- Read the case study listed below.
- Refer to the rubric for grading requirements.
- Utilizing the Week 3 Case Study TemplateLinks to an external site., provide your responses to the case study questions listed below.
- You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
- You must use the current Clinical Practice Guideline (CPG) for the management and prevention of COPD (GOLD Criteria) to answer the classification of severity and treatment recommendation questions. The most current guideline may be found at the following web address: https://goldcopd.org/Links to an external site.. At the website, locate the current year’s CPG and download a personal copy for use. You may also use a medication administration reference such as Epocrates to provide medication names.
- Proper APA format (in-text citations, reference page, spelling, English language, and grammar)
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Week 3 Case Study Template
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Pathophysiology & Clinical Findings of the Disease
1. Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?
2. Explain the pathophysiology associated with the chosen pulmonary disease.
3. Identify at least three subjective findings from the case which support the chosen diagnosis.
4. Identify at least three objective findings from the case which support the chosen diagnosis
Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.
1. Classify the patient’s disease severity. Is this considered stable or unstable?
2. Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.
3. Describe the mechanism of action for each of the medication classes identified above.
4. Identify two (2) “ Evidence A” recommended non-pharmacological treatment options for this patient.
References
[Must be on a separate page and in APA format]
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This assignment is worth 100 points.
Preparing the Assignment
Requirements
Content Criteria:
1. Read the case study listed below.
2. Refer to the rubric for grading requirements.
3. Utilizing the Week 3 Case Study TemplateLinks to an external site. , provide your responses to the case study questions listed below.
4. You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
5. You must use the current Clinical Practice Guideline (CPG) for the management and prevention of COPD (GOLD Criteria) to answer the classification of severity and treatment recommendation questions. The most current guideline may be found at the following web address: https://goldcopd.org/Links to an external site. . At the website, locate the current year’s CPG and download a personal copy for use. You may also use a medication administration reference such as Epocrates to provide medication names.
6. Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.
Case Study Scenario
Chief Complaint A.C., is a 61-year old male with complaints of shortness of breath.
History of Present Illness
A.C. was seen in the emergency room 1 week ago for an acute onset of mid-sternal chest pain. The event was preceded with complaints of fatigue and increasing dyspnea for 3 months, for which he did not seek care. He was evaluated by cardiology and underwent a successful and uneventful angioplasty prior to discharge. Despite the intervention, the shortness of breath has not improved. Since starting cardiac rehabilitation, he feels that his breathlessness is worse. The cardiologist has requested that you, his primary care provider, evaluate him for further work-up. Prior to today, his last visit with your practice was 3 years ago when he was seen for acute bronchitis and smoking cessation counseling.
Past Medical History
· Hypertension
· Hyperlipidemia
· Atherosclerotic coronary artery disease
· Smoker
Family History
· Father deceased of acute coronary syndrome at age 65
· Mother deceased of breast cancer at age 58.
· One sister, alive, who is a 5 year breast cancer survivor.
· One son and one daughter with no significant medical history.
Social History
· 35 pack-year smoking history; he has cut down to one cigarette at bedtime following his cardiac intervention.
· Denies alcohol or recreational drug use
Real estate agent
Allergies
· No Known Drug Allergies
Medications
· Rosuvastatin 20 mg once daily by mouth
· Carvedilol 25 mg twice daily by mouth
· Hydrochlorothiazide 12.5 mg once daily by mouth
· Aspirin 81mg daily by mouth
Review of Systems
· Constitutional: Denies fever, chills or weight loss. + Fatigue.
· HEENT: Denies nasal congestion, rhinorrhea or sore throat.
· Chest: + dyspnea with exertion. Denies productive cough or wheezing. + Dry, nonproductive cough in the AM.
· Heart: Denies chest pain, chest pressure or palpitations.
· Lymph: Denies lymph node swelling.
General Physical Exam
· Constitutional: Alert and oriented male in no apparent distress.
· Vital Signs: BP-120/84, T-97.9 F, P-62, RR-22, SaO2: 93%
· Wt. 180 lbs., Ht. 5'9"
HEENT
· Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva.
· Ears: Tympanic membranes intact.
· Nose: Bilateral nasal turbinates without redness or swelling. Nares patent.
· Mouth: Oropharynx clear. No mouth lesions. Dentures well-fitting. Oral mucous membranes dry.
