NU 451 Women and Men‘s Health, Infectious Disease, and Hematologic Disorders

NU 451 Women and Men‘s Health, Infectious Disease, and Hematologic Disorders

NU 451 Women and Men‘s Health, Infectious Disease, and Hematologic Disorders

 

Women and Men‘s Health, Infectious Disease, and Hematologic Disorders 

Case Study 1 

The case study NU 451 Women and Men‘s Health, Infectious Disease, and Hematologic Disorders portrays HH who has been admitted for three days due to CAP. He has a history of COPD, HTN, hyperlipidemia, and diabetes. HH’s health needs include limited oxygen perfusion as evidenced by a SPO2 of 92% caused by CAP. The patient’s COPD may have contributed to CAP which occurs when bacteria breeds in the mucus clogged in the airways. He also has fever of 100.9 caused by respiratory infection. Besides, he has leukocytosis as seen with an elevated WBC and neutrophil account, indicating an underlying systemic infection. Furthermore, he has nutritional needs since he is not tolerating diet due to nausea and vomiting. The patient has hyperglycemia with elevated glucose levels of 143 mg/dL.

The recommended treatment will include antibiotics, antiemetics, antidiabetic, and lipid-lowering medications. The patient will be continued on IV Ceftriaxone 1 gm for a total of five days. IV Azithromycin will be switched to oral Azithromycin 500 mg OD for 5 days because the patient demonstrates improvement (Metlay et al., 2019). Antiemetics will include Metoclopramide 10 mg PO administered 30 minutes before meals to alleviate nausea and vomiting and in turn promote dietary intake. Metformin 850 mg/day PO will be recommended for diabetes and to maintain glycemic levels at optimum. It is recommended for overweight/obese diabetic patients because it does not cause weight gain unlike other hypoglycemic agents (Flory & Lipska, 2019). The recommended lipid-lowering agent will be Lipitor 20 mg/day PO to manage hyperlipidemia and lower the patient’s risk of cardiovascular conditions.  

My recommended patient education strategy for HH will be to employ the 

“Teach-back” method. When using this method, the provider explains the conditions, treatment options, and self-care strategies to the patient (Yen & Leasure, 2019). The provider then asks the patient to repeat what they have understood in their own words. 

NU 451 Women and Men‘s Health, Infectious Disease, and Hematologic Disorders References 

Flory, J., & Lipska, K. (2019). Metformin in 2019. JAMA, 321(19), 1926–1927. https://doi.org/10.1001/jama.2019.3805 

Metlay, J. P., Waterer, G. W., & Long, A. C. (2019). AMERICAN THORACIC SOCIETY Diagnosis and Treatment of Adults with Community-acquired Pneumonia An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Crit Care Med, 200(7), 45-67. https://doi.org/10.1164/rccm.201908-1581ST 

Yen, P. H., & Leasure, A. R. (2019). Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 36(6), 284–289. 

 

Case Study 2 

The case scenario portrays a 46-year-old who reports hot flushes, night sweats, and genitourinary symptoms. She is obese, has history

of HTN and ASCUS, and has a family history of breast cancer. The patient’s health needs include vasomotor symptoms like the hot flushes, night sweats, and genitourinary symptoms, which are probably because she is in the perimenopause phase. She has weight concerns since she is obese, which puts her at risk of diabetes and cardiovascular conditions. In addition, she has high BP of 150/90 despite being on antihypertensive treatment with Norvasc and HCTZ. The patient’s chronic hypertension increases her risk of developing stroke, heart failure and kidney failure. Furthermore, the client is at risk of cervical cancer because of her ASCUS history as well as breast cancer owing to her family history of breast cancer. 

