Respiratory Case Study

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• Winter is a 4-year-old girl with a history of asthma. Her mother has brought her in an “asthma attack”. Winter is sitting in her mother’s lap and breathing rapidly through an open mouth. She has a cough that sounds congested and wheezy. The physician has already ordered a nebulized treatment containing albuterol (Proventil) and ipratropium bromide (Atrovent).
• Mr. Chung is a 68-year-old man complaining of cough, sore throat, fatigue, and weakness. His BP is 166/82, pulse is 90, respirations are 26, and temperature is 100.4 degrees.
• Jackson is a 19-year-old man who has had a sudden onset of right-sided chest pain and shortness of breath. His chest x-ray film revealed a right pneumothorax, and he is currently receiving 35% oxygen by face mask while waiting for an ambulance to transport him to the hospital for further evaluation.
• Ms. Summers is a 45-year-old homemaker. She says she has been extremely tired, easily becomes short of breath, and is unable to complete her chores without frequent rest breaks. She is pale and seems tired. Her vital signs are as follows: BP 136/78, pulse 86, respirations 24 and unlabored; temp 98.4 and pulse oximetry 98% on room air. She is now waiting for her lab results, which include a complete blood count (CBC).

Answer the following questions that pertain to the above patients.

• Which patients are experiencing problems with ventilation? Explain your answer.
• Which patient appears to be experiencing problems with hypoxia? Does the problem appear to be related to oxygenation or perfusion? Explain your answers.
• Mr. Chung has smoked two packs of cigarettes per day for 50 years. ABGs reveal a low PO2 and a high PCO2 consistent with chronic lung disease. He is diagnosed with an acute exacerbation of chronic bronchitis. He is placed on oral antibiotics and long acting bronchodilators by metered-dose inhaler (MDI). What teaching could you offer to help Mr. Chung mobilize and expectorate secretions?
• Winter receives her nebulizer treatment and markedly improves. The physician has ordered a variety of take-home medications that you must teach her mother about. The treatment plan includes a protocol based on peak expiratory flow monitoring. Discuss how you might involve Mary in her own care.
• Jackson’s chest x-ray film reveals a spontaneous pneumothorax. There is no apparent fluid in the pleural space. What chest tube systems can be used to treat his pneumothorax? Explain your thinking.
• Ms. Summers is diagnosed with severe anemia. She is hospitalized because her hemoglobin is 5.9 g/dL. How will this affect her oxygenation? What interventions would improve her fatigue?

 
What is your evaluation of the effectiveness of the U.S. health care system in the context of delivery, finance, management, and/or sustainability? What are the issues that prompted a need for health care reform? Support your answer with a credible data reference. Do not use a reference already used by another student. 

The nursing profession is both practice-based, referring to the evidence-based practice that we’ve been discussing the last couple weeks and theory based (Younas and Quennell, 2019). The theory part of nursing focuses on the nurses values and beliefs about the human body and the health of it. According to Younas and Quennell, the nursing theory focuses on seeking which approaches to patient care would be best for that individual patient. Essentially it is gathering information from definitions and concepts and making assumptions using both the deductive reasoning and inductive reasoning methods (Nursing Theories, 2020). Younas and Quennell say that nursing theories are just as important as using evidence-based practice (2019). Using theory, evidence-based practice, and research all together can contribute to high knowledge development (Younas and Quennell, 2019). Nursing Theories says that the conceptual model theory is a more abstract way about looking at certain situations; it is a reference used to guide general nursing practice that consists of the patient, the environment, the nurse, and the health of the patient (2020).

Johnson’s Theory 1968 is a theory that focuses on a patient’s ability to adapt to their new-found-out illness. It looks at different stressors that may or may not cause the patient to not be able to adapt. The goal of this theory is to help maintain and control our patient’s stress level so they can more easily cope with and recover from their illness (Nursing Theories, 2020).

An example of Johnson’s Theory- say a person just found out they had cancer (of any sort). Finding this out would be incredibly stressful in many ways, depending on the type of cancer, how long that person has, how old they are, etc. Say this person found out they have Stage 4 pancreatic cancer and they are 50 years old. This would be devastating news for anyone. Using Johnson’s Theory, we can help provide our patient with resources they need in order to decrease their stress level and be able to cope with this new-found news. We can assist them with an advanced directive, a living will, get them into a support group, get their affairs in line for when they pass, have them meet with the chaplain, etc.

Pls always try to support post before writing .its a discussion forum.thanks 200-250 words. 

This assignment describe the teaching experience and discuss your observations. The written portion of this assignment should include:

1) **********5 full pages**************************** (cover or reference page not included)
2)¨**********APA norms
3)********** It will be verified by Turnitin and SafeAssign
4) **********References from the last 5 years  

 _________________________________________________

1. Summary of teaching plan
2. Epidemiological rationale for topic
3. Evaluation of teaching experience
4. Community response to teaching
5. Areas of strengths and areas of improvement

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 rubric. 

Principalism, especially in the context of bioethics in the United States, has often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values. How would you rank the importance of each of the four principles? How do you believe they would be ordered in the context of the Christian biblical narrative? 

350 words. NO PLAGIARISM PLEASE. MINIMUM OF 1 REFERENCE