22 Jan Based on the summary of research

NRS410 Path Physiology and Nursing Management of Client’s Health

Week 1 Assignment

Assess your Knowledge of Foundational Concepts

Assess your knowledge of foundational concepts essential to the nursing management of client health by taking the interactive quiz, located in the media “Arterial Blood Gas Interpretation.” http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_self-assessment-v1.1.php

The quiz is designed as a tool for self-assessment. When you encounter questions that seem vaguely familiar, click on the media’s study materials, which are organized by topic (e.g., anatomy, biology, chemistry, pharmacology). This media will serve as a refresher for the concepts that build upon one another in nursing practice.

You will have the opportunity to retake the quiz until you achieve a passing score of 100%.

Once completed, please save your results and submit to the instructor.

Student ADA Version

ofthe Arterial Blood Gas Interpretation Pre-Assessment

Anatomy

Backward effects of left-sided heart failure include:

A. Pulmonary congestion

B. Jugular vein distention

C. Dependent edema in the legs

D. Bounding pulses

Anatomy

In performing a physical assessment, the nurse notes the patient has a “barrel” configuration to the chest. This is a consequence of:

A. Reduced intrapleural pressures

B. Bronchial airway expansion

C. Increased vital capacity

D. Increased residual lung volume

Anatomy

Ausculation of the chest reveals bilateral fine crackles in the bases bilaterally, indicating:

A. Right-sided heart failure

B. Left-sided heart failure

C. Pneumonia

D. Acute respiratory distress syndrome

Biology

The signs and symptoms of anemia are all related to what common pathophysiologic feature of the condition?

A. Increased oxygen consumption by tissues

B. Decreased blood oxygen content

C. Vasodilation

D. A shift in the oxyhemoglobin dissociation curve

Biology

In addition to hypertension, preeclampsia is characterized by:

A. Nausea and vomiting

B. Fatigue and lower back pain

C. Protein in the urine and edema

D. Retinal changes and rates in the lungs

Biology

Common manifestations of bacterial pneumonia include all of the following except:

A. Fever

B. Productive Cough

C. Tachypnea

D. Hyperinflation

Biology

Closed drainage systems work to re-expand a lung after pneumothorax by:

A. Re-establishing the normal negative intrapleural pressure.

B. Creating a positive pressure in the pleural space

C. Removing excess fluid from the pleural space so that there is room for lung expansion.

D. Pulling oxygen into distal air sacs to re-expand lung tissue

Biology

Patients with chronic renal failure usually exhibit:

A. Bradycardia

B. Hypokalemia

C. Hypocalcemia

D. Hematomas

Biology

The diet of a patient in end-stage kidney disease is restricted in all of the following except:

A. Fluid

B. Potassium

C. Protein

D. Calories

Anatomy

Which of the following is true of the biological functions of progesterone?

A. Progesterone is the most important hormone associated with pregnancy.

B. Progesterone directs male sexual characteristics.

C. Levels of progesterone increases if the egg is not fertilized.

D. Levels of progesterone remain stable if the egg is not fertilized.

Anatomy

Which of the following is true of the biological functions of testosterone?

A. Testosterone is not secreted by the ovaries.

B. Testosterone is needed for development of female secondary sexual characteristics.

C. Testosterone stimulates ovulation.

D. Testosterone is needed for development of male secondary sexual characteristics.

Anatomy

Which of the following is true of the biological functions of estrone?

A. Estrone is required for proper development of male secondary sexual characteristics.

B. Level of estrogen degreases if the egg is not fertilized.

C. Estrone is required for proper development of female secondary sexual

characteristics.

D. Estrone affects only the reproductive organs.

Biology

What is the function of hemoglobin?

A. Hemoglobin is the protein in red blood cells that is responsible for carrying oxygen to the cells of the body.

B. Hemoglobin is a lipid in red blood cells that is responsible for carrying oxygen to the cells of the body.

C. Hemoglobin is a protein in white blood cells that is responsible for carrying oxygen to the cells of the body.

D. Hemoglobin is a protein in red blood cells that is not responsible for carrying carbon dioxide to the cells of the body.

Biology

Why is heat an effective means of sterilization?