           The recommended treatment plan is Hormone replacement therapy (HRT) with combined estrogen and progesterone to alleviate the vasomotor symptoms. Palacios et al. (2019) explain that Estrogen is the primary active component of HRT and is the ‘gold standard’ for managing vasomotor symptoms. However, chronic exposure of the endometrium to unopposed estrogen is associated with a risk of endometrial hyperplasia and cancer (Bansal & Aggarwal, 2019). Thus, progesterone is included in HRT in women with an intact uterus. The HRT for this patient will include Estradiol transdermal patch 0.025 mg and Micronized progestin 100 mg OD. Transdermal patches are preferred due to their lower risk of thromboembolism, stroke, vaginal bleeding, and breast tenderness. 

I would recommend the “Teach-back” method in educating the patient on self-care interventions. The strategy enables the provider to assess if the information they have taught the patient has been properly received and grasped (Talevski et al., 2020).This is because the provider teaches a concept and then instructs the patient to explain what they have learned based on their understanding.  

 

NU 451 Women and Men‘s Health, Infectious Disease, and Hematologic Disorders References 

Bansal, R., & Aggarwal, N. (2019). Menopausal Hot Flashes: A Concise Review. Journal of mid-life health, 10(1), 6–13. https://doi.org/10.4103/jmh.JMH_7_19 

Palacios, S., Stevenson, J. C., Schaudig, K., Lukasiewicz, M., & Graziottin, A. (2019). Hormone therapy for first-line management of menopausal symptoms: Practical recommendations. Women’s health (London, England), 15, 1745506519864009. https://doi.org/10.1177/1745506519864009 

Talevski, J., Wong Shee, A., Rasmussen, B., Kemp, G., & Beauchamp, A. (2020). Teach-back: A systematic review of implementation and impacts. PloS one, 15(4), e0231350. https://doi.org/10.1371/journal.pone.0231350 

 

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Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

The case is about a 46-year-old with hot flushes, night sweats, and genitourinary symptoms that began one month ago. She has a family history of breast cancer, history of HTN, and ASCUS. Her current BP is 150/90, and her weight is 230 lbs. The patient’s health needs include genitourinary and vasomotor, weight management, blood pressure management, and decreasing the risk of cervical and breast cancer. The vasomotor symptoms include night sweats and hot flushes, which can be linked to perimenopause (Pinkerton et al., 2019). The family history of breast cancer and history of ASCUS on Pap smear increases her risk of breast and cervical cancer. Besides, obesity and HTN increase her risk of heart disease, stroke, and obesity.

The recommended therapy is hormonal replacement therapy (HRT), with combined estrogen and progesterone. I would recommend a transdermal formulation like Estradiol 25 mcg patch for estrogen replacement. Estrogen is the primary active constituent of hormonal therapy and is considered the gold standard for managing perimenopausal vasomotor symptoms (Palacios et al., 2019). However, unopposed estrogen increases the risk of endometrial hyperplasia. Thus, I will recommend intravaginal progesterone 100 mg to restore progesterone.

The teach-back technique evaluates patients’ understanding by asking them to explain in their words what they have understood on ways to improve their health. A nurse can use this approach to verify that they have explained things in a way that the patient understands. Therefore, I would recommend the teach-back strategy to educate this client on measures to reduce the severity of hot flushes, like wearing light clothing and using fans to control room temperature (Ward & Deneris, 2018). The strategy will also be applied to educate the patient on lifestyle modification interventions to promote weight loss and lower BP, like increasing physical exercises and reducing caloric dietary intake.

NU 451 Women and Men‘s Health, Infectious Disease, and Hematologic Disorders References

Palacios, S., Stevenson, J. C., Schaudig, K., Lukasiewicz, M., & Graziottin, A. (2019). Hormone therapy for first-line management of menopausal symptoms: Practical recommendations. Women’s Health (London, England), 15, 1745506519864009. https://doi.org/10.1177/1745506519864009

Pinkerton, J. V., Conner, E. A., & Kaunitz, A. M. (2019). Management of menopause and the role For hormone therapy. Clinical Obstetrics and Gynecology, 62(4), 677-686. https://doi.org/10.1097/GRF.0000000000000487

Ward, K., & Deneris, A. (2018). An update on menopause management. Journal of Midwifery & Women’s Health, 63(2), 168-177. https://doi.org/10.1111/jmwh.12737

Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.