Neck/Lymph Nodes
· Neck supple without JVD.
· No lymphadenopathy, masses or carotid bruits.
Lungs
· Bilateral breath sounds clear throughout lung fields. + Bilaterally wheezes noted with forced exhalation along with a prolonged expiratory phase. No intercostal retractions.
Heart
· S1 and S2 regular rate and rhythm, no rubs or murmurs.
Integumentary System
· Skin cool, pale and dry. Nail beds pink without clubbing.
Chest X-Ray
· Lungs are hyper-inflated bilaterally with a flattened diaphragm. No effusions or infiltrates.
Spirometry
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Title
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Predicted
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Pre-bronchodilator
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% Predicted
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Post-bronchodilator
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% Predicted
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Change
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FVC (L)
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5.64
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5.23
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93
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5.77
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102
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9%
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FEV1 (L)
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4.57
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2.92
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64
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3.01
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66
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2%
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FEV1/FVC (%)
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81
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56
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69
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52
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64
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-5%
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TLC
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5.5
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6.9
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125
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6.9
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125
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0%
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Case Study Questions
Pathophysiology & Clinical Findings of the Disease
1. Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?
2. Explain the pathophysiology associated with the chosen pulmonary disease.
3. Identify at least three subjective findings from the case which support the chosen diagnosis.
4. Identify at least three objective findings from the case which support the chosen diagnosis.
Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.
1. Classify the patient's disease severity. Is this considered stable or unstable?
2. Identify two (2) "Evidence A" recommended medication classes for the treatment of this condition and provide an example (drug name) for each.
3. Describe the mechanism of action for each of the medication classes identified above.
4. Identify two (2) "Evidence A" recommended non-pharmacological treatment options for this patient.
Week 3 Respiratory Case Study
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Week 3 Respiratory Case Study
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Criteria
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Ratings
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Pts
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This criterion is linked to a Learning OutcomePathophysiology & Clinical Findings of the Disease
The student: – Identifies the correct spirometry pattern and likely diagnosis. – Explains the pathophysiology associated with the chosen disorder. – Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only). – Identifies at least three subjective findings from the case. – Identifies at least three objective findings from the case. (5 Required Elements)
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45 pts
All 5 required elements are present.
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41 pts
1 required element is missing.
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37 pts
2 required elements are missing
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23 pts
3-4 required elements are missing.
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0 pts
All 5 required elements are missing.
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45 pts
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This criterion is linked to a Learning OutcomeManagement of the Disease
The student: – Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations. – Correctly classifies the disease severity and states whether or not the disease is stable or unstable. – Identifies two (2) “Evidence A” recommended medication classes for the treatment of the condition and provides an example (drug name) for each. – Identifies two (2) “Evidence A” recommended non-pharmacological treatment options for the condition. (4 Required Elements)
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45 pts
All 4 elements are present
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41 pts
1 required element is missing
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37 pts
2 required elements are missing
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23 pts
3 required elements are missing
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0 pts
All 4 required elements are missing
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45 pts
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This criterion is linked to a Learning OutcomeOrganization, spelling, grammar & APA format
The student: Uses the week 3 case study template for case study responses. Provides correct in-text citations for responses which match the reference page. Has minimal spelling, grammar & APA format errors.
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10 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 0-2 errors in spelling, grammar or APA format.
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9 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 3-5 errors in spelling, grammar or APA format.
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8 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 6-8 errors in spelling, grammar or APA format.
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5 pts
Case study template is not used for responses OR In-text citations are incorrect or do not match the reference page AND There are 0-5 errors in spelling, grammar or APA format.
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0 pts
Case study template is not used for responses AND/OR In-text citations are incorrect or do not match the reference page AND There are 6 or more errors in spelling, grammar or APA format.
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10 pts
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The final presentation will be planned with your instructor once the outline is approved. Final Teaching projects will be presented to classmates and the instructor. The presentation site is preferably in the clinical setting. However, the instructor can hold it at the MDC Medical campus.
Each student will present a population-level, evidence-based practice teaching intervention. The presentation should be 15 to 20 minutes at maximum.
Information to include in the presentation consists of:
1. Title of the project.
2. Introduction (what is essential to learn about this issue). You may present statistics such as mortality, morbidity, incidence, and prevalence).
