NRS-410: Pathophysiology and Nursing Management of Clients’ Health

In nursing, critically evaluating a patient's case involves assessing both the clinical manifestations and the effectiveness of interventions used in the patient's care. Mrs. J.’s case is an example where various health issues, particularly related to cardiovascular health and medication management, must be addressed through thoughtful nursing interventions. This critical thinking essay examines Mrs. J.’s clinical situation, appropriateness of the nursing interventions, medications, and nursing strategies to improve patient outcomes.

Below is a sample of the NRS-410 Critical Thinking Essay we’ve completed, demonstrating how to approach these multifaceted healthcare issues with clarity and depth. We also provide tips to help you tackle similar nursing case studies with confidence.

NRS-410: Pathophysiology and Nursing Management of Clients' Health

Case Study: Mrs. J.

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Case Study Overview

Mrs. J presents with anxiety, shortness of breath at rest, heart palpitations, and easy fatigability. She has a BMI of 31.2, classified as obesity, and vital signs indicate a low-grade fever of 37.6C, tachycardia with irregular heart rhythm, tachypnea, and low blood pressure of 90/58. Positive physical findings at the chest include S gallop, faint peripheral pulses, and faint PMI at the 6^th ICS, which suggest left ventricular enlargement. Besides, the patient has bilateral jugular vein distention, which suggests congestive heart failure. Respiratory examination revealed pulmonary crackles, decreased breath sounds on the right lower lobe, cough with frothy blood-tinged sputum, and SpO2 of 82%. This indicates excessive secretions in the airways, presence of fluid in the lungs, limited flow of oxygen to the lungs, and inadequate tissue perfusion. The abdominal exam reveals hepatomegaly of 4cm below the costal margin.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below. NRS 410 Case Study: Mrs. J.

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

• Describe the clinical manifestations present in Mrs. J.
• Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
• Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
• Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
• Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
• Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
• Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Ace Your Nursing Case Studies with Professional Support

Evaluating a patient's clinical situation and making informed decisions about nursing interventions is a crucial skill for nursing students. If you find yourself struggling with case study assignments like Mrs. J.’s, professional support can help you analyze complex situations and develop well-structured responses. Here's how we can assist you:

• Critical Evaluation of Nursing Interventions: Learn how to assess the appropriateness of nursing interventions and medications based on patient needs.
• Cardiovascular and Medication Management: Receive guidance on understanding cardiovascular conditions and strategies to manage medications, especially in older adults.
• Health Promotion and Teaching Plans: Get help creating effective health promotion plans and rehabilitation strategies for patients.
• Expert Feedback on Your Writing: Improve the clarity, depth, and structure of your critical thinking essays, ensuring they meet academic standards.

With personalized guidance, you can master nursing case studies, enhance your critical thinking skills, and produce high-quality work that demonstrates a deep understanding of patient care.