Neurological Disorders Case Study [WLOs: 1, 2] [CLOs: 1, 2]
Prior to beginning work on this discussion forum, read Chapter 15 of your course text.
For this discussion, you will pick one of the cases listed in the Week 5 Discussion – Case Studies Download Week 5 Discussion – Case Studiesdocument, and take on the role of the clinician.
In your initial post,
Identify the patient’s symptoms and the available demographic and historical data.
Discuss your differential diagnosis and provide a thorough basis for any diagnoses you have included.
Determine what (if any) additional testing you would order and how this would be helpful in clarifying the diagnosis.
Finally, explain recommendations for the patient/family for ongoing functioning (social, occupational and academic, if applicable).
You must use a minimum of two peer-reviewed articles in your discussion to support your diagnostic conclusions.
To assist you with your research consider using the library’s Scholarly, Peer-Reviewed, and Other Credible Sources (Links to an external site.) tip sheet.
An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.
Assignment (1- to 2-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following:
Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.
Scenario: A 58-year-old obese white male presents to ED with chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl.
All papers submitted must include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting
Develop an instructional brochure on the nutritional aspects of the disorders below:
Type 2 Diabetes
Include in your brochure all points below:
Explanation of the pathophysiology of the disorder. Provide 4 risk factors OR 4 symptoms of the disorder.
Two common medications used for the disorder. Explain how medications work to treat the disorder. Include 3 nutritional considerations for each medication.
Identify an evidence-based diet to prevent or reduce the incidence of the disorder.
Include at least 3 specific foods that should be included in the diet, provide rational for why foods should be included in the diet for this disease process.
Include at least 3 specific foods that should be avoided in the diet, provide rational for why the foods should be excluded from the diet for disease process.
Examples of Evidence-based diets:
Dash diet
Mediterranean diet
Low carb diet
Low sodium diet
Low fat diet
Modified fiber and bland diet
Protein restricted
High protein diet
Include the information for at least 2 patient resources. One resource on the evidence-based diet and 1 resource on the disorder. Include name of organization and URL for the citation.
Include images or clipart to support your information. Trifold brochure should look professional.
Include at least 2 evidence-based references (less than 5 years old) included in your brochure to support your information. Proper use of in-text citations and references in APA Style
You have studied the 7-step troubleshooting process. For this discussion, provide a thread consisting of the “write up” or symptoms of an aircraft system failure that would be found in the discrepancy record from the flight crew.
The thread must also include a system description, a schematic, and/or a diagram of the system that provides enough information for classmates to determine the probable cause(s) of the failure based on the symptoms. Do not identify how the issue was resolved in your initial post.
Before write thread read whole chapter 4 and learn 7 step of troubleshooting process. https://pdfroom.com/books/troubleshooting-a-technicians-guide-second-edition/8Pe5xr0ZgnN
DISCUSSION ASSIGNMENT INSTRUCTIONS
Discussions are collaborative learning experiences. Therefore, the student will create a thread in response to the provided prompt in the Discussion. Each thread must demonstrate course-related knowledge. The thread must contain at least 500 words. For each thread, the student must support his/her assertions with at least two scholarly citations in APA format. Any sources cited must have been published within the last five years. Acceptable sources include the most current sources you can find which likely means the Internet. Make sure to cite all facts in text.
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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:
What is the disorder and its pathophysiology that you expect the health care provider to diagnose and treat?
Describe the etiology of the disorder A.M is experiencing.
Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
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.
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Enjoy Please Note-You have come to the most reliable academic writing site that will sort all assignments that that you could be having. We write essays, research papers, term papers, research proposals. 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
In your own words, explain the symptoms of the disorder you have identified.
Briefly explain the etiology of this disorder; be specific.
Based upon your perceptions as to the etiology, provide some specific current treatment options.
On the Internet, find at least one organization that would be an excellent resource for clients or family members who suffer from this disorder. Briefly discuss what the organization provides and make sure to list the URL and the name of the organization.
