walden nurs6560 week 4 discussion latest 2017 october

Week 4 discussion

Discussion Part I:
Assessment and Care of Patients With Cardiovascular Conditions

Many cardiac disorders such as myocardial infarctions are a
common problem in the acute care setting. Thus it is essential for you, as the
advanced practice nurse caring for acute patients, to identify potential signs
and symptoms of complications. Although some cardiac disorders require
outpatient treatment and management, other procedures such as CABGs or valve
replacements are more common and frequently require major interventions. In
your role with acute cardiac patients, you must evaluate symptoms and determine
how to treat patients. For this Discussion, consider potential diagnoses,
treatment, and/or referral options for the patients in the following 3 case
studies.

Case Study 1: Tom is 56-year-old African American male who
presented to the ED with chest pain radiating to his back. The pain has been
continuous for 1 hour. The patient complains of shortness of breath. The pain
has not been relieved with rest. The patient’s vitals are: 99.1-98-18-198/110.
The patient’s cardiac enzymes are negative. Labs results are as follows:

Na 134

K 4.1

Cr 1.8

BUN 42

Glucose 248

WBC 13.1

Hbg 14.1

Hct 44.2

Plt 236

EKG sinus rhythm no ekg changes

Case Study 2: Liz is a 79-year-old female with a history of
aortic stenosis and hypertension. The patient underwent elective aortic valve
replacement yesterday. This AM during rounds, the patient is sitting up in the
chair. Vital signs: 99.4-54-20-85/50. Pa 29/13, CVP10. Urine output 20 ml/hr
for the last 3 hours. Cardiac output 3.9, cardiac index 1.8. Patient’s preop ef
was 50%. Labs are as follows:

K 4.0

Cr 1.5

BUN 42

Hgb 9.8

Hct 29.1

Plt 138

Postoperative chest X-ray normal

Case Study 3: Arvid is a 69-year-old male you are seeing in
CCU 1 hour after he had a CABG × 4. The patient is intubated. VS:
97.1-78-14-90/50. PA 30/13, CVP 12. ABG 7.21-49-98-19.6-99%- -6 base deficit.
Mixed venous O2 sat 68. Hgb 10.2, Hct 32.1. The patient is sedated. Vent
settings FiO2 50%, IMV 12, PEEP 5, tidal volume 550.

To prepare:

Review and select 1 of the 3 case studies provided. Analyze
the patient information.

Consider a differential diagnosis for the patient in the
case study you selected. Think about the most likely diagnosis for the patient.

Think about a treatment and management plan for the patient.
Be sure to consider appropriate dosages for any recommended pharmacologic
and/or nonpharmacologic treatments.

Consider strategies for educating patients and families on
the treatment and management of the cardiac disorder.

Post on or before Day 3 an explanation of the differential
diagnosis for the patient in the case study you selected. Explain which is the
most likely diagnosis for the patient and why. Include an explanation of unique
characteristics of the disorder you identified as the primary diagnosis. Then,
explain a treatment and management plan for the patient, including appropriate
dosages for any recommended treatments. Finally, explain strategies for
educating patients and families on the treatment and management of the cardiac
disorder.

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to at least two of your
colleagues on 2 different days in both of the ways listed below. Respond to
colleagues who selected different case studies from yours.

Describe how a patient factor such as age, gender, ethnicity
or culture might affect the diagnosis, management, and follow-up care of
patients with the cardiac disorders your colleagues discussed.

Based on your personal and/or professional experiences,
expand on your colleagues’ postings by providing additional insights or
different perspectives.?

Discussion Part II: Pharmacology

To prepare:

Read the following article to enhance your knowledge of
commonly prescribed medications:

Kalil, A., & Bailey, K. L. (2014, October 20). Septic
shock medication. Retrieved from
http://emedicine.medscape.com/article/168402-medication

All of the following groups of medications are commonly
prescribed in the acute care setting. Choose one of the topics below to
discuss. If it is a medication group, select a specific drug within that group.
(This is a good way for you to prepare for clinical practice, because you will
get to know the drugs you will prescribe for patients.). Focus your discussion
on the hospital or ICU setting and IV usage.

All of the following groups of medications are commonly
prescribed in the acute care setting. This Discussion will focus on CABG
patients. Choose one of the topics below to discuss in terms of management of a
post-CABG patient. Focus your discussion on the hospital or ICU setting and IV
usage.

Amicar

Epinephrine

Vasopressin

Nitroglycerin

Cardene

Insulin drip

Dopamine

Dobutamine

Norepinephrine

Phenylephrine

Note: When sharing your initial post, select a drug that has
not yet been discussed. If all drugs have been discussed, then you may select
that drug again.

For this Discussion, address 1 of the following options.
Post by Day 3:

Option 1: Post a description of a patient you have taken
care of (inpatient as an RN, or as an NP student) who has been prescribed the
medication you selected. Include the scenario, indication, dosing,
complications, and outcome. Then explain whether or not you would have ordered
the same drug and same dose.

Option 2: Conduct an evidence-based drug search on the drug
you selected and post an explanation of any possible issues. Are there any drug
interactions? Any black box warnings? To what type of patient would you
prescribe this medication?

Option 3: Post an explanation of the properties of the drug
you selected, including usages and dosing in the hospital or ICU. Describe a
patient to whom you would prescribe this medication.

Explanation & Answer

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.