his assignment is based on data collection and understanding Research.
The first part includes completion of questions that are found by reviewing the electronic chart of Lisa Rae, which is posted on Sherpath under Week 5, Class 1.
You will also have to look up additional information in order to complete the answers.
The second part involves looking up a research study and BPG and answering questions about them.
Part Select one of Lisa Rae’s past medical diagnoses and write 3 manifestations of this disease. (1.5 marks)
Answer:
Hypertension is a medical condition where the pressure in the arteries is very high. Patients usually do not know that they are actually suffering from hypertension, and that is why hypertension is generally termed to be the “silent killer.” However, in case the symptoms are there, these can be as follows:
Very Severe Headache: This is usually a very severe pain occurring mainly at the back of the head and neck. Pulsating or throbbing type in nature, it may be associated with pressure or tightness sensation in this region.
Blurred Vision: Hypertension might affect the small blood vessels in the eyes such that it results in changes in vision. Blurred vision or difficulty in focus may result, and sometimes, an individual might lose vision suddenly, with temporary blindness in the rarest cases.
Shortness of breath: Hypertension may work on the cardiovascular system, increasing the pressure on the heart and lungs. This might lead to shortness of breath, particularly during exertion or when lying flat. In severe cases, a person has difficulty breathing even at rest, which may be a bad sign indicative of a hypertensive crisis that requires immediate medical attention.
These symptoms result from the increased pressure of the blood that is exerted on the walls of the arteries. Hypertension, if not treated over time, would cause damage to the blood vessels and other organs within the body, and this might result in severe complications like heart disease,
stroke, kidney failure, and loss of vision. It would, therefore, be good to have blood pressure monitored and to report to a healthcare provider any arising symptoms or signs of hypertension.
Explain how 3 of her current orders are directly related to the support of Lisa Rae’s past medical diagnoses. (3 marks)
Monitor vital signs to check for the blood pressure in case it rises and reduced grams of sodium that is 3 grams a day in diet to prevent hypernatremia that may leading to risk of hypertension.
Calcium carbonate 600mg PO twice a day usually indicated for low serum calcium for conditions such osteoporosis
Acetaminophen 100mg PO every 6 hours usually indicated for pain that can be as a risk of osteoarthritis.
Select one of Lisa Rae’s admitting medical diagnoses and write 3 manifestations of this diagnosis. (1.5 marks)
Hypotension is also low blood pressure and it is a medical condition that involves an abnormally low level of blood pressure in the arteries. Unlike hypertension, which is often called the “silent killer” because it typically has no symptoms in early stages, hypotension more often reveals noticeable symptoms, which include:
Dizziness: Hypotension can lead to light-headedness or dizziness, especially when one stands up quickly from a sitting or lying posture. The feeling may be accompanied by a sense of imbalance.
Blurred vision: Hypotension can disrupt blood flow to the eyes and result in temporary vision disturbances. One can experience blurred vision and difficulty focusing, especially when getting up from lying down.
Fatigue: The person with hypotension will feel fatigued even after taking rest. Individuals with hypotension feel less energetic and unenthusiastic about performing their normal activities.
Headache: In hypotensive persons, headache can be slight or moderate, but in most cases, it may be accompanied by feelings of pressure or discomfort in the head or temples.
It results from a critically decreased blood flow and delivery of oxygen to the peripheral tissues and organs of the body. Hypotension may be caused by dehydration, heart, endocrine, the side effects of medication, and neurological conditions. Treatment for mild hypotension may not be necessary. Severe hypotension or hypotension that continues to deteriorate can lead to syncope, shock, or organ damage. That is to say, people experiencing hypotension symptoms should be examined by a health worker for proper identification of the cause and management.
Explain how 2 of her current orders are directly related to the support of her admitting medical diagnoses. (2 marks)
Physiotherapy and hydro morphine 0.2mg/IV every hour as needed for pain for mechanical fall.
Monitoring vital signs to check for Blood pressure for any decline in blood pressure levels due to risk of hypotension.
Lisa Rae has been assessed to be occasional incontinent of urine. Explain in your own words what this means. (1mark)
Incontinence or urine means that Lisa is unable to control her bladder.
Explain 1 reason that might contribute to Lisa Rae’s urinary incontinence. (1mark).
