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The exam is in the form of an essay. It should be typed in a Word document and turned into the appropriate dropbox by the assigned due date. This essay should be written in APA format, to include a cover page and reference page. The essay will need to be between 3- 5 pages long not including the cover page and reference pages. It is required to utilize a minimum of 4 evidence-based sources to support your responses. I suggest using the objectives from the rubric as your first level headings in the paper.Choose three of the prompts below and respond to them.
1. A 55-year-old woman is brought to the emergency department via ambulance complaining of severe, acute chest pain. The patient states, “It came on all of a sudden like someone is sitting on my chest crushing me.” An ECG shows ST-segment elevation, and the presumptive diagnosis is acute ST-elevation myocardial infarction (STEMI). While taking the history on the patient, what symptoms should the nurse prioritize? What are the emergency department goals of management for a patient with a STEMI? What are the current guidelines and nursing interventions to include in the plan of care?
2. An 87-year-old African American male is brought to the clinic by his son for a routine physical exam. His son states, “Dad has been complaining of feeling dizzy, and he is afraid he is going to fall.” When checking the patient’s vital signs, the nurse notes that the blood pressure has reached orthostatic levels and need further evaluation. What assessments need to be made in further evaluating this patient? The son asks what his father’s treatment will be to correct the problem. What is the nurse’s best response? What else can be done if it is not possible to correct the cause of orthostatic hypertension?
3. Baby boy Ellis, 2 hours old, is being evaluated in the newborn nursery by the nursing staff. Findings include temperature 37°C; apical heart rate 140 bpm; respirations 58 breaths per minute; BP (arms) 70/47, (calves) 62/39; head circumference 34 cm; chest circumference 31 cm; length 48 cm; weight 2,700 g. The infant is crying. Based on the physical findings, the newborn is diagnosed with aortic stenosis. What is the pathophysiology of this disorder? What assessments/tests should you expect to be done on this infant? What should you include in the teaching plan for the parents of this infant?
4. Mr. Cook is a 76-year-old African American man admitted to the ED with pain in both legs. His history includes a left femoral popliteal bypass 5 years ago. Smoking history of 45 pack years. Diabetic for 30 years, insulin controlled. He has a diminished right femoral pulse, a popliteal pulse with Doppler only; posterior tibial and pedal pulses are absent. Describe the pathophysiology of Peripheral Vascular Disease? What are the top 3 nursing priorities for this patient? What teaching would you need to include in the plan of care for this patient?
5. Mr. April, 24 years of age, is a male patient who was admitted to the surgical unit after a successful repair of an inguinal hernia. Wt. 342lbs, height 5’10. His vital signs are as follows: blood pressure 122/70 mm Hg, respiratory rate 26 breaths/min, heart rate 88 bpm, and temperature 98.6°F. The patient complains of incision pain and rates it on the pain scale as 7 of 10. His family is visiting at the bedside. You administer a dose of morphine as ordered. Fifteen minutes after administering the pain medication, a family member enters the hallway and yells, “We need help in here! John is not breathing.” Upon arrival you find Mr. April having periods of apnea lasting a few seconds followed by a short snorting gasp and then he begins breathing at a rate of 12 breaths per minute. His lips are bluish in coloration and so are his nail beds. He is lying supine in the bed. He awakens as you enter but is very lethargic and somnolent. Describe the correlation between a patient who is obese and hypoventilation? How does atelectasis, and the retention of CO2 play a role? What are your priority interventions with this patient?
6. A female client has been on a protein-free diet for 3 months. She comes to the clinic with reports of restlessness, heat intolerance, diarrhea, and a significant increase in appetite. Further questioning of the client reveals that she had been diagnosed with hyperthyroidism several years prior, but she had stopped her medication about 6 months ago because she felt so much better. Describe the pathophysiology of Graves’ disease? What is a potentially life-threatening complication associated with hyperthyroidism? What are possible causes for the complication identified?
attached you will find the objectives