Instructions – Half way done. Need more to complete
PurposeAs you are learning this semester, the role of the nurse is to integrate and apply knowledge from your general education background, health-related sciences, and evidence-based nursing science in the application of the nursing process to the nursing care of patients in the acute care setting. The nurse uses knowledge from pharmacology, anatomy and physiology, pathophysiology, microbiology, nutrition, psychology, and other sciences to build a plan of care according to the health assessment findings generated by the nurse. Nursing is practiced within an interdisciplinary health care system, and it is important for the nurse to understand the perspectives of other disciplines in their contribution to the patient plan of care. For this assignment, you will use the case study provided or choose a client from your clinical rotation. You will complete an in-depth analysis of the nature of their health alterations, the pathophysiological and psychosocial aspects of their health needs and how the interdisciplinary team contributes to the treatment plan while the patient is in the hospital and has plans for discharge are put into action.Directions
Read the information about the case study with the chart materials provided or gather the necessary information from one of your patients.
Review the patient assessment information. What other assessments might you do in addition to those provided? What findings would you anticipate with this patient? Complete an in-depth analysis reflecting your ability to prepare a case study based on principles derived from pharmacology, pathophysiology, psychology, nutrition, and evidence-based nursing practice guidelines. Remember to include an introduction to the patient, pathophysiology, history, nursing assessment (given and any additional), and related treatments.
Include selected references for your case study paper/care plan and use APA format.
Specific grading rubric is attached.
CriteriaThe case study is specific, analytical, conceptually sound and based on scientific principles and application of knowledge, reflects evidence-based nursing care approaches and science, and is holistic in its approach to understanding the patient and his/her nursing care needs.
Case Study
Oluwaseun Banjo
Herzing University
NU 208 Pathophysiology
Prof. Carie Johnson
History
JA is an 82-year-old, African American male that was transferred to the emergency department after being noticed with nausea, vomiting and weakness at where he was being monitored at Elevate Care Riverwood nursing home and Rehabilitation center for 7 days following discharged at the hospital for a diagnoses of Colon Cancer stage 4. JA has a medical history of Rheumatoid Arthritis, Coronary Artery disease with a placement of stent, kidney disease stage 2, hypertension, and heart failure. JA resides at home alone and planning to move into a senior living facility. He is a retired school janitor. JA is divorced and has 5 grown children.
Nursing Assessment
Upon arrival to the emergency unit, JA was noted to be very confused, very weak, and lethargic. Vitals upon arrival was Blood pressure 132/67, tympanic temperature 98.5, Room air oxygen saturation of 96%, Pulse 71, and Respiration 19. Heart sound was regular, Pulse was noted thready and weak, Breath was regular and normal. He was noted with electrolytes imbalance of Potassium of 2.4, Sodium of 129 and calcium of 7.2. JA was transferred for the Intensive care unit for further evaluation on his Colon Cancer and electrolyte replacement.
Pathophysiology
Colon cancer begins with as a small benign clump that form on the side of the colon and later become cancerous. Colon cancer typically begins in the large intestine which is the last/final part of the digestive tract. Another term for Colon cancer may be known as Colorectal cancer, which in term is a combination of rectal and colon cancer starting from the rectum. Colon cancer may be observed with no symptom in early stage while symptom may vary due to different stages. Some symptoms are persistent change in bowel habit, blood in the stool, Abdominal discomfort, weakness or fatigue and unexplained weight loss. Risk factors are old age, Race (African American), history of colon cancer or polyps, Inflammatory Intestinal condition, hereditary, Low-fiber/High-fat diet, Obesity, Smoking, Alcohol, and radiation therapy. Other past diagnoses were well managed with medications and regular checkup.
Treatments
JA will be receiving IV fluid to replenish from lost of fluid. He might be undergoing colonoscopy to remove some polyps which depends on the doctor’s decision. In some other cases to minimize invasive surgery due to JA’s age, he could be going through laparoscopic procedure. For more advance Stages, a partial colectomy or ostomy might be in consideration. Some lymph node might be removed for testing. Blocking of some section of the colon might be used depending on how worse the colon is damaged or the stage if the cancer. Chemotherapy, immunotherapy, or radiation therapy can also be use depending on how the patient can tolerate the treatment. Supportive (palliative) care can also be a consideration for comfort or pain manag
2
Case Study
Student Name Here
Department of Nursing, Herzing University
NU208: Pathophysiology
Carie Johnson, MSN, RN, CMSRN
Due date for paper, 2021
Case Study
Introduction to Patient
FK is an 84-year-old, Caucasian man who lives with his wife in their home. Subjective data for the patient was mostly obtained from his wife. FK is a retired high school teacher and has been married to his wife for 57 years. They recently starting using home health nursing services; the home health nurse comes to the house 3 days per week to assist with FK’s care due to his progressing Parkinson disease. FK’s wife is an 82-year-old woman with severe scoliosis, and she is not able to assist with ambulation of the patient or help him up when he falls due to her condition. FK was brought to the emergency room after falling. The patient does not remember the incident. The wife reports that she believes the patient fell as he was standing up from his office chair and hit his head on the desk. The home health nurse was not present in the home the day of the incident, and the patient has been falling more frequently lately. Objective data for this patient was obtained through a head-to-toe analysis performed by the nurse on duty. FK has a 1.5-inch laceration on the left temporal area and presented to the hospital showing signs of confusion along with typical signs and symptoms of Parkinson disease. FK was diagnosed with Parkinson disease 8 years ago according to the electronic health record.
