Case study assigments.

THINK LIKE A NURSEInfection (Case Study 127)
N222 SP 2023 EXERCISE – 50 points
Requirements: Full credit for this exercise will be based on the following:
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Adhere to the information in the scenario.
Concisely answer the questions.
Provide at least one paragraph for each question.
Remember a paragraph has at least 3 statements.
Responses must be well researched & provide nursing rationale.
There must be references for each answer.
References must be in APA format.
M.R., who is 81 years old, lives alone in a senior citizens apartment complex. After she missed
several planned holiday activities, and a neighbor knocked on her door to check on her, M.R.
Answered the door and said that she has had a cold for four days and did not want to spread it
to others. She said, “it happened so fast, and it just won’t go away. It seems to be getting worse
no matter what I do.” She said, she felt very achy and weak, with a headache and has had no
appetite, but did not want to bother her son, who is very busy with his job. M.R.’s neighbor
convinced her to call her health care provider (HCP), whose office is in the same building. The
nurse at the office asked M.R. to come immediately for a visit. When she arrived at the office,
the HCP called for an ambulance to take M.R. to the hospital. you place a mask on M.R. in
anticipation that she may have influenza. M.R. has a history of hyperlipidemia and
osteoarthritis in her knees.
1
List the “cue’s” from this scenario, and identify them as objective or subjective
data. (4 Points)
2
Answer
What causes influeza? (2 Points)
3
Listed below are characteristics of the common cold and influenza. List the ones
that are typical to influenza only. Provide rationale. (6 points)
a. Abrupt onset
b. Gradual onset
c. Fever
d. Headache
e. Exhaustion
f. Sore throat, stuffy nose, sneezing
g. May be prevented with a vaccine
Answer
4
What symptoms indicate that M.R. has influenza? Provide rationale for your
answer. (5 Points)
Answer
5
Are there any diagnostic tests for influenza? Will they be used for M.R.? Explain.
(2 Points)
Answer
M.R. is admitted to a general medical unit and placed on droplet precautions. She is instructed
to remain on bed rest with bathroom privileges, and “Fall Risk” measures are posted because
of her weakness. An IV of D51/2NS at 75 mL/hr is started. In addition to her home medication
for hyperlipidemia, other orders include acetaminophen, 650mg PO every 4 hours as needed
for pain or for temperature over 101o F. Her vital signs are BP 110/72, P 110, R 13. T 102.4o
F. She is told by the admitting HCP that she most likely has the flu.
6
M.R. states, “How can I have the flu? I had a flu shot last year!” What is your
best response? (2 points)
Answer
7
According to the Centers for Disease Control and Prevention (CDC), when is the
flu season and when is the best time to receive the vaccine? (2 Points)
Answer
8
Answer
Which of these statements about droplet precautions is correct? Provide rationale.
(2 Points)
a. These precautions are used to prevent the spread of tuberculosis.
b. Droplet precautions prevent the spread of pathogens by direct contact.
c. Droplet precautions are used to protect the patient from pathogens that
may be carried by health care workers.
d. These precautions are used to minimize contact with pathogens that are
spread to the respiratory tract through the air.
The HCP also orders oseltamivir (Tamiflu), 75 mg PO twice daily for 5 days. M.R. expresses
relief that she is receiving this drug because “it will cure the flu”.
9
True or false? Does Tamiflu cure the flu? Rationale. (2 Points)
Answer
10
Explain the reason for the order for Tamiflu, even though M.R. has had the flu
for several days. (2 Points)
Answer
11
Which measure will be part of M.R.’s treatment as she recovers from influenza?
Select all that apply and provide rationale. (5 Points)
Answer
12
Which assessment findings if noted with M.R., would continue to concern you?
Select all that apply and provide rationale. (6 Points)
Answer
At the change of shift, M.R. calls for help to get up to the bathroom. Before the UAP arrived,
M.R. decided to get up by herself and fell. The UAP found her on the floor and called for help.
M.R. was placed back into the bed and you assess her. M.R. said she did not hit her head and
told the nurse she thinks she hurt her left knee. The on-call hospitalist was notified, and an xray of the knee showed no break.
13
What placed M.R. a risk for falls when she was admitted? (2 Points)
Answer
14
Answer
Name at least 4 measures to prevent future falls. (4 Points)
15
Per the hospital’s policy, an incident report will need to be completed after
M.R.’s fall. Which statement about an incident report is correct? Provide
rationale. (2 Points)
Answer
17
Answer
Case study Outcome:
M.R. is discharge back to her apartment, but she still gets easily tired from
activity. Over the next few weeks, she gradually returns to her usual activities. At
the 6-week checkup, her HCP offers her the flu shot. “It’s still wintertime, and
even though you’ve had the flu, this may still offer some immunity against other
strains of the flu.” M.R. agrees to receive the vaccine. She plans to get the
influenza vaccine next year in early September.
List 2 priority nursing diagnosis with 1 measurable goal and 3 interventions each.
10 Points)
Priority Nursing Diagnosis:
1.
2.
Measurable Goal ND #1
1.
Measurable Goal ND #2
1.
Interventions ND #1:
1.
2.
3.
Interventions ND #2:
1.
2.
3.
References
(2 Points)