Health conditions

choose one (1) of the case studies below and answer the associated questions. The followin" rel="nofollow">ing questions relates to the patient within" rel="nofollow">in the first 24 hours sin" rel="nofollow">ince admission to the emergency department (ED): 1. Outlin" rel="nofollow">ine the causes, in" rel="nofollow">incidence and risk factors of the identified condition and how it can impact on the patient and family (400 words) 2. List five (5) common signs and symptoms of the identified condition; for each provide a lin" rel="nofollow">ink to the underlyin" rel="nofollow">ing pathophysiology (350 words) a. This can be done in" rel="nofollow">in the form of a table – each poin" rel="nofollow">int needs to be appropriately referenced 3. Describe two (2) common classes of drugs used for patients with the identified condition in" rel="nofollow">includin" rel="nofollow">ing physiological effect of each class on the body (350 words) a. This does not mean specific drugs but rather the class that these drugs belong to. 4. Identify and explain" rel="nofollow">in, in" rel="nofollow">in order of priority the nursin" rel="nofollow">ing care strategies you, as the registered nurse, should use within" rel="nofollow">in the first 24 hours post admission for this patient(500 words). Case Study 1: Myocardial in" rel="nofollow">infarction with history of stable angin" rel="nofollow">ina and mitral valve stenosis Mr Tupa Savea is a 54 year old male who has been transferred to the coronary care unit (CCU) from the emergency department for management of episodic chest pain" rel="nofollow">in. He has a history of stable angin" rel="nofollow">ina and mitral valve stenosis. Mr Savea is of Samoan background and has lived in" rel="nofollow">in regional Queensland for the last 20 years with his wife and children. He was brought in" rel="nofollow">in by ambulance havin" rel="nofollow">ing had chest pain" rel="nofollow">in and shortness of breath. He reports havin" rel="nofollow">ing similar symptoms on and off for the past two months but did not visit his GP as he assumed the discomfort was due to in" rel="nofollow">indigestion. Mr Savea is an ex- smoker, tobacco free for the last six months and a social drin" rel="nofollow">inker (approx. 10 units/week). He works full-time as an orderly at a local hospital and is active in" rel="nofollow">in the Samoan support community. On assessment Mr Savea’s vital signs are: PR 90 bpm and irregular; RR 12 bpm; BP 150/100mmHg; Temp 36.9°C; SpO2 98% on oxygen 8L/min" rel="nofollow">in via Hudson mask. He has a body mass in" rel="nofollow">index (BMI) of 35 kg/m2 in" rel="nofollow">indicatin" rel="nofollow">ing clin" rel="nofollow">inical obesity. Blood test results show elevated cardiac enzymes and troponin" rel="nofollow">in levels and cholesterol level of 8.9mmol/L. His ECG in" rel="nofollow">indicates that he has a ST segment elevated myocardial in" rel="nofollow">infarction. Mr Savea was admin" rel="nofollow">inistered sublin" rel="nofollow">ingual glyceryl trin" rel="nofollow">initrate followed by morphin" rel="nofollow">ine 2.5 mg IV for pain" rel="nofollow">in in" rel="nofollow">in the emergency department. He reports bein" rel="nofollow">ing pain" rel="nofollow">in free on admission to CCU. Case Study 2: Cushin" rel="nofollow">ing’s Syndrome Ms Maureen Smith is a 24 year old female who presented to her GP for ongoin" rel="nofollow">ing gastroin" rel="nofollow">intestin" rel="nofollow">inal bleedin" rel="nofollow">ing, abdomin" rel="nofollow">inal pain" rel="nofollow">in and fatigue which has been worsenin" rel="nofollow">ing, and was referred to the local hospital for further in" rel="nofollow">investigation. Maureen was diagnosed with rheumatoid arthritis (RA) when she was 15 years old, and has experienced multiple exacerbations of RA which have required the use of high dose corticosteroids. She is currently takin" rel="nofollow">ing 50mg of prednisolone daily, and has been takin" rel="nofollow">ing this dose sin" rel="nofollow">ince her last exacerbation 2 months ago. Maureen also has type 2 diabetes which is managed with metformin" rel="nofollow">in. She is currently studyin" rel="nofollow">ing nursin" rel="nofollow">ing at university and works part-time at the local pizza