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1. Specify when to refer the patient after therapy and why? Provide rationale.
Given E.D.’s past medical records, her history of obesity and diabetes mellitus further worsens the symptoms of Onychomycosis. After completing her therapy, E.D. needs to receive follow-up treatment and care from different types of specialists in order to better manage her health conditions. A podiatrist needs to provide E.D. with assistance in maintaining hygiene and self-care practices for her infected feet (Nijenhuis-Rosien et. al, 2019, p. 2145). E.D. also needs to receive treatment from an endocrinologist in order to manage her diabetes mellitus. The endocrinologist needs to help E.D. implement self-care practices to improve her cardiovascular health, which will lead to reducing the severity of her Onychomycosis symptoms (Nijenhuis-Rosien et. al, 2019, p. 2145). E.D. should also receive guidance from a nutritionist in order to make important changes to her diet and physical health. E.D. should exercise regularly to reduce her obesity levels, and should make changes to her diet to improve her nutrition (Nijenhuis-Rosien et. al, 2019, p. 2145).
2. According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis?
There are a number of alternatives that E.D. can implement based on recommended guidelines. One of the common non-pharmacological approaches is for E.D. to receive nail avulsions by removing her nail. This can occur through a number of different processes. Chemical removal is common if E.D. has thick nails, and can be carried out by using urea in order to enable the nail to easily be removed (Polat et. al, 2020, p. 219). The nail plate has to be removed in cases where E.D. has a severe infection. Other alternatives include laser treatment, in which a laser is used to kill cancerous or infected cells. Light energy treatment
called photodynamic therapy can also be used in order to use light to destroy
cancerous or infected cells. Nail avulsion can also occur through surgical or
mechanical removal processes (Polat et. al, 2020, p. 218).
3. Provide patient education. Keep in mind the past medical history of this patient.
Patient education would begin by informing E.D. about the way to keep her infected feet clean and dry. E.D. should be instructed to maintain hygiene practices in order to ensure that her nails are dry and clean at all times (Polat et. al, 2020, p. 218). This includes instructing E.D. about the correct way to rinse her infected feet, which includes cleaning in between the toes. E.D. should also be informed about the correct way to dry her feet area, and to use dry powders if she feels that she is sweating in her feet area during the day. Another aspect of E.D.’s self-care is to conduct a self-check of her nails to identify any signs and symptoms of deterioration (Polat et. al, 2020, p. 218). In the event that her feet worsen, E.D. needs to visit a physician to provide timely intervention. E.D. should also use barriers to protect her feet, such as flip-flops or shoes that prevent her infected from being exposed to contaminants. This is important in public spaces where infectious agents are found, such as the floors of public swimming pools. When clipping her nails, E.D. should disinfect the nail clippers with isopropyl alcohol to eliminate any infectious agents. E.D. also needs to regularly monitor her blood glucose levels, exercise regularly, and improve her nutrition to manage her diabetes mellitus and obesity (Polat et. al, 2020, p. 218).
Nijenhuis-Rosien, L., Kleefstra, N., van Djik, P.R., Wolfhagen, M.J.H.M., Groenier, K.H. (2019, Mar. 28). Laser therapy for onychomycosis in patients with diabetes at risk for foot ulcers: a randomized, quadruple-blind, sham-controlled trial. Journal of European Academy of Dermatology and Venereology, 33(11); 2143-2150.
Polat, A.K., Belli, A.A., Karaali, M.G., Aksu, A.E.K. (2020, Jul. 21). The attitudes, behaviors, and opinions about non-pharmacological agents in patients with tinea pedis. Journal of European Academy of Dermatology and Venereology, 21(7); 214-221.