Pathophysiology
Parkinson disease (PD) is a neurodegenerative disorder with a normally slow, but continuous, progression (Huether & McCance, 2017). There is currently no cure for PD. In primary PD, symptoms usually begin in middle age, generally after the age of 40 with increased prevalence over the age of 60 (Huether & McCance, 2017). Parkinson disease is more common in men. The cause of PD is not entirely understood, but it has been linked to several gene mutations (those for alpha-synuclein, parkin, and ubiquitin proteins) in inherited forms of the disease, and possibly to environmental toxins affecting the same proteins in non-inherited primary PD (Burchum & Rosenthal, 2019). Inherited PD accounts for only about 10% of diagnoses, a majority of cases are idiopathic or sporadic (Huether & McCance, 2017). Parkinson disease is the second leading degenerative disease of neurons in older adults behind Alzheimer’s disease (Burchum & Rosenthal, 2019).
In PD, there is a loss of dopaminergic neurons in the substantia nigra and dorsal striatum along with misfolded or dysfunctional alpha-synuclein proteins produced by these cells (Burchum & Rosenthal, 2019). This causes damage to the neuronal network called the extrapyramidal system, which helps to regulate movement. Proper functioning in this area of the brain requires a balance between the neurotransmitters dopamine and acetylcholine. Acetylcholine is an excitatory neurotransmitter, while dopa
Criteria Pts
10 pts 8 pts 6 pts 4 pts 2 pts 0 pts
Level 5 Level 4 Level 3 Level 2 Level 1 Level 0
Clearly explains
who the patient is
(age, gender, etc.)
and distinguishing
between subjective
and objective data.
Discusses what the
principle problem
is.
Contains both
elements of high
proficiency and
moderate
proficiency
Vaguely explains
who the patient is
and what the
problem is, and
distinguishes
between
subjective and
objective data;
missing 1 of the
above areas
Contains both
elements of
moderate
proficiency and
non- proficient
Lack of
introduction to the
patient; missing 2
or more areas in
the first 2 columns
of this row
Not
attempted/Not
submitted
10 pts 8 pts 6 pts 4 pts 2 pts 0 pts
Level 5 Level 4 Level 3 Level 2 Level 1 Level 0
Clearly and
concisely discusses
the disease
pathophysiology as
well as
manifestations and
cause
Contains both
elements of high
proficiency and
moderate
proficiency
Vaguely or missing
minimal
information
regarding the
disease
pathophysiology,
manifestations,
and causes
Contains both
elements of
moderate
proficiency and
non- proficient
Missing important
information
regarding the
disease
pathophysiology,
manifestations,
and cause
Not
attempted/Not
submitted
10 pts 8 pts 6 pts 4 pts 2 pts 0 pts
Level 5 Level 4 Level 3 Level 2 Level 1 Level 0
Clearly and
concisely discusses
patient’s health
history and past
treatments
including any
additional health
history we should
ask the patient
(surgeries,
medications, etc.)
Contains both
elements of high
proficiency and
moderate
proficiency
Vaguely discusses
patient’s health
history and past
treatments
including any
additional health
history we should
ask the patient
Contains both
elements of
moderate
proficiency and
non- proficient
Missing important
information
regarding the
patient’s health
history and past
treatments
including any
additional health
history we should
ask the patient
Not
attempted/Not
submitted
20 pts 16 pts 12 pts 8 pts 4 pts 0 pts
Level 5 Level 4 Level 3 Level 2 Level 1 Level 0
Clearly and
concisely lists all
patient’s
assessment data
from case study
and includes any
important nursing
physical
assessment needed
for the patient
Contains both
elements of high
proficiency and
moderate
proficiency
Vaguely lists all
patient’s
assessment data
from case study;
lacking some
important nursing
physical
assessment still
needed for the
patient
Contains both
elements of
moderate
proficiency and
non- proficient
Missing important
patient assessment
data from case
study; lacking some
important nursing
physical
assessment still
needed for the
patient
Not
attempted/Not
submitted
NU208 Case Study Rubric
Pathophysiology
History
Nursing Physical
Assessment
20 pts
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