3. Findings of your assessment: why do you believe the topic is essential for the audience? Please indicate the learning objectives. After the presentation, the participant will:
4. Include barriers and assets for your specific population. What can you teach to empower the population to take a proactive stand for wellness?
5. The presentation should be age, cultural, and health literacy-appropriate.
6. The health teaching presentation should provide accurate, evidence-based information to the participant.
7. The teaching presentation should have examples of outcomes, what happens if I change…., if I don't.
8. The presentation should have examples of how to do the intended behavior.
8. The presentation should have time for participants to ask questions and make comments.
9. The presentation should have a section that evaluates the audience's attainment of the education objectives.
This criterion is linked to a Learning OutcomeDescription of interest in community selected and identification of health evidence-based practice teaching intervention selected.Student should be able to describe his active service of citizenship, community engagement and social responsibility within the community selected. Student also described the evidence-based practice teaching intervention which will be presented.
25 to >14.0 ptsProficient
Student clearly articulates his/her ideas about active community engagement. Was able to communicate his topic based on community health needs.
14 to >10.0 ptsDeveloping Proficiency
Student did not demonstrate his engagement in the community. Was clear presenting his topic based on community health needs.
10 to >0 ptsNeeds Improvement
Student was not able to communicate his engagement in the community. Was not able to clearly communicate his topic based on community health needs.
25 pts
This criterion is linked to a Learning OutcomeDemonstrates Collaboration with Community StakeholdersDemonstrate reciprocity and responsiveness in his communication with community leaders and organizations. Maintained awareness to community cultural, educational, and health literacy levels.
25 to >14.0 ptsProficient
Student clearly articulates how his/her experience has been more than a one-way relationship. Student articulates how she/he was responsive to those served, and how she/he was affected or challenged, or changed by these relationships. Student was sensitive to the cultural needs, health literacy and educational levels.
14 to >10.0 ptsDeveloping Proficiency
Student showed lack of engagement and limited relationship with community members. Student was not able to assess properly the cultural needs, health literacy and educational levels of the community selected.
10 to >0 ptsNeeds Improvement
Student showed minimal engagement in the community selected. Did not assess the cultural, educational or health literacy needs of the community selected.
25 pts
This criterion is linked to a Learning OutcomeApplication of evidenced based teaching intervention.Student clearly demonstrates knowledge by applying evidenced-based information to the teaching intervention. Student utilizes evidence such as mortality, morbidity rates, and makes a critical analysis of the important social issues facing the population served. Teaching interventions shows depth and complexity of the healthcare needs of the community served.
25 to >15.0 ptsProficient
Student applied accurate, evidence-based information to the participants. The project includes benchmarks of attainable outcomes. The teaching intervention was well planned and appropriate for the community served.
15 to >10.0 ptsProficient
Student did not apply evidence-based information to the participants. The project includes benchmarks of attainable outcomes. The intervention was not well planned or relevant to the community served.
10 to >0 ptsNeeds Improvement
Student did not apply evidence-based information to the participants. The intervention lacked planned outcomes to be achieved.
25 pts
This criterion is linked to a Learning OutcomeEvaluation of teaching presentation to participants.Teaching presentation contained introduction, learning objectives, findings and recommendations. Student was able to reflect on the barriers or limitations of the particular health project within the community.
25 to >14.0 ptsProficient
Student adhered to allotted time 15-20 minutes. Presentation was clear, contained introduction, learning objectives, findings and recommendations. Audience had time for questions and clarification of material. The presentation utilized visual elements such as images, graphics, charts, slides and other visual aids to convey information, ideas or messages to the audience.
14 to >10.0 ptsDeveloping Proficiency
10 to >0 ptsNeeds Improvement
Student did not adhere to allotted time 15-20 minutes. Presentation did not follow required format. Audience did not have time for questions and clarification of material. The presentation did not utilize visual elements such as images, graphics, charts, slides and other visual aids to convey information, ideas or messages to the audience.
25 pts
1
Wideline Colin
Miami Dade College
NUR 4636L: Community Health Nursing Practicum
Dr. Violr4ts Aguilar-Figuly
June , 2024
Goal:
The community teaching project aims to empower patients with diabetes to effectively manage their condition, improve their quality of life, and reduce complications associated with diabetes.
