GCU NRS410 Full Course
Week 1
Discussion
The case scenario provided will be used to answer the
discussion questions that follow.
Case Scenario
Ms. G., a 23-year-old diabetic, is admitted to the hospital
with a cellulitis of her left lower leg. She has been applying heating pads to
the leg for the last 48 hours, but the leg has become more painful and she has
developed chilling.
Subjective Data
Complains of pain and heaviness in her leg.
States she cannot bear weight on her leg and has been in bed
for 3 days.
Lives alone and has not had anyone to help her with meals.
Objective Data
Round, yellow-red, 2 cm diameter, 1 cm deep, open wound
above medial malleolus with moderate amount of thick yellow drainage
Left leg red from knee to ankle
Calf measurement on left 3 in > than right
Temperature: 38.9 degrees C
Height: 160 cm; Weight: 83.7 kg
Laboratory Results
WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
Wound culture: Staphylococcus aureus
Critical Thinking Questions
What clinical manifestations are present in Ms. G and what
recommendations would you make for continued treatment? Provide rationale for
your recommendations.
Identify the muscle groups likely to be affected by Ms. G’s
condition by referring to “ARC: Anatomy Resource Center.”
What is the significance of the subjective and objective
data provided with regard to follow-up diagnostic/laboratory testing,
education, and future preventative care? Provide rationale for your answer.
What factors are present in this situation that could delay
wound healing, and what precautions are required to prevent delayed wound
healing? Explain.
NRS410 Path
Physiology and Nursing Management of Client’s Health
Week 2
Discussion
The American Cancer Society (ACS) is a nationwide,
community-based, voluntary health organization dedicated to eliminating cancer
as a major health problem. Together with its supporters, ACS is committed to
helping people stay well and get well by finding cures and by fighting back.
Critical Thinking Questions:
Imagine that a family friend or colleague has just been
diagnosed with cancer. Explain how the American Cancer Society might provide
education and support. What ACS services would you recommend and why?
According to statistics published by the American Cancer
Society, there will be an estimated 1.5 million new cancer cases diagnosed each
year over the next decade. What factors contribute to the yearly incidence and
mortality rates of various cancers in Americans? What changes in policy and
practice are most likely to affect these figures over time
Select a research program from among those funded by the
American Cancer Society. Describe the program and discuss what impact the
research will have on the prevention or treatment of cancer.
NRS410 Path
Physiology and Nursing Management of Client’s Health
Week 3
Discussion
Use the following Case Scenario, Subjective Data, and
Objective Data to answer the Critical Thinking Questions.
Case Scenario
Mrs. J. is a 63-year-old woman who has a history of
hypertension, chronic heart failure, and sleep apnea. She has been smoking two
packs of cigarettes a day for 40 years and has refused to quit. Three days ago,
she had an onset of flu with fever, pharyngitis, and malaise. She has not taken
her antihypertensive medications or her medications to control her heart
failure for 4 days. Today, she has been admitted to the hospital ICU with acute
decompensated heart failure.
Subjective Data
Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough
air.
Says her heart feels like it is “running away.”
Reports that she is so exhausted she cannot eat or drink by
herself.
Objective Data
Height 175 cm; Weight 95.5 kg
Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
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
Respiratory: Pulmonary crackles; decreased breath sounds
right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
Gastrointestinal: BS present: hepatomegaly 4 cm below costal
margin
Critical Thinking Questions
What nursing interventions are appropriate for Mrs. J. at
the time of her admission? Drug therapy is started for Mrs. J. to control her
symptoms. What is the rationale for the administration of each of the following
medications?
IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
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 rationale for each of the interventions you recommend.
