Nur 502/512 Dus 4

NUR 502 Dus Wk 4

1. Urinary Function: Mr. J.R. is a 73-year-old man, who was admitted to the hospital with clinical manifestations of gastroenteritis and possible renal injury. The patient’s chief complaints are fever, nausea with vomiting and diarrhea for 48 hours, weakness, dizziness, and a bothersome metallic taste in the mouth. The patient is pale and sweaty. He had been well until two days ago, when he began to experience severe nausea several hours after eating two burritos for supper. The burritos had been ordered from a local fast-food restaurant. The nausea persisted and he vomited twice with some relief. As the evening progressed, he continued to feel “very bad” and took some Pepto- Bismol to help settle his stomach. Soon thereafter, he began to feel achy and warm. His temperature at the time was 100. 5°F. He has continued to experience nausea, vomiting, and a fever. He has not been able to tolerate any solid foods or liquids. Since yesterday, he has had 5–6 watery bowel movements. He has not noticed any blood in the stools. His wife brought him to the ER because he was becoming weak and dizzy when he tried to stand up. His wife denies any recent travel, use of antibiotics, laxatives, or excessive caffeine, or that her husband has an eating disorder. Case Study Questions

1. The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented name the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.

2. Create a list of risk factors the patient might have and explain why. 3. Unfortunately, the damage on J.R. kidney became irreversible and he is now diagnosed

with Chronic kidney disease. Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.

2. Reproductive Function: Ms. P.C. is a 19-year-old white female who reports a 2-day history of lower abdominal pain, nausea, emesis and a heavy, malodorous vaginal discharge. She states that she is single, heterosexual, and that she has been sexually active with only one partner for the past eight months. She has no previous history of genitourinary infections or sexually transmitted diseases. She denies IV drug use. Her LMP ended three days ago. Her last intercourse (vaginal) was eight days ago and she states that they did not use a condom. She admits to unprotected sex “every once in a while.” She noted an abnormal vaginal discharge yesterday and she describes it as “thick, greenish-yellow in color, and very smelly.” She denies both oral and rectal intercourse. She does not know if her partner has had a recent genitourinary tract infection, “because he has been away on business for five days. Microscopic Examination of Vaginal Discharge

(-) yeast or hyphae (-) flagellated microbes (+) white blood cells (+) gram-negative intracellular diplococci Case Study Questions

1. According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probably diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.

2. Based on the vaginal discharged described and the microscopic examination of the sample could you suggest which would be the microorganism involved?

3. Name the criteria you would use to recommend hospitalization for this patient.

NUR 512 Discussion week 4

3. Choose a state and review the scope of practice for the advanced practice nurse. How does it compare to Florid

Submission Instruction

You must complete both case studies

• Your initial post should be at least 500 words in total, (250 words per case study), formatted and cited in current APA style with support from a minimum of 2 academic sources PER CASE STUDY that are no older than 5 years old. Your initial post is worth 8 points.

• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)

• All replies must be constructive and use literature such as one intext citation from one scholarly source.

• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date. • Late work policies, expectations regarding proper citations, acceptable means of

responding to peer feedback, and other expectations are at the discretion of the instructor.

Rubric

This criterion is linked to a Learning OutcomeIdentifi cation of Main Issues, Problems, and Concepts

5 to >4.0 pts Distinguished Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts. 4 to >3.0 pts Excellent Identifies and demonstrates an accomplished understanding of most issues, problems, and concepts.3 to >0.0 pts Fair Identifies and demonstrates an acceptable understanding of most issues, problems, and concepts. 0 pts Poor Identifies and demonstrates an unacceptable understanding of most issues, problems, and concepts. Or nothing was posted.

5 pts 


This criterion is linked to a Learning OutcomeUse of Citations, Writing Mechanics and APA Formatting Guidelines

3 pts Distinguished Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors. 2 pts Excellent Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors. 1 pts Fair Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail. 0 pts Poor Ineffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. Or nothing was posted.

3 pts 


This criterion is linked to a Learning OutcomeRespon se to Posts of Peers

2 pts Distinguished Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.1 pts Fair Student constructively responded to one other post and either extended, expanded or provided a rebuttal.0 pts Poor Student provided no response to a peer's post.

