MRS DOLAN DIVERTICULAR DISEASE 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
GENDER Female
AGE 46
SETTING Hospital
ETHNICITY White American
CULTURAL CONSIDERATIONS
PREEXISTING CONDITION
COEXISTING CONDITION Urinary tract infection (UTI)
COMMUNICATION
DISABILITY
Mrs. Dolan (Part 1)
SOCIOECONOMIC Married; no children
SPIRITUAL/RELIGIOUS
PHARMACOLOGIC
Cefoxitin sodium (Mefoxin); metronidazole (Flagyl); morphine sulfate; diphenoxylate hydrochloride with atropine sulfate (Lomotil); propantheline bromide (Pro-Banthine); acetaminophen (Tylenol)
LEGAL
ETHICAL
ALTERNATIVE THERAPY
PRIORITIZATION
DELEGATION
Overview: This case requires the nurse to recognize the clinical presentation of diverticular disease. The nurse is asked to compare the presenting symptoms of other differential diagnoses to those of diverticulitis. Diagnostic testing and the treatment of diverticulitis are discussed.
Client Profile
Mrs. Dolan is a 46-year-old female who presented to the emergency departmentwith complaints of episodic abdominal pain, a low-grade fever, and diarrhea for almost two weeks. Mrs. Dolan was on vacation in another country when she developed pain in the left lower quadrant of her abdomen. Mrs. Dolan delayed seeking health care because of fear of the country’s unfamiliar medical system and the assumption that bad water or food she had while on vacation must have given her a stomach “bug.” Mrs. Dolan also reports a recent onset of painful urination.
Case Study
Upon examination in the emergency room, Mrs. Dolan is found to be dehydrated with a fever of 102.58F (39.2 8C). Vital signs are blood pressure (BP) 106/58, pulse 88, and respiratory rate of 22. Her potassium (K1) level is 2.8 mEq/L, erythrocyte sedimen-tation rate (ESR) is 37 mm/hr, and white blood cell (WBC) count is 16,000 cells/ mm3. A urinalysis showed a positive urinary tract infection (UTI) and an abdomi-nal/pelvic computed tomography (CT) scan revealed diverticulitis with a question of an ileus.
Mrs. Dolan is admitted and started on intravenous (IV) fluid of D51/2 normal saline (NS) with 20 mEq of potassium chloride (KCl) at 50 mL per hour. Two IV antibiotics (cefoxitin sodium and metronidazole) are prescribed. Her admitting orders include nothing by mouth (NPO), bed rest, IV morphine sulfate for pain management, stools to be checked for occult blood, strict intake and output (I & O), and repeat blood work in the morning to monitor her K+. Her height and weight on admission are 5 feet 7 inches and 170 lbs (77.3 kg). She is prescribed diphenoxylate hydrochloride with atropine sulfate, propantheline bromide, and acetaminophen as “as needed” pro re nata (prn) medications.
Questions
- How does diverticulitis differ from diverticulosis?
- Summarize the pathophysiology of acute and chronic diverticulitis.
- Describe the predisposing risk factors for diver-ticulitis. Identify any contributing factors for the development of diverticulitis in Mrs. Dolan’s case.
- The emergency department health care provider also considered that Mrs. Dolan’s symptoms could be indicative of a diagnosis of gastroenteritis. Briefly describe the clinical features of gastroenteritis and diverticulitis. How are the clinical presentations of these diagnoses similar?
- What is the usual source of the bacteria that leads to the development of gastroenteritis?
- Explain how Mrs. Dolan’s symptoms might be related to her urinary tract infection?
- The emergency department health care provider considered several differential diagnoses for Mrs. Dolan and a diagnosis of diverticulitis was determined. What diagnostic test confirmed Mrs. Dolan’s diagnosis of acute diverticulitis?
- Dolan’s abdominal/pelvic CT scan revealed diverticulitis with a question of an ileus. What is an ileus?
- Briefly explain why a barium enema, sigmoidos-copy, and colonoscopy are not considered appropri-ate diagnostic tests for a client with suspected acute diverticulitis.
- Discuss the medical management for a client with acute diverticulitis.
- The admitting health care provider explains to Mr. and Mrs. Dolan that some clients require surgery if conservative treatment does not resolve the acute episode of diverticulitis. What are the indications for surgical intervention?
- Discuss the rationale for including prn orders for diphenoxylate hydrochloride with atropine sulfate, propantheline bromide, and acetaminophen in Mrs. Dolan’s treatment plan.
- When collaborating with Mrs. Dolan to develop a plan of care, what outcome goals will be nursing care priorities?
- Dolan requests morphine sulfate. What should the nurse do before administering the medication?
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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