give Feedback for this essay : In the first paragraph: How did you…

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Question give Feedback for this essay : In the first paragraph: How did you… give Feedback for this essay : In the first paragraph:How did you pick your topic?How did you narrow or expand your ideas for your topic?How did you decide which details to include?What do you like best about your essay? In the second paragraph, reflect on your revising process:What are you still dissatisfied within your essay? What do you wish you could do better?Why are you dissatisfied with this aspect?What specific suggestions did the tutor provide for the revision of your essay?How will you implement the tutor’s suggestions?   Arts & Humanities Writing ENGLISH 106 Share QuestionEmailCopy link Comments (0)

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Question Answered step-by-step Acute Coronary Syndrome FUNDAMENTAL Reasoning Case Study History ofPresent Problem • JoAnn Smith is a 68-year-old woman who presents to the emergency department (ED) after having three days of progressive weakness. • She denies chest pain, but admits to shortness of breath (SOB) that increases with activity. She also has epigastric pain with nausea that has been intermittent for 20-30 minutes over the last three days. She reports that her epigastric pain has gotten worse and is now radiating into her neck. • Her husband called 9-1-1 and she was transported to the hospital by emergency medical services (EMS). Personal/Social History • JoAnn is a recently retired math teacher who continues to substitute teach part-time. She is physically active and lives independently with her spouse in her own home. • She has smoked 1 pack per day the past 40 years. JoAnn appears anxious and immediately asks repeatedly for her husband upon arrival. Vital Signs Current VS: P-Q-R-S-T Pain Assessment (5th VS): T: 99.2 F/37.3 C (oral) Provoking/Palliative: Nothing/Nothing P: 128 (regular) Quality: Ache R: 24 (regular) Region/Radiation: Left arm that radiates into neck BP: 108/58 Severity: 5/10 O2 sat: 99% room air Timing: Intermittent-20-30" at a time Nursing Assessment Current Assessment: GENERAL APPEARANCE: Anxious, appears uncomfortable, body tense RESP: Respirations labored, coarse crackles present in bases bilaterally anterior/posterior CARDIAC: Pale, diaphoretic, no edema, heart sounds regular S1S2 with no abnormal beats, pulses strong, equal with palpation at radial/pedal/post-tibial landmarks NEURO: Alert & oriented to person, place, time, and situation (x4) GI: Abdomen soft/non-tender, bowel sounds audible per auscultation in all 4 quadrants GU: Voiding without difficulty, urine clear/yellow Radiology Reports Radiology Report: Chest x-ray RELEVANT Results: Scattered bilateral opacities consistent with atelectasis or pulmonary edema Clinical Significance: Radiology Report: Echocardiogram RELEVANT Results: Global left ventricle hypokinesis with ejection fraction of 25% Clinical Significance: Diagnostic Data Basic Metabolic Panel (BMP) Current: Na K Gluc. Creat. 135 4.1 184 1.5 Complete Blood Count (CBC) Current: WBC HGB PLTs % Neuts Bands 10.5 12.9 225 70 n/a Cardiac Current: Trop. BNP Mg 1.8 1150 1.8 Lab Planning Lab: Troponin Value: 1.8 ng/mL Normal Value: Critical Value: Clinical Significance: Nursing Assessments/Interven tions Required: Pharmacology Home Med: Classification: Mechanism of Action: Nursing Considerations: Lisinopril Atenolol Metformin Omeprazole Simvastatin Pathophysiology 1. What is the primary problem that your patient is most likely presenting? 2. What is the underlying cause/pathophysiology of this primary problem? Identifying Clinical Relationships 1. What is the RELATIONSHIP of the past medical history and current medications? Past Medical History (PMH): Diabetes mellitus type II Hypertension Hyperlipidemia Cerebral vascular accident (CVA) with no residual deficits Gastro-esophageal reflux disease (GERD) Anemia-Iron deficiency Home Meds: Iron Sulfate 325 mg daily Lisinopril 5 mg daily Atenolol 25 mg PO daily Simvastatin 20 mg daily Aspirin 81 mg daily Clopidogrel 75 mg daily Omeprazole 20 mg daily Metformin 500 mg PO bid Identifying Clinical Relationships 2. Is there a RELATIONSHIP between any disease in PMH that may have contributed to the development of the current problem? PMH: What Came FIRST: Diabetes mellitus type II Hypertension Hyperlipidemia Cerebral vascular accident (CVA) with no residual deficits Gastro-esophageal reflux disease (GERD) Anemia-Iron deficiency Identifying Clinical Relationships 3. What is the RELATIONSHIP between the primary care provider's orders and primary problem? 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What is the patient likely experiencing/feeling right now in this situation? 2. What can you do to engage yourself with this patient's experience and show that she matters to you as a person? Health Science Science Nursing LPN 101 Share QuestionEmailCopy link Comments (0)
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