NURS 6501 32 Year Old Female Presents To ED With Fever Complaint

NURS 6501 32 Year Old Female Presents To ED With Fever Complaint

NURS 6501 32 Year Old Female Presents To ED With Fever Complaint

Scenario 1: A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.

Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, ­ Neuts & Lymphs, sed rate 46 mm/hr, C-reactive protein 67 mg/L CMP wnl

Vital signs T 103.2 F Pulse 120 Resp 22 and PaO₂

99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adenexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.

Scenario 3: 67-year-old female presents with chief complaint of shortness of breath, fatigue, weakness, unintentional weight loss, and mild numbness in her feet. She states she feels unsteady when she walks. PMH includes hypothyroidism well controlled on Synthroid 100 mcg/day. No hx of HTN or CHF.

Vital signs: Temp 98.7 F, pulse 118, Respirations 22, BP 108/64, PaO₂ 95% on room air.

Physical exam revealed pale, anxious female appearing older than stated years.

HEENT- pale conjunctiva of eyes and pale palate. Tongue beefy red and slightly swollen with loss of normal rugae. Turbinates pale but no swelling. Thyroid palpable but no nodules felt. No lymph nodes palpated.

Cardiac-regular rate and rhythm with soft II/VI systolic murmur. Respiratory- lungs clear with no adventitious breath sounds. Abdomen-soft, non-tender with positive bowel sounds. Liver edge palpated two finger breadths below right costal margin. Lab data- hgb, hct, reticulocyte count, serum B₁₂ levels low, mean corpuscle volume, plasma iron, and ferritin levels high, folate, TIBC are normal.

Scenario 2: 42-year-old man presents to ED with 2-day history of dysuria, low back pain, inability to fully empty his bladder, severe perineal pain along with fevers and chills. He says the pain is worse when he stands up and is somewhat relieved when he lies down. Vital signs T 104.0 F, pulse 138, respirations 24. PaO₂ 96% on room air. Digital rectal exam (DRE) reveals the prostate to be enlarged, extremely tender, swollen, and warm to touch.

Scenario 4: A 14-year-old female is brought to the urgent care by her mother, who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. PMH not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.

Labs at urgent care demonstrated normal hgb and hct with normal WBC differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at urgent care referred the patient and her mother to the ED for a complete work-up of the low platelet count, including a peripheral blood smear for suspected immune thrombocytopenia purpura.

Please do a 1- to 2-page case study analysis.

In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):

• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.
• Why prostatitis and infection happens. Also explain the causes of systemic reaction.
• Why a patient would need a splenectomy after a diagnosis of ITP.
• Anemia and the different kinds of anemia (i.e., micro and macrocytic).

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Module 7 Assignment: Case Study Analysis

An understanding of the factors surrounding women’s and men’s health, infections, and hematologic disorders can be critically important to disease diagnosis and treatment in these areas. This importance is magnified by the fact that some diseases and disorders manifest differently based on the sex of the patient.

Effective disease analysis often requires an understanding that goes beyond the human systems involved. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact..

An understanding of the symptoms of alterations in systems based on these characteristics is a critical step in diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):

• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.
• Why prostatitis and infection happens. Also explain the causes of systemic reaction.
• Why a patient would need a splenectomy after a diagnosis of ITP.
• Anemia and the different kinds of anemia (i.e., micro and macrocytic).

Day 7 of Week 10

Submit your Case Study Analysis Assignment by Day 7 of Week 10

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M7Assgn+last name+first initial.(extension)” as the name.
• Click the Module 7 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 7  Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M7Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 7 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Module 7 Assignment

What’s Coming Up in Module 8?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 8, you will examine pediatric pathophysiology. You will identify diseases, disorders and issues relevant to the treatment of children. You will also take the Final Exam for the course.

Week 11 Knowledge Check: Pediatrics

In the Week 11 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 11. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Week 11 Final Exam: Pediatrics

Photo Credit: Giii / iStock / Getty Images Plus / Getty Images

In the Week 11 Final Exam, you will demonstrate your understanding of the topics covered during Weeks 7–11 of the course. This Final Exam will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Final Exam, since the resources cover the topics addressed. Plan

Next Module

To go to the next module:

Module 8

Week 10: Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

Literature, cinema, and other cultural references have long examined differences between women and men. These observations extend well beyond obvious and even inconspicuous traits to include cultural, behavioral, and biological differences that can impact pathophysiological process and, ultimately, health.

Understanding these differences in traits and their impact on pathophysiology can better equip acute care nurses to communicate to patients of both sexes. Furthermore, APRNs who are able to communicate these differences can better guide care to patients, whatever their gender.

