmacology

An intervention that would contribute toward the healing of
a peptic ulcer is:

A. Steroid
administration

B. Blocking
or neutralizing of acid secretion

C. Surgical
removal of the ulcer

D. Intravenous
nutritional support

Pharmacology

Aspirin and NSAIDs are causative factors for the development
of peptic ulcer disease because they:

A. Increase
acid secretion

B. Allow
proliferation of H. pylori

C. Damage
the mucosal barrier

D. Alter
platelet aggregation

Pharmacology

Your patient is interested in trying medication to improve
low mood/depression. All of the following medications might be appropriate
except:

A. Selective
serotonin reuptake inhibitors

B. Amitriptyline

C. Serotonin
and norepinephrine reuptake inhibitors

D. Benzodiazepines

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 2 Assignment

Approach to Care

Write a paper (1,250-1,750 words) describing the approach to
care of cancer. In addition, include the following in your paper:

Describe the diagnosis and staging of cancer.

Describe at least three complications of cancer, the side
effects of treatment, and methods to lessen physical and psychological effects.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the

rubric to grade the assignment; therefore, students should
review the rubric prior to beginning the assignment to become familiar with the
assignment criteria and expectations for successful completion of the
assignment.

You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center. Only Word documents can
be submitted to LopesWrite.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 3 Assignment

Case Study 1

In a short essay (500-750 words), answer the Question at the
end of Case Study 1. Cite references to support your positions.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the rubric to grade the assignment; therefore, students should review the
rubric prior to beginning the assignment to become familiar with the assignment
criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

Ms. A. is an apparently healthy 26-year-old white woman.
Since the beginning of the current golf season, Ms. A has noted increased
shortness of breath and low levels of energy and enthusiasm. These symptoms
seem worse during her menses. Today, while playing in a golf tournament at a high,
mountainous course, she became light-headed and was taken by her golfing
partner to the emergency clinic. The attending physician’s notes indicated a
temperature of 98 degrees F, an elevated heart rate and respiratory rate, and
low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a
problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for
6 days during menstruation.” During the summer months, while playing golf, she
also takes aspirin to avoid “stiffness in my joints.”

Laboratory values are as follows:

Hemoglobin = 8 g/dl

Hematocrit = 32%

Erythrocyte count = 3.1 x 10/mm

RBC smear showed microcytic and hypochromic cells

Reticulocyte count = 1.5%

Other laboratory values were within normal limits.

Question

Considering the circumstances and the preliminary workup,
what type of anemia does Ms. A most likely have? In an essay of 500-750 words,
explain your answer and include rationale.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 3 Assignment

Case Study 2

In a short essay (500-750 words), answer the Question at the
end of Case Study 2. Cite references to support your positions.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the rubric to grade the assignment; therefore, students should review the
rubric prior to beginning the assignment to become familiar with the assignment
criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

Case Study 2

Mr. P is a 76-year-old male with cardiomyopathy and
congestive heart failure who has been hospitalized frequently to treat CHF
symptoms. He has difficulty maintaining diet restrictions and managing his
polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields,
and labored breathing. He has no family other than his wife, who verbalizes
sadness over his declining health and over her inability to get out of the
house. She is overwhelmed with the stack of medical bills, as Mr. P always took
care of the financial issues. Mr. P is despondent and asks why God has not
taken him.

Question

Considering Mr. P’s condition and circumstance, write an
essay of 500-750 words that includes the following:

• Describe
your approach to care.

• Recommend
a treatment plan.

• Describe
a method for providing both the patient and family with education and explain
your rationale.

• Provide a
teaching plan (avoid using terminology that the patient and family may not
understand).

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 4
Assignment

Collaborative Learning Community: Home Visit with Sallie Mae
Fisher

This is a CLC assignment.

As a group, observe the simulated “Home Visit With
Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and
Discharge Orders” for specifics related to the case study used to inform
the assignment.

Using “Home Visit With Sallie Mae Fisher” and
“Sallie Mae Fisher’s Health History and Discharge Orders,” complete
the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of
500-750-words in which you do the following:

Identify, prioritize, and describe at least four problems.