A. Heat is an effective means of sterilization because it destroys the proteins of microbial lifeforms, including fungi, bacteria, and viruses.

B. Heat is an effective means of sterilization because it destroys the proteins of anaerobic microbial lifeforms, including fungi, bacteria, and viruses.

C. Heat is an effective means of sterilization because it destroys the lipids of microbial lifeforms, including fungi, bacteria, and viruses.

D. Both (B) and (C).

Chemistry:

List the enzymes whose levels are elevated in the blood serum following an MI.

A. CPK, LDH, AST, and SGOT

B. LDH, AST, and SGOT

C. CRE, AST, and ALT

D. None of the above

Chemistry

What is the physiological function of gluconeogenesis?

A. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel.

B. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are high. This ensures proper function of brain and white blood cells, which only use glucose as fuel.

C. Gluconeogenesis is production of glucose from carbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel.

D. None of the above

Chemistry

What effect does glycogen metabolism have on glucose levels?

A. Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels.

B. Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes increase blood glucose levels.

C. Glycogen metabolism releases glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels.

D. None of the above

Chemistry

Carbon monoxide binds tightly to the heme groups of hemoglobin and myoglobin. How does this affinity reflect the toxicity of carbon monoxide?

A. Since carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen enhancement result in what divers call the “bends.”

B. Because carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation.

C. Because carbon monoxide binds tightly to the heme groups of hemoglobin, it is not easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation.

D. None of the above

Pathophysiology

Which of the following may be a reason to order an ABG on a patient?

A. The patient suddenly develops shortness of breath

B. An asthmatic is starting to show signs of tiring

C. A diabetic has developed Kussmaul’s respirations

D. All of the above

Pharmacology

How do sulfa drugs selectively kill bacteria while causing no harm to humans?

A. Folic acid is a vitamin required for the synthesis of a coenzyme needed to make the amino acid methionine and the purine and pyrimidine nitrogenious bases for DNA and RNA and folic acid is produced by humans.

B. Sulfa drug binds to the enzyme, no product is formed, folic acid is made and the biosynthesis of methionine and nitrogenous bases increases.

C. Humans are not harmed because they do not synthesize their own folic acid. It is obtained in the diet.

D. None of the above

Pharmacology

What occurs when glycogen metabolism is stimulated by insulin?

A. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis.

B. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates removal of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase.

C. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates uptake of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase.

D. All of the above

Pharmacology

What is the medical application of cortisone? Cortisone is used to treat:

A. Rheumatoid arthritis, asthma, gastrointestinal disorders, and a variety of skin conditions.

B. Kidney disease, high blood pressure, and osteoporosis.

C. Muscle disorders, tuberculosis, and thyroid disorder.

D. All of the above

Anatomy

Oxygen saturation is likely to be lowest when an asthmatic with a diagnosis of pneumonia is positioned:

A. In a high Fowler position

B. Lying on the left side

C. Lying on the right side

D. Lying supine with the head of the bed flat

Chemistry

Laboratory test results indicative of thrombocytopenia, in addition to a low platelet count, would be:

A. Increased PT

B. Prolonged bleeding time and poor clot retraction.

C. Increased aPTT

D. Decreased RBC count.

Pharmacology

The purposes of epinephrine injection include all of the following except:

A. Stabilizing mast cell membranes.

B. Relaxing bronchial smooth muscle.

C. Supporting arterial blood pressure.

D. Blocking histamine receptors.

Pharmacology

Therapeutic interventions focused on increasing the oxygen supplied to the heart and decreasing the heart’s demand for oxygen include:

A. Antiplatelet drugs

B. Anticoagulants

C. Morphine sulphate

D. Thrombolytic drugs

Pharmacology

An intervention that would contribute toward the healing of a peptic ulcer is:

A. Steroid administration

B. Blocking or neutralizing of acid secretion

C. Surgical removal of the ulcer

D. Intravenous nutritional support

Pharmacology

Aspirin and NSAIDs are causative factors for the development of peptic ulcer disease because they:

A. Increase acid secretion

B. Allow proliferation of H. pylori

C. Damage the mucosal barrier

D. Alter platelet aggregation

Pharmacology

Your patient is interested in trying medication to improve low mood/depression. All of the following medications might be appropriate except:

A. Selective serotonin reuptake inhibitors

B. Amitriptyline

C. Serotonin and norepinephrine reuptake inhibitors

D. Benzodiazepines

NRS410 Path Physiology and Nursing Management of Client’s Health

Week 2 Assignment

Approach to Care

Write a paper (1,250-1,750 words) describing the approach to care of cancer. In addition, include the following in your paper:

Describe the diagnosis and staging of cancer.

Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.

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 grading rubric. Instructors will be using the

rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite.

NRS410 Path Physiology and Nursing Management of Client’s Health

Week 3 Assignment

Case Study 1

In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.

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 grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physician’s notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints.”

Laboratory values are as follows:

Hemoglobin = 8 g/dl

Hematocrit = 32%

Erythrocyte count = 3.1 x 10/mm

RBC smear showed microcytic and hypochromic cells

Reticulocyte count = 1.5%

Other laboratory values were within normal limits.

Question

Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In an essay of 500-750 words, explain your answer and include rationale.

NRS410 Path Physiology and Nursing Management of Client’s Health

Week 3 Assignment

Case Study 2

In a short essay (500-750 words), answer the Question at the end of Case Study 2. Cite references to support your positions.

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 grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

Case Study 2

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:

• Describe your approach to care.

• Recommend a treatment plan.

• Describe a method for providing both the patient and family with education and explain your rationale.

• Provide a teaching plan (avoid using terminology that the patient and family may not understand).

NRS410 Path Physiology and Nursing Management of Client’s Health

Week 4 Assignment

Collaborative Learning Community: Home Visit with Sallie Mae Fisher

This is a CLC assignment.

As a group, observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.

Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of 500-750-words in which you do the following:

Identify, prioritize, and describe at least four problems.

Provide substantiating evidence (assessment data) for each problem identified.

Identify and describe at least four medical and/or nursing interventions.

Discuss your rationale for the interventions identified.

Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Scripted Dialogue Portion

Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.

Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”

APA format is not required for this part of the assignment, but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”

Entire Assignment

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite.

Sallie Mae Fisher’s Health History

and Discharge Orders

Sallie Mae Fisher Health History

Ms. Fisher is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.

Ms. Fisher is recently widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but works full time and has family issues of her own. Therefore, family support is limited.

Hospital Discharge Instructions

• Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety.

• Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O2 at 2 liters per nasal prongs PRN.

• Prescriptions given at discharge:

o Digoxin 0.25 mg once a day

o Lasix 80 mg twice a day

o Calan 240 mg once a day

• Order written to continue other home meds.

Sallie Mae’s Home Medication List

• Zocar 50 mg once a day

• Minipres 1 mg once a day

• Vasotec 10 mg twice a day

• Prilosec 20 mg once a day

• Furosemide 40 mg once a day

• Effexor 37.5 mg at bedtime

• Lanoxin 0.125 mg every other day

• Multivitamin once a day

• Potassium 40 mEq once a day

• Ibuprofen 400 mg q 4 hours as needed for pain

• Darvocet N 100 mg q 4 hours as needed for pain

• Nitroglycerin ointment, apply 1 inch every day

NRS410 Path Physiology and Nursing Management of Client’s Health

Week 5 Assignment

Benchmark – Evidence-Based Practice Project—Paper on Diabetes

Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

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 grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite.

NRS410 Path Physiology and Nursing Management of Client’s Health

Week 5 Assignment

Evidence-Based Practice Project—Intervention Presentation on Diabetes

Based on the summary of research findings identified from the Evidence-Based Project—Paper on Diabetes that describes a new diagnostic tool or intervention for the treatment of diabetes in adults or children, complete the following components of this assignment:

Develop a PowerPoint presentation (a title slide, 6-12 slides, and a reference slide; no larger than 2 MB) that includes the following:

A brief summary of the research conducted in the Evidence-Based Project – Paper on Diabetes.

A descriptive and reflective discussion of how the new tool or intervention may be integrated into practice that is supported by sound research.

While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to LopesWrite, unless otherwise directed by your instructor. If so directed, refer to the Student Success Center for directions. Only Word documents can be submitted to LopesWrite.