Analysis of the Issue
Identify the challenges faced by patients with diabetes, such as lack of knowledge about the disease process, difficulty in recognizing symptoms of high and low blood sugar, environmental factors affecting diabetes management, dietary choices, and adherence to treatment guidelines.
Stakeholders:
Engage key stakeholders such as diabetes educators, healthcare providers, community leaders, and patient advocacy groups to ensure a comprehensive and collaborative approach to the project.
Target Group:
The target group for this project includes individuals recently diagnosed with diabetes who require education and support to manage their condition effectively.
Educational Objectives:
– participants will verbalize increased knowledge and understanding of the diabetes disease process.
– they will be able to identify the signs and symptoms of hyper and hypoglycemia.
– they will identify solutions to environmental impacts on diabetes management.
– develop an appreciation for a balanced diet and understand the importance of monitoring blood glucose levels.
– utilize the American Diabetes Association guidelines for optimal blood glucose control.
Implementation Plan:
1. Develop educational materials and resources on diabetes management, healthy lifestyle choices, and blood glucose monitoring based on evidence-based practices.
2. Organize interactive workshops, seminars, and one-on-one sessions to educate participants on diabetes self-care practices, dietary guidelines, and medication management.
3. Collaborate with healthcare professionals to provide hands-on training on insulin administration, glucose testing, and symptom recognition.
4. Create a support network for participants to share experiences, seek advice, and stay motivated in managing their diabetes effectively.
5. Evaluate the effectiveness of the educational interventions through pre-and-post assessments, feedback surveys, and follow-up sessions to measure knowledge gain and behavior change.
By following these steps, the community teaching project can successfully equip patients with diabetes with the knowledge, skills, and resources needed to lead healthier lives and effectively manage their condition.
Specific:
– Target Group: Recently diagnosed diabetes patients in the community, including pre-menopausal women at risk for diabetes.
– Issue: Lack of knowledge and skills in managing diabetes effectively, leading to potential complications.
– Location: Community Health Center in a low-income neighborhood.
– Timeframe: 2-month program duration, with weekly sessions on Tuesdays from 6-8 pm.
Measurable:
– Objective 1: Identify Signs and Symptoms of Hyper and Hypoglycemia
– Conduct a pre-assessment to gauge participants' current knowledge of hyper and hypoglycemia symptoms.
– Provide educational sessions and practical demonstrations on recognizing and responding to hyper and hypoglycemia.
– Post-assessment at the end of the program to measure the improvement in participants' ability to identify symptoms. Aim for at least an 80% increase in correct identification.
Achievable:
– The program will be conducted in collaboration with a diabetes educator and volunteer healthcare professionals.
– Educational materials, such as brochures and handouts, will be provided to participants to reinforce learning.
– Community partnerships will be utilized to ensure access to necessary resources and support.
Relevant:
– The objectives align with the overall goal of empowering patients to manage their diabetes effectively and improve their quality of life.
– By enhancing participants' knowledge and skills, the project aims to reduce the risk of complications and promote self-care behaviors.
Time-Specific:
– Weekly sessions will cover different aspects of diabetes management, including diet, exercise, medication adherence, and monitoring.
– By the end of the 2-month program, participants should demonstrate improved knowledge and skills in diabetes self-care, as measured by post-assessments and surveys.
Monitoring/Evaluation:
– Post-assessment surveys will be conducted to evaluate participants' knowledge and attitudes regarding hyper and hypoglycemia.
– Feedback sessions will be held to gather insights from participants on the effectiveness of the program and areas for improvement.
– Participant progress will be tracked throughout the program to ensure engagement and adherence to educational objectives.
By following this detailed action plan and incorporating the SMART criteria, the community teaching project on diabetes management can effectively address the identified objectives and empower participants to take control of their health and well-being.
References
American Nurses Association. (n.d.). Nursing Resources & Support for Opioid Crisis.
Centers for Disease Control and Prevention. (n.d.). Opioid Overdose. Retrieved from https://www.cdc.gov/drugoverdose/index.html
Healthy People 2030. (n.d.). Leading Health Indicators. Retrieved from https://health.gov/healthypeople/leading-health-indicators
Substance Abuse and Mental Health Services Administration. (n.d.). Prevention of Opioid Overdose. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/opioid-overdose
Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/opioid-education-hub/
