If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided? 

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

Renal Failure

Patient Profile:

J.M. is a 37-year-old woman transferred to a large medical center from a small rural hospital for further evaluation of lower abdominal pain, nausea, vomiting, and progressive deterioration of urinary output.

Subjective Data:

-Long history of ETOH Abuse with a drinking binge two days ago

-Arthritis with heavy use of ibuprofen

-HTN for three years, treated with hydrochlorothiazide and a calcium channel blocker

-Borderline NIDDM for three years, does not want to take medications and has been trying

to lose weight and “watch her sugar intake.”

Objective Data:

B/P: 160/110 K: 6.3 mEq/L Urinary output: <15ml/hr Na: 149 mEq/L Lethargic Hgb A1C: 9.2%

Creatinine: 9.6 mg/dL BUN: 121 mg/dL

CRITICAL THINKING QUESTIONS…

1. Address how the various factors in her past medical history could have contributed to her present renal problem.

2. Is her acute renal failure likely to be prerenal, intrarenal, postrenal, or a combination? Why?

3. Discuss each of the laboratory values and how they reflect the pathophysiology that occurs in renal failure. What is the significance of her Hgb A1C level?

4. What are the specific priorities of treatment for J.M.?

5. Explain the types of dialysis available, their indications, and their advantages/ disadvantages. What type of dialysis will most likely be used for J.M?

6. After two weeks of intensive support and dialysis, J.M’s urinary output returns. Explain the diuretic phase of recovery in Acute Renal Failure, and what complications can occur.

7. Do you think she needs intervention for her diabetes? What guidelines did you consult? How would you start in treating a patient with newly diagnosed Type 2 diabetes? Which medication(s) might you want to start first? What patient education issues would you emphasize in the initial period?

To Prepare:

· Review the Resources and reflect on the web article 
Big Data Means Big Potential, Challenges for Nurse Execs.

· Reflect on your own experience with complex health information access and management and consider potential challenges and risks you may have experienced or observed.

BY DAY 3 OF WEEK 5

Post a description of at least one potential benefit of using big data as part of a clinical system and explain why. Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why. Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described. Be specific and provide examples.

BY DAY 6 OF WEEK

Please see attachment

 

Give a one page description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of healthLinks to an external site., and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.

(Please Note: The underlined “social determinants of health” in the above content is meant to hotlink to the following Walden webpage and content:

Social Determinants of Health – Social Determinants of Health – Academic Guides at Walden Links to an external site.University)