Diagnosis and Management of Hematologic and Metabolic Disorders

 

 

 

Case Study 2:

 

 Jimmy is a 3-year-old “picky” eater according to his mother. He refuses to eat anything but waffles for breakfast and macaroni and cheese or chicken nuggets for lunch and dinner. He will eat apples and bananas but refuses all vegetables except corn. After a normal physical examination, you obtained blood testing that revealed the hemoglobin is 11.4 mg/dl and his hematocrit is 30% (both obtained by venipuncture). The CBC revealed microcytic hypochromic RBCs.

 

 

 

To prepare:

 

•Review “Endocrine and Metabolic Disorders” and “Hematologic Disorders” in the Burns et al. text

 

•Review and  Analyze the patient information.

 

•Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

 

•Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.

 

•Consider strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

 

TO COMPLETE

 

POST   1 TO 2 PAGES DISCUSSION PAPER ON :

 

  1.An explanation of the differential diagnosis for the patient in the case study you selected.

 

2. Explain which is the most likely diagnosis for the patient and why.

 

3. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.

 

4. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.

 

5. Finally, explain strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

 

 

 

References

 

•Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier

 

 

 

◦Chapter 25, “Endocrine and Metabolic Disorders” (pp. 529–556

 

 

 

◦Chapter 26, “Hematologic Disorders” (pp. 557–584)

 

•Hyperbilirubinemia: current guidelines and emerging therapies by Schwartz,H.P., Haberman, B.E., & Ruddy, R.M. in  Pediatric Emergency Care, 27(9), 884-889.

 

 

 

 

Many studies have found that psychotherapy is as effective as psychopharmacology in terms of influencing changes in behaviors, symptoms of anxiety, and changes in mental state. Changes influenced by psychopharmacology can be explained by the biological basis of treatments. But how does psychotherapy achieve these changes? Does psychotherapy share common neuronal pathways with psychopharmacology?

Psychotherapy is used with individuals as well as in groups or families. The idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric-mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential.

Photo Credit: Getty Images/iStockphoto

For this Discussion, you will consider whether psychotherapy also has a biological basis and analyze the ways in which legal and ethical considerations differ in the individual, family, and group therapy settings.

To prepare:

• Review this week’s Learning Resources, reflecting on foundational concepts of psychotherapy, biological and social impacts on psychotherapy, and legal and ethical issues across the modalities (individual, family, and group).
• Search the Walden Library databases for scholarly, peer-reviewed articles that inform and support your academic perspective on these topics.

By Day 3

Post an explanation of whether psychotherapy has a biological basis. Explain how culture, religion, and socioeconomics might influence one’s perspective on the value of psychotherapy treatments. Describe how legal and ethical considerations for group and family therapy differ from those for individual therapy, and explain how these differences might impact your therapeutic approaches for clients in group, individual, and family therapy. Support your rationale with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources. 

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days by providing an additional scholarly resource that supports or challenges their position, along with a brief explanation of the resource.

 Chapter 39, Assessment and Management of Patients With Rheumatic Disorders

1. Ellie Long, a 55-year-old patient, presents to the pain clinic with the diagnosis of fibromyalgia syndrome. The nurse at the clinic obtains a history and physical assessment of the patient. (Learning Objective 2)

1. On what areas should the nurse concentrate when interviewing the patient during the history process?
2. On what areas should the nurse concentrate when assessing the patient?
3. What diagnostic tests are used with fibromyalgia syndrome?

2. Julie Walker, a 22-year-old patient, is newly diagnosed with systemic lupus erythematosus (SLE). She presented with extreme fatigue; muscle and joint aching and swelling; a butterfly-shaped, flat, red rash across the bridge of the nose; patchy alopecia; a low-grade fever; and loss of appetite. Further workup revealed a positive antinuclear antibodies (ANA) titer, anemia, leucopenia, and mild thrombocytopenia. She has an abnormal lipid profile, proteinuria, and hypertension. The liver and renal profiles are within normal range. The physician ordered over-the-counter ibuprofen as needed for joint discomfort, but not to exceed 1,200 mg/day; hydroxychloroquine sulfate (Plaquenil) before meals at the same time each day; and prednisone in tapering doses over the next month. The physician also started the patient on lisinopril, an ACE inhibitor for the hypertension and a statin for the elevated lipids. The clinic nurse is asked by the physician to provide patient and family education. (Learning Objective 5) 

1. What teaching-plan topics should the nurse provide for the patient?

 

Directions:

Reflective writing will assist with improving your critical thinking and provide an opportunity to synthesize classroom knowledge. Reflection also assists with developing self-awareness, promoting professional growth and behaviors.

Reflection Discussion Question

Reflect on the content learned during the course. Include how this course helped you begin to form your professional identity as a nurse. Include how you will continue to form your professional identity.

Please make your initial post by midweek, and respond to at least one other student’s post by the end of the week. Please check the Course Calendar for specific due dates.