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what precautions are required to prevent delayed wound healing?

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In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
Max Points: 20.0
This is the case study 1 :

The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.

Subjective Data

  • Complains of pain and heaviness in her leg.
  • States she cannot bear weight on her leg and has been in bed for 3 days.
  • Lives alone and has not had anyone to help her with meals.

Objective Data

  • Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
  • Left leg red from knee to ankle
  • Calf measurement on left 3 in > than right
  • Temperature: 38.9 degrees C
  • Height: 160 cm; Weight: 83.7 kg

Laboratory Results

  • WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
  • Wound culture: Staphylococcus aureus

Critical Thinking Questions

  1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
  2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
  3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
  4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients.

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In a short essay (500-750 words), answer the Question at the end of Case Study 2. Cite references to support your positions.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

This is the case study:

Max Points: 20.0

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is so exhausted she cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5 kg
  2. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
  3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
  5. Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

Changes in Eyes Due to Certain Medical Conditions and Ear Changes Caused by Aging Process

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Please, respond to the following discussion in one  paragraph, using only one reference from peer-reviewed Nursing Journal not older than  years. APA format required, no need for cover page.

Changes in Eyes Due to Certain Medical Conditions and Ear Changes Caused by Aging Process

The eyes are our windows to the word. Different medical conditions can cause changes to the eyes. In this discussion I will write about Cataracts, Glaucoma, Diabetes Mellitus, and Chronic Hypertension.

Cataracts is when protein clumps up and clouds the lens, this reduces the light that reaches the retina. The easiest symptom to see objectively is clouded eyes. The patient complains of sensitivity to light and glares. Difficulty with night vision and halos around lights is also a complaint. Blurred vision is reported due to seeing thru clouded eyes.

Glaucoma causes damage to the optic nerve and gets worse over time. It can cause vision loss and blindness overtime. Early treatment can protect from vision loss. Symptoms can be hazy or blurred vision, rainbow colored circles around bright lights, severe eye and head pain, nausea and vomiting with eye pain and sudden eye loss.

Diabetes Mellitus can lead to Diabetic Retinopathy which affects vessels in the light sensitive tissue called the retina. This is the leading cause of blindness among the working age. Symptoms can be wavy vision, color changes, spots or floaters, trouble with night vision. Increase in sugar level causes the lens of the eye to swell which affects vision. Decrease in sugar level causes blurriness and double vision.

Chronic Hypertension can cause damage to the blood vessels in the retina, the area at the back of the eye where images focus, this is known as hypertensive retinopathy. This can lead to blindness. Symptoms can be fluid oozing from blood vessels, double vision, blurred vision, swelling of the optic nerve or macula, and spots on retina known as cotton wool spots.

These conditions can be managed and prevented in some cases if not most with proper attention and education.

There are changes to the ears due to the aging process. Older adults should be asked about hearing loss, vertigo, ringing in the ears ( tinnitus), and even dizziness.

Otoslerosis is a possibility especially in older adults. Otoslerosis happens due to slow fusion of ossicles in the middle ear, this obstructs sound waves. This can cause difficulty with distinguishing sounds when it is noisy. Mumbled speech can also be a symptom.

Presbycusis happens over time and it is a natural sensor neural loss. The hair cells in the cochlea become less flexible. Hearing deficiency is a symptom.

During Review of Systems these conditions should be asked about. Sometimes patients are not even aware of these changes and need to be educated so they can seek help.

What are the key roles for government in serving the public’s health?

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Public health is an essential function of the government on a par with, and for reasons similar to, national defense and law enforcement. Specific public health needs, such as sanitation systems and clean water, cannot be met by individuals acting alone. The government is required to organize community efforts as well as compel cooperation when necessary; otherwise, individuals would be free to benefit from, but not contribute to, the resulting public good.

Considering the above, respond to the following:

  • What are the key roles for government in serving the public’s health? Why?

Submission Details:

  • Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week.
  • Give examples and reasons in support of your responses.
  • Write your initial response in 300–500 words.