Case Study: Mrs. J.


It is essential for an RN-BSN-prepared nurture to evidence an enhanced intellect of the pathophysiological processes of illness, the clinical manifestations and composition protocols, and how they enjoy clients resisting the vitality brace.

Evaluate the Vigor Deed and Medical Instruction for Mrs. J., confer-uponed underneath.

Based on this instruction, makeulate a misrecord grounded on your evaluation, and consummate the Critical Thinking Essay assignment, as instructed underneath.

Health Deed and Medical Information

Health History

Mrs. J. is a 63-year-old married mother who has a deed of hypertension, constant nucleus need, and constant indivert pulmonary illness (COPD). Despite requiring 2L of oxygen/nasal cannula at residence during motive, she continues to fume two packs of cigarettes a day and has produced so for 40 years. Three days ago, she had quick onslaught of flu-enjoy symptoms including fervor, causative cough, disgust, and malaise. Over the late 3 days, she has been unfitted to act ADLs and has required maintenance in walking incomprehensive distances. She has not assumen her antihypertensive medications or medications to curb her nucleus need for 3 days. Today, she has been admitted to the hospital ICU after a while sharp decompensated nucleus need and sharp exacerbation of COPD.

Subjective Data

  1. Is very uneasy and asks whether she is going to die.
  2. Denies refusal but says she feels enjoy she cannot get sufficient air.
  3. Says her nucleus feels enjoy it is "running separate."
  4. Reports that she is unemployed and cannot eat or absorb by herself.

Objective Data

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


The forthcoming medications administered through garbage therapy curb her symptoms:

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)
  5. Inhaled incomprehensive-acting bronchodilator (ProAir HFA)
  6. Inhaled corticosteroid (Flovent HFA)
  7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 articulation, critically evaluate Mrs. J.'s birth. Include the forthcoming:

  1. Describe the clinical manifestations confer-upon in Mrs. J.
  2. Discuss whether the nursing interventions at the opportunity of her admissions were divert for Mrs. J. and decipher the rationale for each of the medications listed.
  3. Describe filthy cardiovascular states that may bring to nucleus need and what can be produced in the make of medical/nursing interventions to hinder the crop of nucleus need in each state.
  4. Taking into compensation the deed that most confirmed adults assume at lowest six order medications, examine filthy nursing interventions that can acceleration hinder problems caused by multiple garbage interactions in older patients. Provide a rationale for each of the interventions you approve.
  5. Provide a vigor encouragement and redintegration instruction sketch for Mrs. J., including multidisciplinary media for rehabilitation and any modifications that may be needed. Decipher how the rehabilitation media and modifications achieve relieve the patients' transition to insurrection.
  6. Describe a process for providing direction for Mrs. J. in-reference-to medications that need to be maintained to hinder forthcoming hospital admission. Provide rationale.
  7. Outline COPD triggers that can extension exacerbation abundance, resulting in restore visits. Considering Mrs. J.'s prevalent and long-term tobacco use, examine what options for smoking stopping should be offered.

You are required to mention to a reserve of two sources to consummate this assignment. Sources must be published after a whilein the latest 5 years and divert for the assignment criteria and pertinent to nursing exercitation.

Prepare this assignment according to the guidelines set-up in the APA Style Guide, located in the Student Success Center. An contemplative is not required.