(PLEASE PAY GREAT ATTENTION TO THE RUBRIC BELLOW)

Case Study: Mr. C.   

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 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 by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height: 68 inches; weight 134.5 kg

2. BP: 172/98, HR 88, RR 26

3. 3+ pitting edema bilateral feet and ankles

4. Fasting blood glucose: 146 mg/dL

5. Total cholesterol: 250 mg/dL

6. Triglycerides: 312 mg/dL

7. HDL: 30 mg/dL

8. Serum creatinine 1.8 mg/dL

9. BUN 32 mg/dl

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.

2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.

3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (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.)

4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.

5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.

6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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

 RUBRIC 

1) Clinical Manifestations of Mr. C. – Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms. 10pts  

2) Potential Health Risks for Obesity and Bariatric Surgery – A detailed discussion of the potential health risks for obesity is presented. A through and compelling discussion on whether bariatric surgery is an appropriate intervention is presented. The discussion is well-developed and supported by evidence and additional rationale. 10pts

3. Functional Health Patterns – Five or more actual or potential problems identified from the functional health patterns are discussed. The discussion is insightful, and the identified problems are highly relevant for the patient and his condition. The discussion is well-supported by rationale and evidence.15pts

4. Staging and Contributing Factors of End-Stage Renal Disease (ESRD) – The staging of ESRD and the contributing factors for ESRD are explained. The information is accurate and reflects contemporary practice and research. 10pts

5. Health Promotion and Prevention for ESRD – Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is thoroughly described. The proposed items are clearly presented and highly relevant and supportive of patient and his health status. Strong evidence and rationale generally support the discussion. 20pts

6. Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach – 

A clear and detailed explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. The explanation demonstrates insight into both resources and multidisciplinary approaches for nonacute care for ESRD patients. 15pts

7. Thesis Development and Purpose – Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.  5pts

8. Argument Logic and Construction – Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 5pts

9. Mechanics of Writing (includes spelling, punctuation, grammar, language use) – Writer is clearly in command of standard, written, academic English. 5pts

10. Paper Format (use of appropriate style for the major and assignment) – All format elements are correct.  2pts

11. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) – Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 3pts

Melissa, a 12-year-old girl with cystic fibrosis comes to the primary care office with complaints of increased cough and productive green sputum over the last week. She also complains of increasing shortness of breath. She denies sore throat or nasal congestion. On physical examination her temperature is 101 and she has inspiratory wheezes bilaterally. Negative lymphadenopathy noted. Posterior pharynx is pink without exudate. BP 112/72 HR 96 RR 28.

1. In cystic fibrosis, the airway microenvironment favors bacterial colonization. In a minimum of 150 words explain the pathophysiological reason for this occurrence.

    

Discussion: The Rise of Communism and Fascism      

Required Resources
Read/review the following resources for this activity:

• Textbook: Chapter 4, 5, 6
• Lesson
• Minimum of 1 scholarly source (in addition to the textbook)

Initial Post Instructions
For the initial post, select and address one of the following:

• Option 1: Examine Marx’s writings on communism and  socialism and compare them to how they manifested in reality? What  worked and what didn’t? What misconceptions do we have about his  original intent based on what we see in past or current governments?
• Option 2: Compare and contrast communism and fascism.  Select one example for each to examine the origins of the governments,  their accomplishments, and their failures. What accounts for the fact  that the masses mobilized to support these movements? Elaborate.
• Option 3: Examine Depression-Era social programs  (select one or more to examine in detail). Were the fears of a communist  take-over based on the implementation of these programs grounded in  reality? Why or why not? How do they compare to social programs in place  today?

 

Assignment Directions

1. Read over each of the following directions, the required Reading Research Literature worksheet, and grading rubric.
2. Review the video below these directions, which contains a tutorial for your Week 6 Assignment. Tutorial may look slightly different session to session. Grading criteria and rubric will be the same. 
3. Download and complete the required Reading Research Literature (RRL) worksheet (Links to an external site.). This must be used. 
4. Your required article is available to you in an announcement: IMPORTANT: Assigned Article for Week 6 Assignment. Please go to your announcement to locate the required article assigned for this session.
5. This assignment contains:
   • Purpose of the Study:  Using information from the required article and your own words, summarize the purpose of the study.  Describe what the study is about. 
   • Research & Design:  Using information from the required article and your own words, summarize the description of the type of research and the design of the study.  Include how it supports the purpose (aim or intent) of the study.
   • Sample:  Using information from the required article and your own words, summarize the population (sample) for the study; include key characteristics, sample size, sampling technique.
   • Data Collection:  Using information from the required article and your own words, summarize one data that was collected and how the data was collected from the study.
   • Data Analysis:  Using information from the required article and your own words, summarize one of the data analysis/ tests performed or one method of data analysis from the study; include what you know/learned about the descriptive or statistical test or data analysis method.
   • Limitations:  Using information from the required article and your own words, summarize one limitation reported in the study.
   • Findings/Discussion:  Using information from the required article and your own words, summarize one of the authors’ findings/discussion reported in the study. Include one interesting detail you learned from reading the study.
   • Reading Research Literature:  Summarize why it is important for you to read and understand research literature.  Summarize what you learned from completing the reading research literature activity worksheet.
6. You are required to complete the worksheet using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.). Click on the envelope at the top of the page.
7. Submit the completed Reading Research Literature Worksheet to the Week 6 Assignment.

Best Practices

• For questions about this assignment, please contact your instructor.
• Spell check for spelling and grammar errors prior to final submission. 
• Please see the grading criteria and rubrics on this page.
• Please use your browser’s File setting to save or print this page.

Scholarly Sources and Citations 

• Use APA format in citations and references.

Choose a legislator on the state or federal level who is also a nurse and discuss the importance of the legislator/nurse’s role as advocate for improving health care delivery. What specific bills has the legislator/nurse sponsored or supported that have influenced health care.

Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished. What additional steps need to be taken to continue advocacy for this issue?