MRS BENNET MALABSORPTION SYNDROME CASE STUDY
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
Mrs. Bennett
GENDER Female
AGE 63
SETTING Hospital
ETHNICITY White American
CULTURAL CONSIDERATIONS
PREEXISTING CONDITIONS Cared for in a nursing home for the past five years
SPIRITUAL/RELIGIOUS
PHARMACOLOGIC
Allergy to erythromycin, tetracycline, tape, pneumococcal polysaccharide (pneumonia) vaccine
LEGAL
ETHICAL
Malabsorption syndrome (celiac disease); chronic wounds; pancreatitis with a pancreatic resection; depression
COEXISTING CONDITION
Stage III coccyx pressure ulcer
COMMUNICATION
DISABILITY Has been on disability for the past five years
ALTERNATIVE THERAPY
PRIORITIZATION
DELEGATION Collaboration with dietician and assistive nursing personnel
Overview: This case requires the nurse to consider the holistic effects of malabsorption syndrome on the client’s health and quality of life. Symptoms of nutrient deficiencies are reviewed. The impact of poor nutrition on wound healing is discussed. The nurse must be attentive to the safety risks specific to this client. Priority nursing diagnoses are identified.
Client Profile Mrs. Bennett is a 63-year-old woman with a history of malabsorption syndrome secondary to celiac disease. She is 5 foot 6 inches tall and weighs 100 pounds. She arrives in the emergency department from a nursing home with an elevated temperature and a decreased blood pressure and heart rate from her baseline. Her oxygen saturation is 89% on room air. She has a stage III pressure ulcer on her coccyx.
Case Study
Laboratory tests in the emergency department reveal Mrs. Bennett’s white blood cell (WBC) count is 12,000 cells/mm3, red blood cell (RBC) count is 3.16 million/mm3, hemoglobin (Hgb) 8.9 g/dL, hematocrit (Hct) 25.7%, mean cell (or corpuscular) volume (MCV) 70.8 μm3, mean cell (or corpuscular) hemoglobin (MCH) 20 pg, ferritin 7 mg/L, iron (Fe) 30 μg/L, total iron binding capacity (TIBC) 496 μg/ dL, and transferrin 195 mg/dL. Her potassium (K+) is 1.7 mEq/L, sodium (Na2+) mEq/L, chloride (Cl2) 79 mmol/L, calcium (Ca2+) 7.8 mg/dL, and protein 0 g/dL. Mrs. Bennett is admitted to the telemetry unit. She is placed on 4 liters of oxygen by nasal cannula. Her oxygen saturation improves to 96%. A regular diet is prescribed, with strict intake and output documentation and calorie counts. Because she will be primarily on bed rest, compression boots, graduated compres-sion stockings (TEDs), and heel protectors are prescribed. Her dressing change documentation for the wound on her coccyx indicates that during each shift, the wound is to be gently irrigated with 250 mL of normal saline (NS), Mesalt rope moistened with NS is to be packed in the wound and in the areas of undermining, and then the entire wound is to be covered with Mesalt gauze dressings.
Questions
- A colleague is not familiar with malabsorption syndrome. How would you explain what this condition is?
- Intrigued, the colleague asks, “How would you know if you had malabsorption? What are the symp-toms?” How would you answer?
- If Mrs. Bennett were to have a deficiency of each of the following nutrients, what symptoms might she experience?
Calcium
magnesium
iron
folic acid
protein
niacin (nicotinic acid)
vitamin A (Retinol)
vitamin B1 (thiamine)
vitamin B2 (riboflavin)
vitamin B12
vitamin C (ascorbic acid)
vitamin D
vitamin K
- What would the nurse expect to find during assessment of Mrs. Bennett’s HEENT (head, eyes, ears, nose, and throat), skin, abdomen, and extremities?
- The nurse assesses Mrs. Bennett for Trousseau’s and Chvostek’s sign. What is the nurse looking for and if positive, what do these signs indicate?
- The nurse is concerned that a regular diet is prescribed for Mrs. Bennett. The nurse calls Mrs. Bennett’s health care provider to discuss the concern and suggest an alternate diet. What foods are allowed on a regular diet and what type of diet will the nurse suggest instead?
- The nurse calls the dietician to discuss the scheduling of Mrs. Bennett’s meals. What type of scheduling will the nurse suggest?
- Why has Mrs. Bennett been admitted to a telemetry unit?
- Intravenous (IV) potassium chloride is prescribed. Should the initial dose be administered as an IV push (“bolus dose”) to help begin to correct Mrs. Bennett’s critically low potassium (K+) level of 1.7 mEq/L? Explain your answer.
- Before hanging Mrs. Bennett’s potassium, the nurse asks the assistive nursing personnel what Mrs. Bennett’s urine output has been during the shift. Why is the nurse concerned about the client’s urine output?
- A type & cross match of two units of packed red blood cells (PRBC) has been added to Mrs. Ben-nett’s medical treatment plan. Explain what it means to “type & cross match” and the rationale for includ-ing a PRBC transfusion in Mrs. Bennett’s plan.
- Bennett says to the nurse “The other day I overheard my doctor tell someone I had nontropi-cal sprue. As much as I wish that I was on a tropical vacation somewhere and not in the hospital, there is nothing warm and relaxing about what I have. What was he talking about?” Explain which disease the health care provider was discussing.
- Briefly explain the significance of Mrs. Bennett’s history of pancreatitis with a pancreatic resection to her present condition.
- Which factors for proper wound healing are inadequate in Mrs. Bennett’s case?
- Bennett has a prescription to obtain a wound culture during the next dressing change. Should the nurse obtain the wound sample before or after irrigating the wound with normal saline? Explain your answer.
- Provide a rationale for including compression boots, graduated compression stockings (TEDs), and heel protectors in Mrs. Bennett’s plan of care.
- What must the nurse keep in mind when gathering supplies to do Mrs. Bennett’s dressing change?
- Identify five nursing diagnoses appropriate for Mrs. Bennett’s plan of care. List the diagnoses in order of priority.
- Which of Mrs. Bennett’s allergies is of greatest concern and why?
- Discuss the impact that a chronic illness has on a person’s quality of life?
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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