Critique the 3 presentations attached and follow the rubric.

total of 3 pages, one per powerpointapa format

references from the last 5 years

Crohns Disease
Definition

A type of Inflammatory Bowel Disease

“Causes inflammation of the digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrion” (Crohn’s Disease, 2019)

1

Risk Factors

Age

Race or Ethnicity

Family History

History of Smoking

Use of Nonsteroidal Anti-Inflammatory Medications

Environmental Factors

Majority of people who have IBD are usually diagnosed before the age of 30, however, some people don’t begin to have symptoms until their 50s or 60s.

The white population generally have the highest risk of Crohn’s disease than any other race. Though Crohn’s disease is found in all races.

If a person has a family member such as a child, parent or sibling they are at a higher risk for developing Crohn’s disease

According to the Mayo Clinic “cigarette smoking I the most important controllable risk factor for developing Crohn’s Disease.” (Crohn’s Disease, 2019)

Examples of NSAIDS are Ibuprofen, Naproxen, diclofenac sodium. If a person already has a a diagnosis of inflammatory bowel disease (IBS) and takes NSAIDs they are a risk for worsening the disease. Taking NSAIDs also places a person at risk for developing IBD.

Environmental factors that place a person at risk for Crohn’s include diet choices such has eating foods high in fat, and areas where a person resides such as industrialized country.

2

Etiology

The exact cause of Crohn’s disease is unknown

Begins with Inflammation and abscesses

A bacterium or virus could trigger Crohn’s disease

Genetic Factor

According to the Crohn’s Colitis foundation “studies have shown that between 5% and 20% of people with IBD have a first-degree relative, such as a parent, child, or sibling, who also has one of the diseases”. (Long, 2020)

3

How Crohn’s Disease
Affects The Body

“As the disease progress you may start to feel fatigued and develop anemia. You may also experience nausea from constant irritation of the GI tract.”(Healthline)

A Progressive Disease

Will have this disease for the rest of their life

Common Symptoms

Diarrhea

Fever

Fatigue

Abdominal pain and cramping

Blood in the stool

Loss of appetite and weight

Because Crohn’s disease is a progressive disease it can lead to many complications such as bowel obstructions, ulcers, anal fissures, colon cancer and many other issues which could lead to the patient needing surgery. In many

Top of Form

Benchmark – Health Screening and History of an Adolescent or Young Adult Client

 

1
Unsatisfactory
0.00%

2
Less than Satisfactory
75.00%

3
Satisfactory
79.00%

4
Good
89.00%

5
Excellent
100.00%

80.0 %Content

 

20.0 % Include All Components of the Health Screening and Health History (Biographical Data, Past Health History, Family History, Review of Systems)

Does not provide health history and/or screening.

Provides some components of the health screening and history in an incomplete form.

Provides all components of the health screening and history in a complete form.

Provides all components of the health screening and history in detail and relates information to the diagnoses.

Provides all components of the health screening and history in extensive detail and relates information to the diagnoses and integrates into treatment plan.

30.0 % Develop Actual Nursing, Wellness, and ?Risk For? diagnoses for the Client Based on Health History and Screening

Does not provide nursing diagnoses.

Provides incomplete nursing diagnoses (Actual, Wellness, and Risk For) based upon the information collected in the health screening and history, and review of systems. Rationale absent.

Provides complete and accurate nursing diagnoses (Actual, Wellness, and Risk For) and includes rationale based upon the information collected in the health screening and history.

Interrelates complete and accurate nursing diagnoses (Actual, Wellness, and Risk For) and provides rationale based upon the information collected in the health screening and history, and review of systems.

Interrelates complete and accurate nursing diagnoses (Actual, Wellness, and Risk For), provides rationale based upon the information collected in the health screening and history, and review of systems, and integrates each diagnosis into a recommended wellness plan for the patient.

20.0 % Wellness Plan

Does not provide wellness plan.

Provides incomplete wellness plan based upon the diagnoses developed.

Provides complete and accurate wellness plan based upon the diagnoses developed.

Provides all components of the wellness plan in detail and relates information to the diagnoses.

Provides all components of the wellness plan in extensive detail a

Grand Rounds Presentation: Recurrent/Chronic UTI

Case Study

Patricia Jones DOB 06/01/1967 53-year-old African American female patient.

History of present illness: urinary frequency, urgency, and burning onset one week ago until present.

Past Medical History: Diabetes mellitus type 2, hypertension, kidney stones, urinary tract infections.

