Assessing, Diagnosing, and Treating Adults With Mood Disorders
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Describe your clinical experience for this week. This is for a children/family clinical. Please make case about 17 year old female
Submission Instructions:
J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.
Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.
Labs:
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.
Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.
Case study questions:
Submission Instructions:
Hello everyone,
Heart failure (HF) is a chronic, progressive condition in which the heart cannot effectively circulate enough blood to meet the body’s needs. It occurs due to structural or functional issues that disrupt the heart’s ability to fill or eject blood properly. The pathophysiology of HF involves neurohormonal activation, including the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system, leading to fluid retention, vasoconstriction, and myocardial remodeling (McDonagh et al., 2021).
Janessa’s symptoms, such as shortness of breath, weakness, and dizziness, may suggest HF, as reduced cardiac output and impaired tissue perfusion contribute to these manifestations. However, the absence of lung congestion and the presence of pale mucous membranes are not typical HF symptoms. HF is often associated with pulmonary congestion, which presents crackles on auscultation and symptoms like orthopnea or paroxysmal nocturnal dyspnea. The finding of pale mucous membranes suggests a different underlying cause such as anemia.
While HF may partially explain Janessa’s symptoms, the lack of fluid retention, including edema or pulmonary congestion, makes it a less likely primary diagnosis. However, anemia and HF can coexist, as anemia increases cardiac workload and reduces oxygen delivery, exacerbating HF symptoms (Groenewegen et al., 2020).
For my peers assigned asthma, you might suggest that Janessa’s shortness of breath is due to airway obstruction and inflammation. However, her clear lung sounds and absence of wheezing do not strongly support an asthma diagnosis.
Diagnostic testing that would be most appropriate to investigate HF:
Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart failure. European Journal of Heart Failure, 22(8), 1342-1356. https://doi.org/10.1002/ejhf.1929
McDonagh, T. A., Metra, M., Adamo, M., Gardner, R. S., Baumbach, A., Böhm, M., … & Anker, S. D. (2021). 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 42(36), 3599-3726. https://doi.org/10.1093/eurheartj/ehab368
In 1-2 pages, you will answer the questions provided following the case scenario. You must use current evidence-based resources to support your answers. Follow APA guidelines. Follow the grading rubric.
In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:
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