What does this mean and what could be the underlying cause of her pain and her abnormal lab values?

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A 58-year-old female is admitted for a work up for a complaint of neck and low back pain. During admission, you discover that she underwent a renal transplant six years ago. The patient also had blood work collected. When you review the findings, you notice that her serum calcium is elevated at 13.9 (Normal values range from 8.5 to 10.2 mg/dl), her CBC shows a hematocrit of 33%, and hemoglobin of 11.1 g/dl (normal adult female hematocrit Range: 37-47%, normal adult female hemoglobin range: 12-16 g/dl).

  • What does this mean and what could be the underlying cause of her pain and her abnormal lab values?
  • What other assessments would be helpful?

Discuss the cause and effect relationship between Candy’s level of growth and development and her diagnosis. What other data would be helpful for the nurse practitioner to have?

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Case Study

Hematology Case study

Candy is a 13 year old who lives with her father and younger sister. Her mother died when Candy was 6 years old and her sister was 4 years old. Her father works a 12 hour shift full time to support himself and his daughters, and Candy makes sure she and her sister get to school each morning, take care of the house after school, and prepare their father’s dinner so he can eat as soon as he gets home from work. All three are very close and on his days off, Candy’s father is very devoted to his children. Candy began her menses when she was 11 years old and experiences regular periods every 28 days. She has excelled in school, being on the honor rolls consistently for the past 3 years. The past semester Candy’s school performance began to decline and she has been complaining of being tired “all of the time.” Her father notes that Candy “looks pale” and makes an appointment for Candy to be seen at the clinic .

At the clinic, the nurse practitioner performs a nursing history during which Candy’s father shares the observations he has made and Candy verifies the information. The nurse practitioner’s assessment reveals Candy is a clean, appropriately dressed, pale adolescent who appears fatigued. Candy’s vital signs are:

Temperature: 35.9 C (96.6 F)

Pulse: 116 beats/minute

Respirations: 30 breaths/minute

Blood pressure: 90/60

Candy’s lab values are:

Hemoglobin: 10 g/dL

Hematocrit: 28%

Total Iron Binding Capacity (TIBC): 450 mg/dL

Serum iron: 35 microgram/L (Broyles, 2006). You will need to answer the following questions and summarize in 1-2 paragraphs.

Be sure to include the diagnosis, differential diagnosis, pathophysiology, epidemiology, physical exam findings, diagnostic testing any needed referrals, management plans, patient education and follow-ups. Please submit to dropbox by the assigned due date.

  1. What is diagnosis?
  2. List 3 differential diagnosis (rule out by physical exam, diagnostic testing and/or labwork).
  3. Discuss the pathophysiology, epidemiology and risk factors for the diagnosis.
  4. Is there any other diagnostic testing that you would like to perform?
  5. Is there a relationship between Candy’s change in school performance and her diagnosis?
  6. Discuss the relationship between the symptoms and the diagnosis.
  7. Discuss the significance of the laboratory values.
  8. Discuss the cause and effect relationship between Candy’s level of growth and development and her diagnosis.
  9. What other data would be helpful for the nurse practitioner to have?
  10. What are the priorities of care for Candy?
  11. What pharmacological and not pharmacological education would you give to this patient and her father?
  12. What other responsibilities should the nurse practitioner delegate to Candy and her father?

 

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal

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Trends and Issues in Health Care – Every Nurse Is a Leader

 

Rate yourself using the results from the “Nurse Manager Skills Inventory”:

 

http://www.aacn.org/wd/practice/docs/nurse-manager-inventory-tool.pdf

 

Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

1. Personal and professional accountability

2. Career planning

3. Personal journey disciplines

4. Reflective practice reference behaviors/tenets

 

Discuss how you will use your current leadership skill set to advocate for change in your workplace.

 

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal

 

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

 

 

Is there anything you learned that you are questioning why it might be important for you to know?

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During your time in this course there has been a lot of information for you to learn. Looking back how do you feel this knowledge is helping you prepare for your career? Is there anything you learned that you are questioning why it might be important for you to know?

Take some time and think about your answers to these questions and then share them with the class. Initial discussion posts are due by Wednesday. Reply to at least two other students post explaining why you agree or disagree with their opinion.

 

I am doing Medical Assistant. So just write 1 full page of reflection towards the question.

Discuss possible interventions or resources for the family using the resources available in your community.

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A nurse conducts an assessment on a young family with a new baby boy. The husband has recently been promoted to a higher paying position but is not sure if he will be making enough money to move a new apartment in a safer neighborhood. Based on this information, the nurse determines that this family currently has risk factors. Identify those risk factors associated with the young family. Discuss possible interventions or resources for the family using the resources available in your community.

What data was gathered? How was this done? What outcomes were measured and how was change implemented to improve the quality of care and patient outcomes?

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Patient Outcomes (graded)

This discussion topic requires you to reflect on the Performance Improvement (Quality Improvement) processes at your facility. Make sure you address all components of the topic for a robust discussion. It is anticipated that all clinical areas will be mentioned.

Recall an improvement method initiated at your facility. What data was gathered? How was this done? What outcomes were measured and how was change implemented to improve the quality of care and patient outcomes?

Describe the culture of safety at your organization. Who is leading the charge to promote safety? What is your role as a BSN-prepared nurse in ongoing strategies to promote safety?

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A “culture of safety” is a term about which we hear a great deal. Describe the culture of safety at your organization. Who is leading the charge to promote safety? What is your role as a BSN-prepared nurse in ongoing strategies to promote safety?

How would you explain the relationships among quality, safety, and costs to the director and staff?

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How would you explain the relationships among quality, safety, and costs to the director and staff? How would you demonstrate the importance of nursing care in addressing this issue? What outcome variables would you recommend?

How can the patient engage in self-care practices, such as modifying diet and exercise, and understand the nature of the illness, treatment, and prognosis?

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Topic: Disease Process: Alzheimer’s Disease

For a hypothetical patient who Alzheimer’s Disease, create a socioeconomic profile of your choice.

 

  • What is the level of this patient’s income, education, work experience, and cultural influences?
  • How might these socioeconomic factors influence his or her ability to access the necessary healthcare?
  • How can the patient engage in self-care practices, such as modifying diet and exercise, and understand the nature of the illness, treatment, and prognosis?
  • What healthcare services for this disease does the patient has access to?

Submit your answers in a 4- to 5-page Microsoft Word document. Support your answers with appropriate examples and research.

Cite all references in APA forma