Case Study 2.1 -Cardiorespiratory Exercise Prescription Yolanda L. is a 33-year-old, moderate-risk client. She is overweight and sedentary but otherwise appears healthy. She states that she would like to become more fit, but she has trouble finding time in her schedule for exercise. Design a general exercise program for her to improve cardio respiratory fitness.
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- MAKE SHORT TERM GOAL AND 5 OBJECTIVES FOR THIS DX. SHORT TERM GOAL: OBJECTIVES: 1. 2. 3. 4. 5. dx: Imbalanced nutrition related to lack of knowledge about diet SCENARIO: Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as she can remember. Her mother ensures that she takes daily supplemental vitamins such as vitamin C and B complex, and every year she gets flu vaccine from their family doctor. During the interview with the nurse, Aubrey mentioned that she has no known allergies. She said “I don’t think I have any problems with my health. I am lacto-ovo…Case Study # 2 A 50-year-old man has developed shortness of breath with exertion several weeks after experiencing a viral iliness. This is accompanied by swelling of the feet and ankles and some increasing fatigue. On physical examination he is found to be mildiy short of breath lying down, but feels better sitting upright. Pulse is 105 and regular, and blood pressure is 90/60 mm Hg. His lungs show crackles at both bases, and his jugular venous pressure is elevated. A third heart sound is present but no mumurs are heard on auscultation of the heart. The liver is enlarged, and there is 3+ edema of the ankles and feet. An echocardiogram shows a dilated, poorly contracting heart with a left ventricular ejection fraction of about 20%. Because of an abnormal ECG, he undergoes a coronary angiogram, which shows normal coronary arteries. The presumptive diagnosis is dilated cardiomyopathy secondary to a viral infection with stage C heart failure. He is placed on a low-sodium diet and treated…Case Scenario John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Summary: Given case: 53 years old, male History of Type-1 diabetes mellitus, CAD ( Coronary Artery Disease) PAD ( peripheral artery disease) Cigarette smoking 40 packs per year COMPLAINTS: 6 weeks ago, he developed a wound in his left heel. Despite antibiotics, patient developed a gangrene infection. ADVISE: To undergo BKA ( Below knee amputation) of left lower extremities MEDICATION: Daily insulin, aspirin 325 mg /day, pletaal 100 mg BD Post-operative Data: Post-operatively, Mr. Doe goes to the Post Anesthesia Care Unit…
- MAKE SHORT TERM GOAL AND 5 OBJECTIVES FOR THIS DX. Main Dx: Imbalanced nutrition less than body requirements related to Lacto-Ovo vegetarian diet as evidenced by lack of essential minerals & nutrients (Iron, Zinc & Omega Fatty-acids) SHORT TERM GOAL: OBJECTIVES: 1. 2. 3. 4. 5. SCENARIO: Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as she can remember. Her mother ensures that she takes daily supplemental vitamins such as vitamin C and B complex, and every year she gets flu vaccine from their family doctor. During the interview with the nurse,…Case Scenario: John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: Mr. Doe was very restless the evening before. He verbalizes to his wife that he is “scared to death” and worried about losing his foot. She asks the nurse what can be done to help him. How will the nurse address the psychological comfort of Mr. Doe? (Discuss in 2-3 sentences only)Case Scenario: John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. What preoperative testing is appropriate for Mr.Doe? (Give at least 4 priority examples) Note to Tutor: Thank you so much, Ma'am/Sir
- Case Study: Jason is a 52-year-old Asian American male visiting his doctor for a routine exam. He works as a warehouse manager and mentions that his job is very stressful. He also states that he wishes he could be more physically active during the day. Questions: 1. In addition to weight, name 4 other risk factors that increase the likelihood of a person developing cardiovascular disease. 2. Provide Jason some specific recommendations for physical activity that are in line with the Physical Activity Guidelines for Americans. Name three health benefits to Jason if he were to meet this recommendation. 3. Jason has heard that the Mediterranean Diet is good for your heart and would like to know more about it. Briefly describe the Mediterranean diet. Name one element or nutrient found in the Mediterranean diet and describe its possible effects on cardiovascular health.Case Scenario: John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Please make 1 intraoperative NCP with 1 diagnosisCase Scenario: John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: During the admission assessment, the nurse questions Mr. Doe to determine if there is a latex allergy or sensitivity. Why is this essential to the patient’s safety? What symptoms would the nurse question Mr. Doe about in order to determine this? (Discuss in 3-5 sentences only)
- CASE STUDY 2: (re) Sam Smith is a 57-year-old male, who lives alone in a large city in New Jersey. Sam had recently been feeling weaker and noticed he was having difficulty picking up his pen or lifting a cup of coffee. Sam decided to schedule an appointment in the Federally Qualified Health Center at which you are employed. After seeing the Nurse Practitioner and multiple tests, Sam is diagnosed with Amyotrophic Lateral Sclerosis (ALS). After receiving the diagnosis and some literature to read, Sam schedules a follow up appointment to discuss his options further. Sam returns to the center in a few days and informs you he has been reading about ALS online and knows that it is a terminal disease. Sam states he does not have family nearby and does not want to be a burden on any of his friends. Sam is exhibiting signs of depression and asks you about ending his life. He has read about the laws in New Jersey and would like to know how he goes about getting the medication. 1. What are your…Case Study (Overweight/Obesity and Metabolic Syndrome) – Bob This client is a male 46 years old, nonsmoker, and drinks on average two standard drinks a day, but he’s cutting back to just the weekends. Bob regularly exercises 3 times a week for at least 30 min at a moderate intensity. No history of cardiac events or stroke. Family history shows no history of cardiovascular disease and he currently takes medication for cholesterol. He got a blood panel done because he wants to take better care of himself and needs an exercise prescription. His main goal is general fitness and to lose his ‘beer belly’. He passed the fitness screening exercise test with no problems apparent. Height: 5’7.5” Weight: 189lbs Waist Circumference: 40.5 inches Glucose: 109 mg/dL Hemoglobin A1C: 5.3 Triglycerides: 109 mg/dL Cholesterol: 235 mg/dL HDL: 71 mg/dL LDL:128 mg/dL Resting BP: 132/90…R9. N.H. is a 76-year-old male admitted to the hospital through the emergency department. He fell outside his home. It appears that he may have sustained a fracture to his left hip. He has a history of type 2 diabetes mellitus and has a 40 pack-year smoking history that is now complicated by chronic obstructive pulmonary disease. Data Collected (use only those that apply) Complains of excruciating pain and tenderness in left hip Pain not relieved with morphine BP 166/94 mmHg Diaphoretic and pale skin Respiratory rate 36; crackles, expiratory wheeze X-ray of left hip reveals extracapsular fracture Hematocrit 30%; hemoglobin 15g/dL; WBC 15,000/uL Do ASAP.