2 pts

NUR 502 Dus Wk 4

1. Urinary Function: Mr. J.R. is a 73-year-old man, who was admitted to the hospital with clinical manifestations of gastroenteritis and possible renal injury. The patient’s chief complaints are fever, nausea with vomiting and diarrhea for 48 hours, weakness, dizziness, and a bothersome metallic taste in the mouth. The patient is pale and sweaty. He had been well until two days ago, when he began to experience severe nausea several hours after eating two burritos for supper. The burritos had been ordered from a local fast-food restaurant. The nausea persisted and he vomited twice with some relief. As the evening progressed, he continued to feel “very bad” and took some Pepto- Bismol to help settle his stomach. Soon thereafter, he began to feel achy and warm. His temperature at the time was 100. 5°F. He has continued to experience nausea, vomiting, and a fever. He has not been able to tolerate any solid foods or liquids. Since yesterday, he has had 5–6 watery bowel movements. He has not noticed any blood in the stools. His wife brought him to the ER because he was becoming weak and dizzy when he tried to stand up. His wife denies any recent travel, use of antibiotics, laxatives, or excessive caffeine, or that her husband has an eating disorder. Case Study Questions

1. The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented name the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.

2. Create a list of risk factors the patient might have and explain why. 3. Unfortunately, the damage on J.R. kidney became irreversible and he is now diagnosed

with Chronic kidney disease. Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.

2. Reproductive Function: Ms. P.C. is a 19-year-old white female who reports a 2-day history of lower abdominal pain, nausea, emesis and a heavy, malodorous vaginal discharge. She states that she is single, heterosexual, and that she has been sexually active with only one partner for the past eight months. She has no previous history of genitourinary infections or sexually transmitted diseases. She denies IV drug use. Her LMP ended three days ago. Her last intercourse (vaginal) was eight days ago and she states that they did not use a condom. She admits to unprotected sex “every once in a while.” She noted an abnormal vaginal discharge yesterday and she describes it as “thick, greenish-yellow in color, and very smelly.” She denies both oral and rectal intercourse. She does not know if her partner has had a recent genitourinary tract infection, “because he has been away on business for five days. Microscopic Examination of Vaginal Discharge

(-) yeast or hyphae (-) flagellated microbes (+) white blood cells (+) gram-negative intracellular diplococci Case Study Questions

1. According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probably diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.

2. Based on the vaginal discharged described and the microscopic examination of the sample could you suggest which would be the microorganism involved?

3. Name the criteria you would use to recommend hospitalization for this patient.

NUR 512 Discussion week 4

3. Choose a state and review the scope of practice for the advanced practice nurse. How does it compare to Florid

Submission Instruction

You must complete both case studies

• Your initial post should be at least 500 words in total, (250 words per case study), formatted and cited in current APA style with support from a minimum of 2 academic sources PER CASE STUDY that are no older than 5 years old. Your initial post is worth 8 points.

• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)

• All replies must be constructive and use literature such as one intext citation from one scholarly source.

• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date. • Late work policies, expectations regarding proper citations, acceptable means of

responding to peer feedback, and other expectations are at the discretion of the instructor.

Rubric

This criterion is linked to a Learning OutcomeIdentifi cation of Main Issues, Problems, and Concepts

5 to >4.0 pts Distinguished Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts. 4 to >3.0 pts Excellent Identifies and demonstrates an accomplished understanding of most issues, problems, and concepts.3 to >0.0 pts Fair Identifies and demonstrates an acceptable understanding of most issues, problems, and concepts. 0 pts Poor Identifies and demonstrates an unacceptable understanding of most issues, problems, and concepts. Or nothing was posted.

5 pts 


This criterion is linked to a Learning OutcomeUse of Citations, Writing Mechanics and APA Formatting Guidelines

3 pts Distinguished Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors. 2 pts Excellent Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors. 1 pts Fair Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail. 0 pts Poor Ineffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. Or nothing was posted.

3 pts 


This criterion is linked to a Learning OutcomeRespon se to Posts of Peers

2 pts Distinguished Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.1 pts Fair Student constructively responded to one other post and either extended, expanded or provided a rebuttal.0 pts Poor Student provided no response to a peer's post.

2 pts