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. 

Jane and Jackie, 30 year old twin sisters, adopted when they were two years old, lived mirrored lives to this point. They do everything together, from having a double wedding, living next door to each other, and making any appointments, medical or social together.

Today they made an appointment with their OB/GYN. Information was as follows:

Jane Information: Jackie’s Information:

BP 115/70 BP 165/96

HR 70 HR 96

Resp. 20 Resp, 22

Temp 98.6 Temp 99.2

N/A Normal U/A + Hematuria

+ Proteinuria

Weight No gain Weight +15 pounds

C/O Intermittent Headache C/O Has lower back and stomach

at times relieved with pain at times and is relieved also

Tylenol by Tylenol.

Other: This individual is noted to have

some loss of muscle mass in her

arms and legs and less subcutaneous

tissue overall.

1. At this point, what do your think is the problem with Jackie? Why is this problem co common in women? What test would you request to confirm your diagnosis?

The physician uses the ultrasound to assess Jackie’s back and abdomen. He finds that her kidneys are about 4 times larger than normal and appear to have numerous fluid filled cysts noted. At this point he asks BOTH sisters to see a nephrologist and to be scheduled for MRI’s of the kidneys. The MRI showed that Jackie’s kidneys were indeed larger and filled with cysts. Jane’s kidneys were somewhat larger than normal, and no cysts were present at this time.

2. What problem do you anticipate that Jackie has now? How was it acquired?

3. Why did Jackie gain so much weight over the last year?

4. Why does Jackie have high blood pressure and the UTI?

5. Why were both sisters requested to have this test.

The sisters went to see the nephrologists who requested that they have MRI’s of the brain and an echocardiogram. Jane’s MRI and echocardiogram were normal. Jackie’s brain MRI and echocardiogram were not. Jackie had a cerebral angiogram that followed which confirmed complications of her disease process, an Intracranial aneurysm and Mitral regurgitation. Jackie undergoes a procedure called Coil Embolization Therapy to resolve the aneurysm.

6. What is an Intracranial aneurysm? How does Coil Embolization Therapy resolve the problem.? Please be specific of the procedure.

7. What is Mitral Valve Prolapse and how will it affect Jackie’s health care needs before procedures in the future?

8. What education is needed to be shared with these sisters related to their children having this condition in the future?

Neafsey. P. (2010).Sisters for life:
Case Mysteries in Pathophysiology. Englewood:

Morton Publishing Company

gmt/2015

 Fill out the Table below comparing the Acute Complications of Diabetes. 

follow all directions

Chamberlain

NR599-11532

Week 5

Clinical Decision Support Systems

Preparing the Assignment

Post a written response in the discussion forum to EACH threaded discussion topic:

1. This week we learned about the potential benefits and drawbacks to clinical decision support systems (CDSSs). Create a “Pros” versus “Cons” table with a column for “Pro” and a separate column for “Con”. Include at least 3 items for each column. Next to each item, provide a brief rationale as to why you included it on the respective list.

2. The primary goal of a CDSS is to leverage data and the scientific evidence to help guide appropriate decision making. CDSSs directly assist the clinician in making decisions about specific patients. For this discussion thread post, you are to assume your future role as an APN and create a clinical patient and scenario to illustrate an exemplary depiction of how a CDSS might influence your decision. This post is an opportunity for you to be innovative, so have fun! 

Adhere to the following 
guidelines regarding quality for the threaded discussions in Canvas:

· Application of Course Knowledge: Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings.

· Scholarliness and Scholarly Sources: Demonstrates achievement of scholarly inquiry for professional and academic decisions using valid, relevant, and reliable outside scholarly source to contribute to the discussion thread. 

· Writing Mechanics: Grammar, spelling, syntax, and punctuation are accurate. In-text and reference citations should be formatted using correct APA guidelines.

· Direct Quotes: Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category. 

For each threaded discussion per week, the student will select no less than 
TWO scholarly sources to support the initial discussion post.

Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are 
NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality.  It is the responsibility of the student to determine the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.