Case Study Week 8

A 63 years old obese female presents with 4 to 5 months history of mid-epigastric pain that is worse after eating. She is unable to identify any specific foods that may be triggering the symptoms. She denies excessive gas, denies regurgitation of food or a water brash. She has normal daily bowel movements but states that sometimes her stools are very dark. She denies nausea and vomiting. She has no previous history of these symptoms and they are becoming disruptive in her daily life. She has been taking TUMs, “like they are candy.”

Past Medical History: surgical menopause at age 35 secondary to endometriosis, hypertension (HTN), diabetes mellitus Type II, morbid obesity, dyslipidemia. Surgical History: T&A as child, total abdominal hysterectomy with bilateral salpingo-oophorectomy, appendectomy, cholecystectomy. Her medication regimen includesPremarin 0.625mg q day, lisinopril 10mg q day, metformin 500mg bid, and atorvastatin 40mg q HS. VS: BP 145/94, P 90, R 18, T 98.2. The patient’s height is 5’4” and her weight is 225lbs., consequently her BMI is 38.6.  Physical examination is within normal limits.

Questions for response:

1. What additional history would you like for this patient?

2. If you plan to start drug treatment today

a. what is your choice, the dose, and the duration of the treatment?

b. what are some alternatives to this choice

c. what is your rationale for this choice

3. What risk factors for this patient will guide your choice?

4. Are there any major drug-to-drug interactions, side effects or adverse reactions to this drug?

5. Provide patient education regarding the use of this drug. Besides drug therapy, are there any other interventions you would consider or recommend?

References less than 5 years and at least 6. no less than 2 pages

 
Find a program (provide a link to the program) which was developed to provide health promotion and education to a specific population. Evaluate this program on its ability to identify with the specific population, on its implementation of effective intervention methods, and on its program planning strategy. This evaluation will be very broad in scope and not as in-depth as your research assignment 

Urinary tract infections (UTIs) are caused by bacteria—most often Escherichia coli. However, certain viruses, fungi, and parasites can also lead to infection. The infection can affect the lower and upper urinary tract, including the urethra, prostate (in males), bladder, ureter, and kidney. Due to the progression of the disease and human anatomy, symptoms present differently among the sexes as well as among age groups. It is important to understand how these factors, as well as others, impact the pathophysiology of UTIs. Advanced practice nurses must have this foundation in order to properly diagnose patients.

To Prepare

• Review Chapter 30 in the Huether and McCance text. Identify the pathophysiology of lower and upper urinary tract infections. Consider the similarities and differences between the two types of infections.
• Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

Post a description of the pathophysiology of lower and upper urinary tract infections, including their similarities and differences. Then explain how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

A great deal of past and recent healthcare concern has centered on the errors made in patient care or overall healthcare of people. Many suggest that the legalities of healthcare attempt to balance the expectations of society for healthcare and the mistakes of caregivers with thousands of successful events of exceptional care each year. Yet many cases of errors in care also often go unnoticed or unreported simply because a patient or family member is reluctant to complain about their or their loved one’s care for a variety of reasons. Why do you think patients are reluctant to complain about their care and what are some of the reasons for mistakes or errors in care? Discuss this in two different contexts: you as a patient, and your parent or child as a patient.

APA FORMAT ARIAL FONT 12

Please answer the following 3 questions.  Each answer must be at least 3 paragraphs to receive full credit.  Research at least 3 sources to subtantiate your answer and include in your references.

1.  Describe the link between qualiyt and safety in the healthcare setting.

2.  Discuss the role of the nurse in quality improvement.

3.  Describe nursing-sensitive measurements and why they are important in Nursing care delivery.