walden nurs6560 week 9 discussion latest 2017 october

Week 9 discussion

Discussion Part I:
Assessment and Care of Patients With Adrenal and Urogynecologic Conditions

Many genitourinary (GU) disorders such as kidney disease
start developing during adolescence (Johns Hopkins Children’s Center, 2010).
This early onset of disease makes it essential for you, as the advanced
practice nurse caring for adolescent patients, to identify potential signs and
symptoms. Although some adolescent GU disorders require long-term treatment and
management, other disorders such as urinary tract infections are more common
and frequently require only minor interventions. In your role with adolescent
patients, you must evaluate symptoms and determine whether to treat patients or
refer them for specialized care. For this Discussion, consider potential
diagnoses, treatment, and/or referral options for the patients in the following
3 case studies.

Case Study 1: Alicia is an 18-year-old female who is brought
into urgent care by her mother. She is complaining of dizziness. She recently
started to lift weights for softball season. She has been healthy up to this
point. Vitals are: temp 101.9°F, HR 120, RR 24, BP 90/54. She has lower
extremity edema and decreased skin turgor. She states that her shoulders,
thighs, and lower back hurt. She is having trouble moving her arms and legs.
She also complains of vague abdominal pain, with nausea and vomiting. Labs came
back with CK 10,000, uric acid 40 mg/dl, WBC 14.3, BUN:creatinine ratio 6:1, K
5.8. Urinalysis shows a presence of myoglobin of more than 25.

Case Study 2: Mark is a 15-year-old male with a complaint of
acute left scrotal pain with nausea. The pain began approximately 6 hours ago
as a dull ache and gradually has worsened such that he can no longer stand
without doubling over. He is afebrile and in marked pain. Physical exam results
are negative except for elevation of the left testicle, diffuse scrotal edema,
and the presence of a blue dot sign.

Case Study 3: Maya is a 16-year-old female who presents to
the ER for urinary pain. She is a healthy adolescent with complaints of lower
abdominal pain, low back pain, and burning with urination. She had a fever of
102°F at home. Physical examination results are normal. Routine urinalysis
indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood.
Leukocytes are moderate and nitrites, moderate. Her blood pressure is normal,
and she is at the 60th percentile for height and weight. Vitals are: temp
103.1°F, HR 116, RR 18, BP 100/58. P Ox is 98% (Johns Hopkins Children’s
Center, 2010).

To prepare:

Review and select 1 of the 3 provided case studies. 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 genitourinary 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
genitourinary 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 culture might affect the diagnosis, management,
and follow-up care of patients with the genitourinary 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

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

Daley, B. (2015, February 23). Peritonitis and abdominal
sepsis. Retrieved from http://emedicine.medscape.com/article/180234-overview

Shahedi, K., Chudasama, Y. N., Dea, S. K., & Cooperman,
A. (2015, January 14). Diverticulitis treatment and management. Retrieved from
http://emedicine.medscape.com/article/173388-treatment

Tobias, J. D., & Leder, M. (2011). Procedural sedation:
A review of sedative agents, monitoring, and management of complications. Saudi
Journal of Anasthesia, 5(4), 395–410. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/

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.

Sedation

Diazepam

Fentanyl

Ketamine

Lorazepam

Midazolam

Propofol

Nonsedation

Chlorpromazine

Peritonitis—what antibiotics are chosen for peritonitis?

Nerve blocks—what drugs are used with nerve blocks?

Diverticulitis—what drugs are used with diverticulitis?

Note: When sharing your initial post, select a topic that
has not yet been discussed. If all topics have been discussed, then you may
select that topic again, but select a different drug within the medication
group.

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

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