University of Nevada, Las Vegas NURS 320 Pathophysiology and...

QuestionUniversity of Nevada, Las Vegas NURS 320 Pathophysiology and… University of Nevada, Las VegasNURS 320 Pathophysiology and Pharmacology for Nursing IIPaper: Unfolding Case StudyParkinson’s Disease (PD)Directions:1. Download this document and save in Word adding your first name initial and last name to the end of the document title: for example, save as Unfolding Case Study-PD-MJones.2. Answer all of the questions. Use APA for references and through the paper when appropriate and necessary.3. References: It is acceptable to use your course text but you also must use 3 additional reference sources and at least two of them MUST be current journal articles (no older than 5 years).3. Following completion, upload to the appropriate place in the Assignments section by the due date and time.4. This is NOT a group assignment and you must complete this assignment on your own. This paper is worth 25% of your course grade. Refer to the Course Evaluation section of your syllabus. Current Situation:Jill Henderson is an 82-year-old female and is a new resident of a long-term care facility known as Mead Health Care Center. Jill has a history of gastroesophageal reflux disease (GERD) and Parkinson’s disease. Medications include carbidopa-levodopa (25mg carbidopa/100mg levodopa) oral three times a day; and nizatidine 150mg oral twice daily. Jill was hospitalized three months ago at a local hospital known as Lima Hospital due to a urinary tract infection (UTI) and dehydration. Prior to her hospitalization, she resided at home and her daughter Stephanie lived with her and cared for her. Jill’s Parkinson’s disease progressed and she is beginning to experience tremors and her daughter was no longer able to care for her because of a new job that required quite a bit of traveling. Jill had not been eating well or drinking adequate amounts of fluids. She lost ten pounds in the month prior to hospitalization. She is 5 feet-6 inches tall and weighs 110 pounds; BMI (body mass index) is 17. Her daughter Stephanie traveled on a business trip for 1 week after Mary was admitted to Mead Health Care Center. On her return from her trip, Stephanie went to visit her mother and found her sitting in her room alone staring out the window. Stephanie sought out the nurse and said: “My mother just sits staring out the window and does not look at me when I call her name. She looks thinner than when she arrived here, I thought she would improve by being here.” Personal/Social History:Jill was married for 50 years to her husband Jack. They had one daughter, Stephanie. Jill lived alone in her home that she and Jack resided for all of their married years. After Jack’s death 2 years ago, Jill moved in with her daughter Stephanie. Stephanie is unmarried and has no children. Stephanie has medical power of attorney and health care proxy for Jill’s healthcare decisions. Prior to her current illness, Jill was very active in the church and community. She was a secretary for 20 years at a local factory. Her hobbies include crocheting and knitting and reading. Jill reluctantly agreed to go live at Mead Health Care Center after Stephanie accepted a job that required her to travel.1. Recognize Cues -this is the skill of identifying significant data. There are 2 Parts to this question:a). What data from the current situation and personal/social history are RELEVANT CUES and significant data? Identify 5 cues from the current situation. Identify 3 from the personal/social history. b). For each RELEVANT CUE (significant data) recognized, describe its clinical significance. – Five RELEVANT CUES from Current Situation:- Clinical Significance: – Three RELEVANT CUES from Personal/Social History: – Clinical Significance: 2. What is Parkinson’s Disease? Include a brief description, manifestations (list 6), pathophysiology, and general treatment (list 3). Brief Description a- Manifestations (List 6 of them) 1.2.3.4.5.6. b- Pathophysiology c- General Treatment (List 3)(It can be both pharmacological and nonpharmacological: Please do not list three medical drugs, drug therapy is only treatment) 1.2.3. 3. What are the contraindications of carbidopa-levodopa? (List 4) Contraindications: — 4. What is the rationale for avoiding vitamin B6 intake when taking levodopa? Rationale: – 5. What is the drug classification of nizatidine? Drug Classification:– 6. Why is Jill receiving nizatidine? 7. Analyzing cues – this is the skill of connecting the data to the client’s presentation and identifying hypotheses.Analyzing the relevant cues (data), what are the primary physiological problems (hypotheses) for Jill? What is the pathophysiology of each problem? (list 2) Note: Do not use the same problem listed in Q. 2. (please support your answers with citations). Two Problems: Pathophysiology of Problem in OWN Words:1–2- Progress NotesThe nurse performs an assessment on Jill and calls the primary health care provider (PHCP) to report results.The PHCP prescribes the following.Referral to a speech pathologistReferral to an occupational therapyReferral to physical therapyWeekly weightsDietary consultMVI (multivitamin) 1 tab po dailyBasic metabolic profile (BMP) and Complete blood cell count (CBC) 8. Generating solutions – – this is the skill of using hypotheses to determine interventions for an expected outcome.PRIORITY Setting: Which prescriptions do you plan to implement (in order of priority) and why (rationale)? Note: Prioritize the PHCP prescription provided above. DO NOT create your own interventions. – Order of Priority at least 5 – Rationale at least 5 (1 rationale for each order of priority) Taking actions – this is the skill of implementing the generated solutions addressing the highest priorities or hypotheses. Evaluate outcomes – this is the skill of comparing your observed outcomes with expected ones. 9. The nurse has created a plan of care and has listed the following interventions in the plan. -First, write one rationale for each listed Nursing Intervention- Second, write one expected outcome for each intervention. Nursing Interventions: give me at least 1 Rationale:and 1 Expected Outcome: for each Nursing Interventions: below – Assess self-feeding abilities; consider assigning a staff member to assist with eating if needed. – Weigh weekly; calculate BMI – Note serum albumin level as available – Monitor food intake; record percentages eaten -Provide companionship and a homelike environment at meal time – Administer MVI po daily Follow-upJill has slowly adjusted to her new home at Mead Health Care Center. She now eats in the dining room with others and has an assigned feeding assistant for meals times. Intake and output’s (I&Os) are monitored daily as well as weekly weights. A registered dietitian has developed a meal plan and snacks specific to her food preferences. A speech pathologist has evaluated her ability to swallow and is currently working with her to strengthen muscles and maintain range of motion. Occupational therapy has evaluated Jills’s ability to perform activities of daily living (ADLs) and she now has adaptive tools to assist her ADLs. Physical therapy is working with Jill to maintain mobility. Interprofessional meetings are held monthly. Jill and her daughter Stephanie are invited to attend to discuss progress and express any concerns.Case Study adapted with permission from: Keith Rischer, RN Health ScienceScienceNursingNURS 320Share Question