Jennifer
1. Specify when to refer the patient after therapy and why? Provide rationale.
E.D. has a medical history that includes diabetes and obesity, which further worsens the onset of Onychomycosis. As a result, it is important for E.D. to immediately be referred to a specialized care clinic. E.D. needs to receive medical attention from a podiatrist that will provide directed care based on her health conditions and nail (Romero-Cerecero et. al, 2020, p. 1678). Additionally, an endocrinologist tis needed to conduct an evaluation of E.D. to provide follow-up care. This includes ongoing treatment for type 2 diabetes mellitus, which provides predisposition to dermatological diabetes. Since E.D. has diabetes metillus and onychomycosis, there can be worrisome symptoms in her feet if E.D. does not receive timely treatment. One of the recommended interventions is to make dietary changes by working closely with a nutritionist in order to reduce her body mass index and improve her diet (Romero-Cerecero et. al, 2020, p. 1678).
2. According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis?
The CDC recommends a number of nonpharmacological treatments for
onychomycosis. One of the recommended approaches is laser treatment, in which the
fungal infection is surgically removed. Another recommended intervention is
photodynamic therapy, which occurs through a two-step process (Hassan et. al,
2020, p. 237). The first step features light energy treatment that destroys cancerous
cells along the nail. However, the second step is a form of pharmacological treatment,
in which photosensitizer drugs are used to treat the nail disorder. A third
approach is to conduct nail avulsion through mechanical, surgical, or chemical
processes (Hassan et. al, 2020, p. 236). If E.D. has thick nails, chemical
removal can be used with a compound of 40 to 50% urea in order to improve the
nail avulsion process (Hassan et. al, 2020, p. 236). In some cases where there
is severe infection, the nail plate can be removed, but E.D. would have to take
oral therapy to treat her symptoms.
3. Provide patient education. Keep in mind the past medical history of this patient.
There are a number of important aspects of the patient education process that are important to improve self-care practices. First, E.D. must maintain good hygiene to keep her nails clean and dry. E.D. needs to thoroughly wash her hands and clean in between her toes. E.D. needs to continue to monitor the progress of her nails and visit a physician immediately if any issues arise. Drying powders can be used to keep her feet dry. E.D. needs to avoid exposure to public spaces that can harbor bacteria, such as changing rooms, swimming pools, and gym lockers. It is important to use barrier methods in these areas by wearing flip flops or socks to avoid direct exposure to bacteria (Hassan et. al, 2020, p. 236). E.D. should also take measures to clean and disinfect her nail clippers with rubbing alcohol. E.D. should also avoid sources that could harbor bacteria, such as old shoes or footwear that is shared with family members. E.D. should work with a nutritionist to manage her weight through dietary interventions and regular physical exercise. E.D. should also monitor her blood sugar levels daily to reduce the impact that obesity and diabetes mellitus has on her onychomycosis symptoms (Hassan et. al, 2020, p. 236).
Hassan, N., Dhamija, P., Bharti, V., Vishwakarma, S., Mansoor, S., Iqbal, Z. (2020, Mar. 31). Clinical tools for successful treatment of onychomycosis: a narrative review. Journal of Drugs &
Therapy Perspectives, 36(21): 236-242.
Romero-Cerecero, O., Islas-Garduno, A.L., Zamilpa, A., Tortoriello, J. (2020, Feb. 22). Effectiveness of an enecalin standardized extract of Ageratina pichinchensis on the treatment of onychomycosis in patients with diabetes mellitus. Journal of Psychotherapy Research, 34(7); 1678-1686
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The purpose of this theory is that it accentuates the intricacy and interaction of the symptoms bringing out their interrelationships. The main purpose is ensuring that the factors that affect the symptoms, the results and the repercussions are brought to the fore to facilitate the preparation of nursing interventions in pediatric oncology. It ensures that the symptoms clusters are testable in an empirical resulting in pragmatic adequacy (Lee, Vincent, & Finnegan, 2017).