Medication Allergies: NKDA

Case Study Continue

Vitals

Temp: 100°F (37.8° C) oral

Pulse: 80

BP: 145/82

Respirations: 18

Pulse Oximetry: 98% on room air

Pain: 2/10

Case Study Continue

Physical Exam Findings

Alert and oriented x 4

Lung sounds clear

Heart sounds normal

Abdomen soft, suprapubic tenderness with palpation.

Lab Findings: Urine Sample and Culture

Urine specimen cloudy in appearance.

Urine culture moderate leukocytes in urine.

Description of Disease

Urinary Tract Infections (UTI) occurs when bacteria such as E.coli or Staph enters in the urinary tract causing infection and inflammation (Hunstad & McLellan, 2016).

Recurrent or chronic urinary tract infection is defined as two or more episodes of a UTI within 6 months (Hunstad & McLellan, 2016).

Hunstad, D. A., & Mclellan, L. K. (2016). Urinary Tract

Infection: Pathogenesis and Outlook. Trends in Molecular Medicine, 22(11), 946-957. doi:10.1016/j.molmed.2016.09.003

Description of Disease continue

SIGNS & SYMPTOMS

Burning with urination

Frequent urination

Urgency with urination

Fever

Suprapubic pain

WBCs in urine (leukocyturia)

(Jhang & Kuo, 2017).

Jhang, J., & Kuo, H. (2017). Recent Advances in

Recurrent Urinary Tract Infection From Pathogenesis and Biomarkers to Prevention. Tzu Chi Medical Journal, 29(3), 131. doi:10.4103/tcmj.tcmj_53_17

Description of Disease Continue

Cultural barriers related to Urinary Tract Infections:

In African American and Hispanic cultures, urinary tract infections and the symptoms associated with it are viewed as a normal part of the aging process (Bennett, Callan, & Duane, 2016).

Bennett, K., Callan, A., & Duane, S. (2016).

Using Qualitative Insights to Change Practice: Exploring the Culture of Antibiotic Prescribing and Consumption for Urinary Tract Infections. BMJ Open, 6(1). doi:10.1136/bmjopen-2015-008894

Solution:

Cultural assessment regarding the patient’s belief and understanding of UTI’s and proper education.

Mediation

Influenza

Overview

Case Study

Pathophysiology

Symptoms

Potential Barriers

Medication management

Image retrieved from : https://micro.magnet.fsu.edu/cells/viruses/influenzavirus.html

Case Study

67yr old female presents with reported productive cough and congestion, fever and chills, muscle aches, nausea, decreased appetite and sore throat for two days. She has been in contact with a family member who had similar symptoms five days ago. She has a history of diabetes and hypertension.

Medications:

Metformin 850mg once daily with breakfast

Amlodipine 5 mg once daily

Allergies: Penicillin

Case Study Cont.

Physical exam

Skin is warm and moist

Lungs are clear bilaterally

Throat is mildly red

Sputum is tan/greenish color

ABD is soft and nontender

Vital Signs:

Oral temp- 101.7

heart rate- 103

Resp- 20

BP- 138/82

O2-98%

Labs:

Glucose: 145

PCR: Positive for Influenza A virus

Creat: 0.8

Influenza

Respiratory Virus

Immune response

Replication: transcription

Sign and symptoms

Image retrieved from:https://upload.wikimedia.org/wikipedia/commons/9/9e/Symptoms_of_influenza.svg

Symptoms of the influenza virus are caused by the bodies immune response. The virus enters the body when a person comes in contact and breathes in aerosols from an infected person. The virus begins to infected epithelial cells of the respiratory tract where they replicate via transcription in the host cells nucleus and continue to infect other cells. The body detects the virus as being foreign and attempts to get rid of it. It does so by bringing immune cells to the area of the infection causing inflammation. The body also attempts to rid the virus by secreting mucous through goblet cells causing congestion. Influenza can cause severe symptoms and lead to pneumonia is the virus reached the lungs and infects the cells lining the alveoli. Common signs and symptoms include cough, sore throat, runny nose, fever, chills, myalgia, and headache. More severe symptoms include shortness of breath, tachycardia, and hypotension (Kalil, & Thomas, 2019).

5

Potential Barriers

Vaccinations

Disbelief

Untrustworthy of officials

Social Determinants

Access to healthcare

Health insurance

Education

Crowding

Possible Solutions

Continue to educate public

Increase access to healthcare

Participate in free vaccine clinics