The total hystrectonomy that she underwent at the age of 45 may have caused an injury to her pelvic floor muscles and nerve tissues thus causing urinary in continence.
Write 1 nursing diagnosis/problem statement for one of Lisa Rae’s unmet needs. It should include a problem statement, a related to section and a section with evidence to support the diagnosis. (3 marks)
Impaired skin integrity related to Ischemic attack as evidenced by big bruise in Lisa’s right hip.
Total Marks for Part 1 = 13 marks
Part 2
1. Find an article from a credible resource that is based on a research study that is related to one of Lisa Rae’s past medical problems.
a. Write the full title of the research article and a direct link to the full text of this article. (1 mark)
Immunotherapies and placebo for change in left ventricular mass in patients receiving nutritional-hygienic therapy in the Treatment of Mild Hypertension Study (TOMHS)
b. Identify what type of research method has been used in this study. (1 mark)
The research method type used is clinical trial.
c. Explain this type of research method. (2 marks)
The research method usually is done to check for the effectiveness and the safety of medical interventions i.e. medications, treatments, and procedures. It involves the division of participants into groups to be able to receive the placebo treatments and the results of the treatment are observed after a certain period. They are usually done in phases with each phase playing a special purpose could be checking for the safety, efficacy, and long-term effects
d. Explain the relevance of this research study to a nurse caring for Lisa Rae. (2 marks)
Through the use of evidence-based practice, the nurses that are managing patients with hypertension such as our case Lisa Rae can gain from the findings of the final results which provide projections into the efficacy of the various treatment strategies thus enabling proper development of informed decisions. Nurses can also use the findings from this study that aid in patient education and counseling of Lisa Rae and her family on the management of hypertension.
BPGBPB
2. Find 1 Best Practice Guidelines from the RNAO that addresses 1 of Lisa Rae’s current problems. One of Lisa’s Rae problems is mechanical fall where she got to hurt at the knee.
a. Include the full title of the BPG and a direct link to the BPG. (1 mark)
Knee osteoarthritis related pain: a narrative review of diagnosis and treatment.
b. Write a brief summary of what the BPG is about (in your own words) and how it is relevant to a nurse caring for Lisa Rae. (2 marks)
This best practice guideline is what nurses through evidence-based practice can provide to prevent falls and fall-related injuries in the elderly. It covers risk assessment, preventive strategies, and interventions developed for those identified as high-risk. Now, this is what it would do for a nurse who is caring for Lisa Rae and the mechanical fall she has suffered: to
directly attend to her needs by providing strategies for how to assess her and reduce the risks of further falls.
c. Select 1 recommendation from the BPG that could be added to Lisa Rae’s care plan. (1 mark)
From the BPG we can promote the use of an exercise program that will aid in emphasizing her balance, strength, and walking exercises which are the recommended strategies from the Best Practice Guideline for patients who have mechanical falls especially the elderly. It is important to implement such a program for Lisa Rae since it will aid her improve from the mechanical fall she experienced. This program improves her mobility by working on certain areas of weakness as it promotes muscle strength and coordination which help improve mobility and reduce and future risk of falls.
3. Write a reference list to include the resources you used in questions 1 and 2 in Part 2.
Your reference list should be APA format (2 marks).
Registered Nurses’ Association of Ontario (RNAO). (2017). Prevention falls and reducing injury from falls (4 th ed.). Toronto, ON: RNAO.
Freeman, R. (2008). Clinical practice. Neurogenic orthostatic hypotension. New England Journal of Medicine, 358(6), 615-624.
Low, P. A., & Singer, W. (2008). Management of neurogenic orthostatic hypotension: an update. The Lancet Neurology, 7(5), 451-458.
Shaw, B. H., Loughin, T. M., & Sandroni, P. (2015). Orthostatic hypotension in the elderly: diagnosis and treatment. American Journal of Medicine, 128(8), 837-847.
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey Jr, D. E., Collins, K. J., Dennison Himmelfarb, C., … & Smith Jr, S. C. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA
guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on
Clinical Practice Guidelines. Journal of the American College of Cardiology, 71(19), e127-e248.
Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., … & Task Force Members. (2013). 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European Heart Journal, 34(28), 2159-2219.
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., … & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507-520.
