Health History

I’m studying for my Writing class and need an explanation.

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 Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two 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.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Rubric

Due Date: 04-Aug-2019 at 11:59:59 PM

Follow directs attached and rewrite the entire paper so it doesn’t pick up plagiarism.Preparing the assignmentFollow these guidelines when completing this assignment. Speak with your faculty member if you have questions.1. Complete a health assessment/history on an individual of your choice who is 18 years of age or older and NOT afamily member or close frienda. The purpose of this restriction is to avoid any tendency to anticipate answers or to influence how the questionsare answered. Your goal in choosing an interviewee is to simulate the interaction between you and an individualfor whom you would provide care.b. Inform the individual that information obtained will be kept confidential and do not use identifying informationwithin the assignment.c. The Health History Worksheet can be used to help you organize the Family Medical History information you willobtain from the Adult Participant (document link is on the Assignment page).d. The use of this tool is optional. There are three parts to this assignment.2. Include the following sections when completing the assignment.a. Health History Assessment (70 points/70%)1) Demographics2) Perception of Health) Past Medical History4) Family Medical History5) Review of Systems6) Developmental Considerations7) Cultural Considerations8) Psychosocial Considerations9) Collaborative Resourcesb. Reflection(20 points/20%)Reflection is used to intentionally examine our thought processes, actions, and behaviors in order to evaluate outcomes. Provide a written reflection that describes your experience with conducting this Health History.1) Reflect on your interaction with the interviewee holistically.a) Describe the interaction in its entirety: include the environment, your approach to the individual,time of day, and other features relevant to therapeutic communication and to the interviewprocess.2) How did your interaction compare to what you have learned?3) What barriers to communication did you experience?a) How did you overcome them?b) What will you do to overcome them in the future?4) What went well with this assignment?5) Were there unanticipated challenges during this assignment?6) Was there information you wished you had available but did not?7) How will you alter your approach next time?c. Style and Organization (10 points/10%)Your writing should reflect your synthesis of ideas based on prior knowledge, newly acquired information, and appropriate writing skills. Scoring of your work in written communication is based on proper use of grammar, spelling, APA, and how clearly you express your thoughts and reasoning in your writing.1) Grammar and mechanics are free of errors.2) Verbalizes thoughts and reasoning clearly.3) Uses appropriate resources and ideas to support topic with APA where applicable.