Week 4 Discussion.docx - Week 4 Discussion Esther Jackson...

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Week 4 Discussion Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient's room for report. Approximately 1 hour later, you return to Ms. Jackson's room with her morning pills and find her slumped over the bedside stand in tears. The patient states, "I don't know what is wrong, I don't feel right. My back hurts and I'm just so tired. What is wrong with me?" The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach. Just then the nursing assistant comes into the patient's room to record Ms. Jackson's vital signs, you take this opportunity to quickly research the patient's medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn't get the patient's pulse because "it is all over the place." Please address the following questions related to the scenario. 1. What do you suspect is the cause of the patient's symptoms? 2. Describe the course of action that you will take to confirm this suspicion and prevent further decline. 3. What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so. 4. While you are caring for this patient, how will you ensure that the needs of your other patients are being met? Here are some additional questions to consider for the week four discussion... 1. How is smoking linked to cardiac disease? 2. Why would a change in mental status in an older adult be significant in assessing cardiac status? 3. Is having a Type A personality a risk factor for cardiac disease? Explain.
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4. Describe a murmur. What are conditions that can result in a murmur? 5. What are modifiable risk factors men and women can change to decrease risk for cardiovascular disease? 6. What are extracardiac or cardiac signs in children that may indicate heart disease? 7. Let us know something you've learned from the reading or lesson this week. Something interesting, something you'd forgotten, something you have a new perspective on! :) Hello Professor and Class, Based on our case scenario, our patient one day post-op after major surgery. Pain is the fifth vital sign, that provides us with additional, very important, information of the patient’s condition. Pain after any surgery is always a major issue and it is significant to input critical thinking during assessing a type, intensity and reasons for pain. After mastectomy, adhesions or scar tissues can
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