Hematopoietic:
J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy.

Past Medical History (PMH):
Upon reviewing her past medical history, the gynecologist notes that her patient is a G5P5with four pregnancies within four years, the last infant having been delivered vaginally four months ago. All five pregnancies were unremarkable and without delivery complications. All infants were born healthy. Patient history also reveals a 3-year history of osteoarthritis in the left knee, probably the result of sustaining significant trauma to her knee in an MVA when she was 9 years old. When asked what OTC medications she is currently taking for her pain and for how long she has been taking them, she reveals that she started taking ibuprofen, three tablets each day, about 2.5 years ago for her left knee. Due to a slowly progressive increase in pain and a loss of adequate relief with three tablets, she doubled the daily dose of ibuprofen. Upon the recommendation from her nurse practitioner and because long-term ibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on a regular basis to prevent gastrointestinal bleeding. Patient history also reveals a 3-year history of HTN for which she is now being treated with a diuretic and a centrally acting antihypertensive drug. She has had no previous surgeries.

Case Study Questions

1. Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.
2. Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.
3. Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells?
4. The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia.
   In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.
5. If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.
6. Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.

Cardiovascular
Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and having had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. In route to the hospital, the patient was placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills.

Case Study Questions

1. For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors.
2. What would you expect to see on Mr. W.G. EKG and which findings described on the case are compatible with the acute coronary event?
3. Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarct, which would be the most specific laboratory test you would choose and why?
4. How do you explain that Mr. W.G temperature has increased after his Myocardial Infarct, when that can be observed and for how long? Base your answer on the pathophysiology of the event.
5. Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarct. Elaborate and support your answer.

Submission Instructions:

• Include both case studies in your post.
• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
• Checked for plagiarism and  AI

 

Mr. Mason is a 78-year-old retired, widowed ironworker.  He has been estranged from his adult son, an only child, for many years.  He was recently diagnosed with advanced lung cancer.  He recognized that he needed to make some plans for his immediate future, so he contacted his son and allowed him power of attorney.  Mr. Mason is admitted to your unit in severe pain.  He is somewhat confused, and you are unable to elicit information from him about his wishes regarding life-sustaining measures.  You carefully begin discussing this difficult subject with his son, as it is your hospital’s policy that everyone admitted to your oncology unit be informed about advanced directives. 

Mr. Mason’s son begins to sob uncontrollably, saying, “I was never a good son.  I left home when I was barely 19 and didn’t even write or call for many years.  I am just getting to know my dad, and now this happens.  I want as much time with him as possible.  He told me a few days ago that he was ready to die and didn’t want to be kept alive on machines.  But I need some more time with him.  Please, do everything you can to keep him alive.  I need for him to forgive me.”

Post: Answer the following questions in your post:

1. What are the ethical principles involved in this scenario?  What ethical principles are at play when considering the view of the son, when considering the view of the patient?
   • Please respond using the ethical terms and principles reviewed in the textbook and interactive modules to support your points.
2. What is the best decision to make based on ethical principles?  In other words, what would you do and based on what ethical principles?
3. Does your answer change when you consider your legal duties and responsibilities?

Note: Be sure to discuss how the advanced directive does or does not fit into the healthcare 

  

Complete:  Review requirements for Vulnerable Population Concept Map

Presentation: Refugees

 Concept(s): Vulnerable Populations (Health Risks, Disparities)

Purpose: The purpose of this assignment is to analyze a vulnerable population to identify variables contributing to strengths, health risks, and other disparities. From the analysis, create a concept map showing the relationship between the variables and the vulnerable population. An audio/visual presentation of the concept map to explain the rationale for the variables and relationships identified.

Skills: Integrate nursing research and professional literature findings for evidenced-based care to vulnerable populations (caring, clinical competence, decision making, communication, collaboration, management of care, and commitment to professionalism).

Task: Create Vulnerable Population Concept Map and Audio/Visual Presentation

Review Concept Map Examples: The University of North Carolina at Chapel Hill (UNC) Learning Center Using Concept Maps.

Review requirements for Vulnerable Population Concept Map Presentation

#1  Assignment: Choose a population only and submit for approval

#2 Instructions: for the rest of the assignment.

You will use the vulnerable population selected to complete this assignment.
The concept map must be your original work, be clear, and legible. (Make it make sense)
You may use Microsoft Word, PowerPoint (PPT), or handwritten. If handwritten, it must be clear and legible.

#3 Use the following concepts as links to the vulnerable population to develop a one-page concept map.
Income & Social Status
Education
Social Support Networks
Social Environment
Personal Health & Coping Practices
Physical Environment
Gender
Age

#4. For each of the concepts above, include at least two (2) factors that contribute to the vulnerability of your selected population. Use your textbook and research scholarly credible sources [within the past seven (7) years]to identify and support the factors you select.
Include connections between the concepts and variables. Example: Is there a connection between income and education?

 #5 Develop a summary (250 words) to describe the relationships identified in the concept map.
Create an audio/visual using the concept map and summary for the presentation.
Submit both the concept map and audio/visual presentation when the assignment is due.

Note:

Include a title, your name, and date.
Include an APA 7th reference list.

Minor correction needed