NRS-455 – Case Studies: Indirect Care Experience Hours

NRS-455 – Case Studies: Indirect Care Experience Hours

Case Study: Mrs. R. has indirect care experience requirements. The “NRS-455 – Case Studies: Indirect Care Experience Hours” form, found in the Topic 1 Resources, will be used to document the indirect care experience hours completed in the case study. As progress is made on the case study, update this form indicating the date(s) each section is completed. This form will be submitted in Topic 3.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

U.S  healthcare delivery system

U.S  healthcare delivery system

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 900-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

Outline a current or emerging health care law or federal regulation introduced within the last 5 years to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years in response to upcoming trends or predicted issues in health care.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Functional Health Patterns Assessment Guide

Functional Health Patterns Assessment Guide

Case Study: Mr. D.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the
pathophysiological processes of disease, the clinical manifestations and treatment protocols, and
how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mr. D., presented below.
Health History and Medical Information
Mr. D. is a 65-year-old male nonadherence diabetic with end-stage renal disease receiving
dialysis. He is a retired certified public accountant in the last 5 years and practices the Muslim
faith. He reports that he avoids all pork products. His complaints included decreased balance,
loss of sensation, fear of falling, and decreased endurance during activities of daily living due to
the effects of dialysis treatment. Patient’s previous medical evaluation includes end stage renal
disease (ESRD) on dialysis and referral for recommendations for initiating exercise program.
Patient comorbidities include obesity with a body mass index (BMI) of 45, type II diabetes
mellitus with long-term insulin use, hypertension, sleep apnea, depression with lack of family
support and understanding, and diabetic neuropathy. Patient denies suicidal ideation but does
report feelings of loneliness and helplessness. Mr. D. reports increasing shortness of breath with
activity, swollen ankles, and pruritus over the last 6 months.
Objective Data:
1. Height: 68 inches; weight 134.5 kg
2. BP: 140/94, HR 84, RR 22
3. 2+ pitting edema bilateral feet and ankles
4. Fasting blood glucose: 146 mg/dL
5. Total cholesterol: 250 mg/dL
6. Triglycerides: 312 mg/dL
7. HDL: 30 mg/dL
8. Serum creatinine 1.8 mg/dL
9. BUN 32 mg/dl
10. GRF (glomerular filtration rate)-13mL/min
2
Clinical Manifestations
Describe the clinical manifestations present in Mr. D., focusing on the normal and abnormal
findings and how this relates to his current condition.
Subjective
Objective
Potential Health Risks for Diabetes With End-Stage Renal Disease
Identify the potential health risks for a diabetic with ESRD and the impacts of nonadherence.
Identify the potential health
risks for a diabetic with end-
stage renal disease (ESRD) that
are of concern for Mr. D.
How does Mr. D.’s
nonadherence to his diabetes
self-management plan for DM
Type II contribute to ESRD?
Describe the common
considerations with insulin use
for practicing Muslims.
Pathophysiology of Renal Dialysis
Explain the pathophysiology of renal dialysis.
Explain the pathophysiology of
renal dialysis. Compare
peritoneal dialysis and
hemodialysis.
Describe in detail the
pathophysiological explanation
and stages of renal disease that
leads to ESRD.
Explain the potential factors
that contributed to Mr. D.’s
ESRD.
3
Functional Health Problems
Evaluate of Mr. D.’s functional health patterns.
Evaluate each of Mr. D.’s
functional health patterns using
the information given.
Discuss at least five actual or
potential problems you can
identify from the “Functional
Health Patterns Assessment
Guide,” located in the Topic 3
Resources. Provide a rationale
for each.
Nursing Health Management and Health Promotion
Provide ESRD nursing management and health promotion opportunities.
Provide ESRD nursing
management and health
promotion opportunities.
Develop a patient education
plan for ESRD that could be
offered to Mr. D. for prevention
of future events, health
restoration, and maintaining
renal status.
Assume Mr. D. lives in your
community. Include community
resources and supportive care
available for Mr. D. for ESRD
care and management at home.
Discuss the nurse’s role in
using the holistic
multidisciplinary care approach
that would be safe and effective
for patients like Mr. D.,
including aspects such as
devices, transportation,
eligibility for transplant, living
conditions, promotion of
resiliency, and independence.

Interoperable communications

Interoperable communications

The role of interoperable communications is imperative to successful operations. Discuss the importance of interoperable communications during the Tokyo Subway attack. What were some of the lessons learned from this particular event for improving interoperable communications?

Alleviating crisis

Alleviating crisis

○ Explore the nature of the crisis presented
○ Suggest steps for alleviating the crisis
○ Teach coping skills; and
○ Help the victim(s) develop resiliency

● For the nature of the crisis section, be sure to identify the type of crisis, the people you’re
likely going to need to prioritize for debriefing, and their likely symptoms.
● For steps for alleviating the crisis, use scholarly sources to support your approach to
crisis intervention for the scenario you cover. For example, you could use Mitchell’s
CISM model, the ABC Model outlined by Kanel, Basic Intervention Procedures
discussed by Wright, or find another approach not covered in the class to alleviate the
crisis. However, be sure to show outside support for that approach. If you cover prayer as
a coping skill, you might want to find research on religious coping skills to support your
approach.

Pop culture and Relationships

Pop culture and Relationships

• What did the songwriter(s) do well?
• What aspect might be missing or could be included to strengthen the
message?
• What are the implications of the lyrics? Helpful? Harmful? Why?
• Do the songwriter(s) promote faulty beliefs?
• Do the songwriter(s) help address typical stages/concepts that are key to
relationships?

Costa and McCrae

Costa and McCrae – In Search of the Big Five

Costa and McCrae: Review the section in Chapter 13 titled “In Search of the Big Five” and the article “Big Five Personality Factors and Facets as Predictors of Openness to Diversity” (Han & Pistole, 2017). Review the “Fruit of the Spirit” found in Galatians 5:22-23. Using Han and Pistole’s (2017) research as a foundation, select one of Costa and McCrae’s Five-
Factors and discuss how this factor relates to an open attitude toward diversity. Include information from your additional research as well. Think about what you read in Galatians 5.
How can you implement what you learned about openness to diversity in your own life?

McCrae and Costa

McCrae and Costa

Costa and McCrae: Review the section in Chapter 13 titled “In Search of the Big Five” and the article “Big Five Personality Factors and Facets as Predictors of Openness to Diversity”
(Han & Pistole, 2017). Review the “Fruit of the Spirit” found in Galatians 5:22-23.
Using Han and Pistole’s (2017) research as a foundation, select one of Costa and McCrae’s Five- Factors and discuss how this factor relates to an open attitude toward diversity. Include
information from your additional research as well. Think about what you read in Galatians 5.
How can you implement what you learned about openness to diversity in your own life?

Cognitive development in infants

Cognitive development in infants

Jack is a five month old baby; he spends most of his time playing with his toys and his Mommy. He makes gurgling sounds and kicks his mobile of animal figurines hanging above his crib. As it jingles, it makes funny noises that he seems to enjoy. He is very curious about his environment and takes every opportunity he gets to explore it.

Based on the above description of baby Jack,

1. Identify all four stages of Piaget’s theory of cognitive development
2. Describe the stage of cognitive development he is in according to Piaget.
3. Describe the milestones and/ or limitations of this stage, i.e., what cognitive skill(s) he does not possess and what skill(s) he will come to possess by the end of this stage.
4. Also, what stage will baby Jack enter if he successfully navigates this stage of development?