Case Study

A 60 year old woman with a 10 year history of Type II diabetes presents with multiple complications including retinopathy, peripheral neuropathy and declining renal function.

She has not had the urge to eat as of recently she feels “full” after a few bites. The incidence of nausea and feeling bloated occurs at least twice a day and even after a glass of water she feels bloated. She also complains of fatigue and not been able to keep up with daily chores.

A radiographic gastric emptying study shows a prolonged gastric emptying time.

Assignment Questions

1. What is the typical diagnosis for a patient who presents with this clinical picture?
2. What is the likely pathophysiologic process responsible for the presenting symptom? Support your response with a credible source.
3. What is the class of the drug used to treat the pathophysiolog?. Discuss the pharmacologic management plan for this patient.
4. Outline the mechanism of action and any possible contraindications of the pharmacologic management plan that you identified for the patient.

Instructions

• Prepare and submit a 3-4 page paper [total] in length (not including APA format).
• Answer all the questions above.
• Support your position with examples.
• Please review the rubric to ensure that your assignment meets criteria.
• Submit the following documents to the Submit Assignments/Assessments area:
  • Case Study: Gastrointestinal

The Beer’s criteria contain a list of drugs that are potentially unsafe for use in older persons. Go to https://www.sigot.org/allegato_docs/1057_Beers-Criteria.pdf. Select a drug on the “avoid” list that you have administered to an older patient or a drug that you know is prescribed for an older adult. Relate the outcome of using this drug to the pharmacokinetics (absorption, metabolism, distribution, and excretion) of drugs in an older client. In addition to the link, cite one other reference to support your post. 250 words

Mrs. Jones, a widow, is no longer able to live independently and is requiring more and more help with her self-care. Her daughter, Susie, who is married with three school-aged children, agrees to let her mother move in with her. Susie is concerned with balancing the demands of her career and the needs of her family, especially now that her elderly and chronically ill mother will need assistance. She is also unsure about how she feels with the reversal of roles, having to now be the primary caregiver of her mother. How can the nurse, caring for this family, assist with the changes they are about to undergo? How can both the family structural theory and the family developmental theory be applied to this scenario? How can health education enhance health promotion for this family?

Compose a brief and focused paper which explains and describes your healthcare issue/topic from a scientific and/or mathematical/analytical perspective of inquiry. Your instructor will guide you through the choices you have for this inquiry, including options and strategies for combining the perspectives.

Your paper must be 5 pages in length and reference 4-6 scholarly, peer-reviewed resources. Be sure to follow APA formatting standards (spacing, font, headers, titles, abstracts, page numbering, etc.) as you demonstrate informative, explanatory, descriptive writing. Use the provided template

.

• Address your general topic by forming and answering two levels of research questions, developed to provide specific and detailed inquiry, discovery and understanding: 
  • Choose a “Level 1 Research Question/ Writing Prompt” from either or both of the lists below to answer in the paper.
  • Compose a “Level 2 Research Question/ Writing Prompt” that provides detail, specificity, and focus to your inquiry, research and writing**.
• State your research questions in the introduction of your paper.
• Form the body of your paper by answering each research question, using references to the resources found in your research.
• Review the process and the resulting understandings in the conclusion of the paper (briefly review the issues, research questions, answers, and insights.)

Level 1 Research Questions/Writing Prompts
SCIENTIFIC Perspective of Inquiry
What are the anatomical, physiological, pathological, or epidemiological issues?
Which body systems are affected?
What happens at the cellular or genetic level?
Which chemical or biological issues are most important?
Level 1 Research Questions/Writing Prompts
MATHEMATICAL/ANALYTICAL Perspective of Inquiry
What are the economical issues involved?
Which economic theories or approaches best explain the issue?
What are the statistical facts related to the issue?
Which statistical processes used to study the issue provide for the best explanation or understanding of the issue?

Refer to the rubric for evaluation details and to assist in preparing the paper.

Due: Submit by 11:59 pm (Pacific time) the evening before the Week 4 onsite class
Points: 100

**Notes about research questions and team meetings:

• Discuss and share your research questions with your teammates during your team meetings to ensure that each team member is addressing uniquely specific questions and details about your topic.
• If two or more team members use the same Level 1 Research Question, the Level 2 Research Question composed by those team members must be demonstrably different (confirmed through your weekly interactions in online and in-class team meetings.)

Part 1

My post

Hello class and Professor,

The advent of the technological era has been linked to improved patient outcomes. Most of the technologies in place are patient-centered and are aimed at improving the quality of care and service delivery. At the facility I work for, there are several technologies in place. The most recent is the point of care technology. As much as this technology is in its initial stages of implementation, the benefits have had profound effects on the operations of nursing. This technology allows nurses to access patient data such as X-rays and medication directly from the bedside. This is achieved through linked computers placed at the bedside of patients to ensure that their records can easily be accessed (Adam, 2017).

Considering that the facility has not yet adopted electronic health records, the point of care technology comes with great significance to the hospital. Through the technology, time is saved which would have otherwise been used to access the documents physically. This also allows for easier update of the patient information ensuring that they stay up to date. Point of care technology also ensures that nursing practice focuses on patient-centered care (Adam, 2017). This means that the patient is engaged in making decisions, follow-ups, and education to better their health.

The facility should, however, consider the importance of implementing electronic health records to complement the point of care technology. With electronic records coupled with this technology, nurses will have diverse alert systems such as mobile phones and tablets to ensure that they can access patient data away from the bedside.

Part2 

Professor Comments and question

It is really interesting that your organization has not implemented the electronic health record (EHR). The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provided $35 billion dollars for organizations to implement electronic health records. The incentive did not cover the entire costs of implementation to organizations, but are mandatory to meet the requirements for the Centers for Medicare and Medicaid Services the Merit-Based Incentive Payment System, or MIPS which will start in 2019. Do you think the organization will change to the EHR in the near future?

 References
Schwartz, S. (2016). Defensive medicine versus value-based care. Medical Economics. Retrieved from: http://medicaleconomics.modernmedicine.com/medical-economics/news/defensive-medicine-versus-value-based-care?page=0,0

Part 3/another students comments and question

I found your topic very interesting. Prior to working on the PCU unit at a hospital, my last employer was just in the process of implementing EMR. They were actually using paper charts. It is interesting that some health care organizations are behind when it comes to information technology. Do you think that this could be due to cost? I think cost was the major reason as to why my prior employer was slow to using EMR.