This week, you examine fundamental concepts of women’s and men’s health disorders. You also explore common infections and hematologic disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the life span
• Analyze processes related to women’s and men’s health, infections, and hematologic disorders
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

•  Chapter 24: Structure and Function of the Reproductive Systems (stop at Tests of reproductive function); Summary Review
• Chapter 25: Alterations of the Female Reproductive System (stop at Organ prolapse); pp. 787–788 (start at Impaired fertility) (stop at Disorders of the female breast); Summary Review
•  Chapter 26: Alterations of the Male Reproductive System (stop at Hormone levels); Summary Review
•  Chapter 27: Sexually Transmitted Infections, including Summary Review
•   Chapter 28: Structure and Function of the Hematological System (stop at Clinical evaluation of the hematological system); Summary Review
• Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function, including Summary Review
• Chapter 30: Alterations of Leukocyte and Lymphoid Function, including Summary Review

Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481

Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview

Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3

Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true

Credit Line: Anemia at older age: Etiologies, clinical implications and management by Stauder, R., Valent, P., & Theurl, I., in Blood Journal, Vol. 131/Issue 5. Copyright 2019 by American Society of Hematology. Reprinted by permission of American Society of Hematology via the Copyright Clearance Center.

Document: NURS 6501 Final Exam Review (PDF document) 

 

Note: Use this document to help you as you review for your Final Exam in Week 11.

Required Media (click to expand/reduce)

Module 7 Overview with Dr. Tara Harris 

Dr. Tara Harris reviews the structure of Module 7 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Assignment. (3m)

Khan Academy. (2019a). Chronic disease vs iron deficiency anemia[LK1] . Retrieved from https://www.khanacademy.org/science/health-and-medicine/hematologic-system-diseases-2/iron-deficiency-anemia-and-anemia-of-chronic-disease/v/chronic-disease-vs-iron-deficiency-anemia

Note: The approximate length of the media program is 5 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 24, 26, 28, and 30 that relate to the reproductive and hematological systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Rubric Detail

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Content

Name: NURS_6501_Module7_Case Study_Assignment_Rubric

• Grid View
• List View

		Excellent	Good	Fair	Poor
Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following as it relates to the case you were assigned (omit section that does not pertain to your case, faculty will give full points for that section): Explain the factors that affect fertility (STDs)		Points Range: 23 (23%) – 25 (25%) The response accurately and thoroughly describes the patient symptoms. The response includes accurate, clear, and detailed explanations of the processes related to women’s and men’s health, infections, and hematologic disorders and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 20 (20%) – 22 (22%) The response describes the patient symptoms. The response includes accurate, explanations of the processes related to women’s and men’s health, infections, and hematologic disorders and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 18 (18%) – 19 (19%) The response describes the patient symptoms in a manner that is vague or inaccurate. The response includes explanations of the processes related to women’s and men’s health, infections, and hematologic disorders, with explanations that are vague or based on inappropriate evidence/research.	Points Range: 0 (0%) – 17 (17%) The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. The response does not include explanations of the processes related to women’s and men’s health, infections, and hematologic disorders, or the explanations are vague or based on inappropriate evidence/research.
Explain why inflammatory markers rise in STD/PID		Points Range: 18 (18%) – 20 (20%) The response includes an accurate, complete, detailed, and specific analysis of the concepts and principles of pathophysiology across the life span and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 16 (16%) – 17 (17%) The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 14 (14%) – 15 (15%) The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/research.	Points Range: 0 (0%) – 13 (13%) The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/research.
Explain why prostatitis and infection happen. Also explain the causes of systemic reaction.		Points Range: 18 (18%) – 20 (20%) The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 16 (16%) – 17 (17%) The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 14 (14%) – 15 (15%) The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/research.	Points Range: 0 (0%) – 13 (13%) The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/research.
Explain why a patient would need a splenectomy after a diagnosis of ITP.		Points Range: 5 (5%) – 10 (10%) The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 4 (4%) – 4 (4%) The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 3 (3%) – 3 (3%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations are based on inappropriate evidence/research.	Points Range: 0 (0%) – 2 (2%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research.
Explain anemia and the different kinds of anemia (i.e., micro and macrocytic).		Points Range: 5 (5%) – 10 (10%) The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 4 (4%) – 4 (4%) The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.	Points Range: 3 (3%) – 3 (3%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations are based on inappropriate evidence/research.	Points Range: 0 (0%) – 2 (2%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.		Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.	Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. The purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.	Points Range: 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%-79% of the time. The purpose, introduction, and conclusion of the assignment are vague or off topic.	Points Range: 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation		Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	Points Range: 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors.	Points Range: 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors.	Points Range: 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.		Points Range: 5 (5%) – 5 (5%) Uses correct APA format with no errors.	Points Range: 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors.	Points Range: 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors.	Points Range: 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors.
Total Points: 100

Name: NURS_6501_Module7_Case Study_Assignment_Rubric