Hello, I am please in need of assistance with a homework assignment. I will attach the case study with information to answer the questions, as well as a sample/example of how the assignment should be
Spring Homework 2 Case study • Olga Brenheim is a 65-year old female presenting with “heaviness” and pain in her lower thighs and calves during walking. • She has a history of coronary artery disease, myocardial infarction, heart failure, carotid stenosis , hypertension, hyperlipidemia, type 1 diabetes mellitus, and asthma. Physical examination and diagnostic test results • General , neuromuscular : Obese , alert, oriented, cooperativ e. Pupils equal, round, reactive to light and accommodation. Nasopharyngeal mucous membranes pink and moist. Slow, but steady gait . • Vital signs: Temperature = 98.6 degrees Fahrenheit (oral) ; heart rate = 84 beats/min , sinus rhythm with 1 -2 monomorphic, pre mature ventricular complexes per min ; respiratory rate = 18 breaths/min , slightly labored with exertion ; blood pressure = 1 40 /80 mmHg ; oxygen saturation = 90% on room air; pain = 0/0 when resting, but increases to 4/10 with prolonged walking. • Cardiopulmonary : Bilateral chest expansion symmetrical . Lung sounds clear. S1, S2, and S3 auscultated , but no murmur . Bilateral jugular vein distention noted. • Extremities: Full ROM in all e xtremities . Strength 4/5 in upper extremities and 3/5 in lower ext remities. Lower extremities coo l and pale. Diminished sensation and prolonged c apillary refill in both feet. Bilateral 2+ pedal edema . Doppler pedal pulses difficult to find and weak. • Abdomen: Large, soft, non -tender, and bowel sounds in all quadrants. • Serum test results: Complete blood count results , chemistry panel, and troponin levels within normal ranges . • Other results: Chest x -ray shows clear lungs and cardiomegaly . Electrocardiogram shows no acute ischemic changes. Echocardiogram with decreased left ventricle motion and decreased ejection fraction consistent with her baseline; no new changes . Abdominal aortogram with arteriogram of the lower extremities showed aortoiliac disease with multiple stenoses of varying degr ees and affecting both legs . The r esting ankle -brachial index was 0.50 and 0.70 at the right and left dorsalis pedis, respectively (normal = 0.90 -1.30). Spring To answer questions 1 -3, use the scenario above 1. Identify the likely disorder, the underlying pathophysiology (i.e., cellular and tissue changes), and relate the changes to abnormal findings to support your interpretation. (20 points) Hint: We are in the cardiovascular system ☺ ! 2. Identify all nursing d iagnoses labels (just the label!) that apply to this patient (e.g., impaired swallowing). Identify the priority (#1) nursing diagnosis label; and for the (#1) nursing diagnosis label, explain the nursing interventions to address the identified problem. Pro vide evidence -based rationale to explain the need and/or benefit of each intervention. For interventions, include what the nurse should “monitor/assess”, “do”, and “teach” to the client.(20 points) 3. Describe 2 medical therapies used to treat the disorder and explain their specific mechanism of action and intended impact at the cellular and/or tissue level. (15 points) To answer questions 4 -5, choose ONE disorder from this week’s reading 4. For the chosen disorder, identify the disorder and describe the impa ct on the population in the United States including incidence, prevalence, costs, morbidity, mortality, and/or other appropriate issues. Be sure to identify the disorder, the population associated with the data, and the year(s) of data. (15 points) 5. For t he chosen disorder, locate recommendations in a nursing journal article or professional nursing organization . Provide a brief summary of the information and specific recommendation s for nursing actions to improve care for patients. (15 points) Hint: To increase the likelihood of locating a nursing journal or organization, look for some form of the word “nurse” in the journal or organizational name! Scholarly Writing: Use correct sp elling, grammar, sentence structure, formatting, professional terms, title page, paraphrasing, citations, and references. Sources current (<5 years old) and professional (15 points)