restaurant. On assessment, Maureen’s vital signs are: PR 88 bpm; RR 18 bpm; BP 154/106 mmHg; Temp 36.9ºC: SpO2 99% on room air. She has a body mass in" rel="nofollow">index (BMI) of 28kg/m2 and thefat is main" rel="nofollow">inly distributed around her abdomin" rel="nofollow">inal area, as well as a hump between her shoulders. Maureen’s husband notes that her face has become more round over the past few weeks. Her fastin" rel="nofollow">ing BGL is 14.0mmol/L. Blood test results show low cortisol and ACTH levels, and high levels of low density lipoprotein" rel="nofollow">in cholesterol. She is awaitin" rel="nofollow">ing a bone min" rel="nofollow">ineral density test this afternoon, and is currently collectin" rel="nofollow">ing urin" rel="nofollow">ine for a 24-hour cortisol level measurement. Case Study 3: Decompensated Liver Cirrhosis Mr Ronald Stone is a 47-year-old man who was brought in" rel="nofollow">in by ambulance to emergency department with haematemesis. Accordin" rel="nofollow">ing to his partner he vomited a total of 300 mL of fresh blood this mornin" rel="nofollow">ing. He reported that he has been spittin" rel="nofollow">ing blood stain" rel="nofollow">ined sputum for the last few weeks with no associated cough or shortness of breath. For the past 3 days he has complain" rel="nofollow">ined of in" rel="nofollow">increasin" rel="nofollow">ing abdomin" rel="nofollow">inal pain" rel="nofollow">in but with no diarrhoea or black stools. Mr Stone tested positive for Hepatitis C virus (HCV) genotype 1A in" rel="nofollow">in June 2010. He has cirrhosis and a history of heavy alcohol use, although he no longer drin" rel="nofollow">inks. He ceased in" rel="nofollow">intravenous drug use 10 years ago, and stills smokes tobacco and marijuana on a daily basis. He used to work with City Rail but has been made redundant 13 months ago and has been unemployed sin" rel="nofollow">ince. He lives with his partner and 2 young children from a previous marriage. On assessment Mr Stone’s vital signs are: PR 112 bpm; RR 24 bpm; BP 105/64mmHg; Temp 37.4 °C; SpO2 94% on room air. He has a body mass in" rel="nofollow">index (BMI) of 31.5kg/m2. He islethargic but orientated to time, place and person. He has a swollen and tight abdomen typical of ascites and bilateral leg oedema. Blood test results show Hb 85 g/L, decreased WBC, platelets and albumin" rel="nofollow">in, and a marked in" rel="nofollow">increase in" rel="nofollow">in both serum ammonia and total bilirubin" rel="nofollow">in levels. 6 months ago he underwent an eosophagogastroduodenostomy (EGD) which showed grade 2 oesophageal varices. He is ordered the followin" rel="nofollow">ing medications: Vitamin" rel="nofollow">in K 1 mg IV stat, aldactone 25mg PO TDS, lactulose 15mls PO TDS, and vitamin" rel="nofollow">in B12 100mg IV TDS. He is awaitin" rel="nofollow">ing a CT abdomen scheduled for this afternoon. Q 1: Outlin" rel="nofollow">ine the causes, in" rel="nofollow">incidence and risk factors of the selected disease and how it can impact on the patient and their family (400 words) : Lin" rel="nofollow">inked to case study. Provides comprehensive identification of causes, in" rel="nofollow">incidences and risk factors. Provides comprehensive understandin" rel="nofollow">ing of the disease impact on patient and family. Q 2: List five (5) common signs and symptoms of the selected disease, and for each one provide a lin" rel="nofollow">ink to the underlyin" rel="nofollow">ing pathophysiology (350 words) : Provides a comprehensive look at the identified five (5) common signs and symptoms. Provides a comprehensive lin" rel="nofollow">ink to pathophysiology. Q 3: Describe two (2) common classes of drugs used for patients with the selected disease in" rel="nofollow">includin" rel="nofollow">ing physiological effect of each class on the body (350 words) : Two (2) classes of drugs appropriately identified. A comprehensive understandin" rel="nofollow">ing and explanation of the physiological effects on the body. Q 4: Identify and outlin" rel="nofollow">ine, in" rel="nofollow">in order of priority the nursin" rel="nofollow">ing care strategies you, as the registered nurse, should use within" rel="nofollow">in the first 24 hours post ED admission for this patient (500 words