Provide substantiating evidence (assessment data) for each
problem identified.

Identify and describe at least four medical and/or nursing
interventions.

Discuss your rationale for the interventions identified.

Prepare this step of the assignment according to the APA
guidelines found in the APA Style Guide, located in the Student Success Center.
An abstract is not required.

Scripted Dialogue Portion

Utilizing the information learned from the home visit,
health histories, and discharge orders, write a scripted dialogue in which you
provide Sallie Mae with education that describes her problems and the
interventions identified to improve her condition. Consider Sallie Mae’s
physiological, psychosocial, educational, and spiritual needs when developing
your dialogue.

Your dialogue should resemble a script. The following is an
example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and
I will be your nurse today. I understand you are experiencing problems with
________.”

APA format is not required for this part of the assignment,
but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading
Criteria.”

Entire Assignment

You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center. Only Word documents can
be submitted to LopesWrite.

Sallie Mae Fisher’s Health History

and Discharge Orders

Sallie Mae Fisher Health History

Ms. Fisher is an 82-year-old female with a history of
chronic congestive heart failure (CHF), atrial fibrillation, and hypertension.
During the last 6 months, she has been hospitalized four times for exacerbation
of her CHF. She was discharged home last Saturday from the hospital after a
3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.

Ms. Fisher is recently widowed and lives alone. She has a
daughter, Thelma Jean, who lives in town but works full time and has family
issues of her own. Therefore, family support is limited.

Hospital Discharge Instructions

• Mountain
Top Home Health to evaluate cardio-pulmonary status, medication management, and
home safety.

• Medical
Equipment Company to deliver oxygen concentrator and instruct patient in use.
O2 at 2 liters per nasal prongs PRN.

• Prescriptions
given at discharge:

o Digoxin
0.25 mg once a day

o Lasix 80
mg twice a day

o Calan 240
mg once a day

• Order written
to continue other home meds.

Sallie Mae’s Home Medication List

• Zocar 50
mg once a day

• Minipres
1 mg once a day

• Vasotec
10 mg twice a day

• Prilosec
20 mg once a day

• Furosemide
40 mg once a day

• Effexor
37.5 mg at bedtime

• Lanoxin
0.125 mg every other day

• Multivitamin
once a day

• Potassium
40 mEq once a day

• Ibuprofen
400 mg q 4 hours as needed for pain

• Darvocet
N 100 mg q 4 hours as needed for pain

• Nitroglycerin
ointment, apply 1 inch every day

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 5 Assignment

Benchmark – Evidence-Based Practice Project—Paper on
Diabetes

Identify a research or evidence-based article that focuses
comprehensively on a specific intervention or new diagnostic tool for the
treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of
the research findings for a specific patient population. Research must include
clinical findings that are current, thorough, and relevant to diabetes and the
nursing practice.

Prepare this assignment according to the APA guidelines
found in the APA Style Guide, located in the Student Success Center. An
abstract is not required.

This assignment uses a grading rubric. Instructors will be
using the rubric to grade the assignment; therefore, students should review the
rubric prior to beginning the assignment to become familiar with the assignment
criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center. Only Word documents can
be submitted to LopesWrite.

NRS410 Path
Physiology and Nursing Management of Client’s Health

Week 5 Assignment

Evidence-Based Practice Project—Intervention Presentation on
Diabetes

Based on the summary of research findings identified from
the Evidence-Based Project—Paper on Diabetes that describes a new diagnostic
tool or intervention for the treatment of diabetes in adults or children,
complete the following components of this assignment:

Develop a PowerPoint presentation (a title slide, 6-12
slides, and a reference slide; no larger than 2 MB) that includes the
following:

A brief summary of the research conducted in the
Evidence-Based Project – Paper on Diabetes.

A descriptive and reflective discussion of how the new tool
or intervention may be integrated into practice that is supported by sound
research.

While APA format is not required for the body of this
assignment, solid academic writing is expected, and in-text citations and
references should be presented using APA documentation guidelines, which can be
found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to
LopesWrite, unless otherwise directed by your instructor. If so directed, refer
to the Student Success Center for directions. Only Word documents can be
submitted to LopesWrite.

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