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G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic

 Instructions: Response must be 510 words per case study written in current APA format with at least two academic references cited. References must be within the last five years. 1020 words in total.

Musculoskeletal Function:
G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.

Case Study Questions

  1. Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
  2. Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
  3. Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
  4. How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.

Neurological Function:
H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.
Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.

Case Study Questions

  1. Name the most common risks factors for Alzheimer’s disease
  2. Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
  3. Define and describe explicit and implicit memory.
  4. Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
  5. What would be the best therapeutic approach on C.J
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Writers Solution

A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days

Using the case study below, prepare a 2 – 3-page paper.

A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, her skin is warm and flushed, and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.

You get more information from A.M. and learn the following:

  • She had some readings on her glucometer which were reading ‘high’
  • She vomits almost every time she takes in fluid
  • She hasn’t voided for a day but voided a great deal the day before
  • She’s been sleeping long hours and finally woke up this morning and decided to seek care

Current labs and vital signs:

  1. What is the disorder and its pathophysiology that you expect the health care provider to diagnose and treat?
  2. Describe the etiology of the disorder A.M is experiencing.
  3. Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
  4. Identify and describe the expected treatment options for A.M. based on the disorder and clinical manifestations.

Instructions:

Summarize the questions above and formulate what may be happening with A.M. and how you would improve her condition.

Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.

You can find useful reference materials for this assignment in the School of Nursing guide: https://guides.rasmussen.edu/nursing/referenceebooks

Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa

Case study adapted from:

Harding, M.M. & Snyder, J.S. (2015). Winningham’s critical thinking cases in nursing: Medical-surgical, pediatric, maternity, and psychiatric. Retrieved from: https://ebookcentral.proquest.com/lib/ras/detail.action?docID=2072336.

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Writers Solution

The RN is working in a pediatric clinic.

Assignment details: The RN is working in a pediatric clinic. Mrs. S. reports her 5-year-old has a sore throat, nasal congestion and frequent episodes of crying that have been going on for two days. After being examined by the pediatrician, the child is diagnosed with a cold. Mrs. S. tells the RN: “I am confused. I thought the doctor would have given me a prescription for my child to get an antibiotic. I don’t want anyone else in my family to be sick!”

Initial Discussion Post:

Based on the statements made by the parent, what nursing diagnosis is a priority for this patient?
What outcome should the RN establish for the priority nursing diagnosis?
Using evidence based guidelines, identify an intervention that the RN would implement to help this patient reach the outcome.
Base your initial post on your readings and research of this topic.

The Week 4 DQ basically pertains to a nursing care plan for this scenario. Please be reminded of the following:
Nursing diagnosis should include the diagnosis, related to _ as evidenced by___
Outcomes need to measurable and time specific
Interventions should be specific to this patient/parent situation rather than generic

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Introduction

            The first priority for the nurse is to determine whether the infection was as a result of virus or bacteria in order to make informed decision. Nonetheless, the analysis of the case study indicated that the cold is caused by viral infection. This means that the first priority of the RN nurse is to inform the Mrs. S. that the doctor could not prescribe antibiotics because the infection was as a result of virus which could not be prevented and treated by antibiotics(Fashner, Ericson, & Werner, 2012). The important thing that RN nurse should do is to make sure that Mrs. S. understand that antimicrobial agent, in others words antibiotics which she was anticipating to be prescribed does not affect virus or reduce the chances of bacterial complication. Also, the nurse should inform Mrs. S. that continued use of antibiotics make the organism to be resistant to the therapy that is why the doctor did not prescribed for antibiotics.

What the RN nurse should establish from diagnosis

            The appropriate prescription for Mrs. S. is to allow the baby to have enough rest, increase the fluid intake for the baby and give ibuprofen to reduce pain and discomfort. The management of cold involves the use of symptomatic therapy which include the prevention of chilling, adequate intake of fluids as well as the use of expectorant as much as possible(Pratter, 2006). Also, prescribing the Mrs. S. to give the baby warm saltwater gargles which helps in the management of sore throat. In addition, the nurse should consider prescribing non-steroidal anti-inflammatory drugs (NSAIDS) which is ibuprofen………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

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……………………………………………………………………………..The RN is working in a pediatric clinic……………………………………………………………………………………………………………………………………………………

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