Q-2
It brings out a more detailed way of experiencing cancer symptoms iteratively. It provides more examples in demonstrating the implications of the symptoms in a revised manner, and its application in practice. A more revised way of this theory describes the interactions of the symptoms encouraging successful breastfeeding as a result of a multifaceted intervention.
Q-3)
This theory was introduced in 1995, and it adds to the existing information concerning a variety of symptoms. It incorporates three major facets: the symptoms that a patient is portraying, factors that influence them, and, factors that gives rise to that type of symptoms and the effects of the symptom experience. Every symptom is dealt with in a multidimensional familiarity and can be measured with the others, or they can be measured independently(Lee, Vincent, & Finnegan, 2017).
Q-4)
It is presented so that the nurses can understand that physiological, psychological and situational factors are capable of influencing multiple symptoms. This can in turn influence the performance of the individual. At the same time, the nurses should realize that the performance results can loopback to impact the symptom experience itself; it can as well alter the influencing factors. Thus, the nurses should understand that this theory can be applied in a different setting in understanding the symptoms affecting the patients, even though particular nursing interventions are presently lacking in theory(Lee, Vincent, & Finnegan, 2017).
Q-5)
The theory gives nurses a way of dealing with the new cluster of symptoms as it proposes non-pharmacological mediations symptom management and measurement. It makes them combine clinical practices with theory, and it facilitates the exploration of the science of nursing plus its respective theories.
Q-6)
The primary assumption is that there are interrelationships that exist among various symptoms that are presented by this theory is daunting. In case the symptoms are surveyed in their totality, the nursing interventions are thus created from the interactive nature of symptoms, the interventions thus are specific and can be personalized for every patient, and they can be termed effective.
Q-7)
It is used in nursing to combines concepts that are related to…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….. Theory of Unpleasant Symptoms Critique
You are seeing a client who has recurring symptoms of endometriosis. She is interested in reviewing her options for family planning advice. She is six weeks postpartum and did not start a birth control method since delivery. What would be in your care plan? What would you advise regarding family planning methods? 2. A client presents to you with a complaint of perineal itching. What are your differential diagnoses, and how would you go about determining the diagnosis? You might want to create a table to which you can refer. Cite sources. What would you consider to be your best source of up-to-date information? Have you ever called up the CDC for information? What would you discuss regarding partner management? 3.Your client comes in stating that she “always gets yeast infections” and that she has one again. You verify this diagnosis with a wet mount that supports your inspection and speculum exam. How would you approach management? What differential diagnosis as to etiology would you include? What additional testing would you consider? 4. Your client presents complaining of “a swollen lump down there.” What would your initial differential diagnoses include? What parts of your physical assessment would help with your diagnosis? What labs would be indicated? For each possible diagnosis (relate directly to this primary symptom), what would be your treatment plan? If you needed to wait for lab results, what measures might be taken immediately until diagnoses are confirmed?
The main objectives of family planning is to avoid unwanted pregnancies, control the number of children, manage the intervals between children, prevent women with genetic diseases from getting pregnant and control the time in which the pregnancy occur. As a medical profession, it is important to develop a comprehensive care plan for the patient(Kjetland, et al, 2008). While developing a care plan, the following factors should be considered personal lifestyle, support programs, willingness of the patient to cooperate, cost, sexual expression, psychological and medical contraindication, and social, cultural and religious orientation. It is important to assess the health of a patient as well as medical history in order to ensure the family planning method recommended is effective and appropriate.
Depending with the outcome of the health assessment, I would advise the patient to consider some of the following family planning methods, natural family planning methods which include calendar/rhythm, cervical mucus, basal body temperature, symptothermal and coitus interrupts: Barrier methods such as spermicide, female condom, male condom, cervical cap, diaphragm and intrauterine device: p………………………………………………………………………………………………………………………………………………………………………………………………………………………………….
………………………………………………………………Recurring symptoms of endometriosis………………………………………………………………………………………………………………………………………………………………….
