Requirements of paper:
Paper meets length requirements at least 6 pages
Minimum of 3 scholarly references (in addition to the required textbook and readings.)
References are current – within a 5-year time frame unless a valid rationale is provided for use of older references
You are to meet patient Charles Gibson, who is in rehab recovering from stroke. A CT scan showed that he had a left sided Ischemic Stroke that left him with right sided weakness. Fortunately, Mr. Gibson was given tissue Plasminogen Activator (TPA) within the 3hrs time of symptoms onset. He is now in rehab with his wife getting Physical and Occupational Therapy.
History and Physical
Date of Birth: OCTOBER 12, 1942
RACE: African American
ALLERGIES: No Known Allergies
WEIGHT: 250 pounds
HEIGHT: 6’0″ / 113.398 kg
He has history of hypertension for which he refuses to take the medication prescribed for him. Patient states “I feel fine without it.” He has the medication but has not yet opened the prescription bottle. Has been diagnosed with Diabetes Mellitus Type II for which he takes Metaforim at 1000 mg/day. Keeps up with his doctor’s visits which are scheduled every four months. Smokes a half of a pack of cigarettes every day. Cut down from one pack per day over the past couple of years as his doctor told him. Enjoys all kinds of food including fried food, fast food and “soft drinks”. He has no acute distress.
Post Stroke MRI showed evidence of recent ischemic event with no worsening ischemia and reperfusion to compromised area of cortex. Patient Gibson suffers some speech difficulties which looks to be motor in origin. Is able to identify words when shown a picture of several everyday items. Tolerating nectar thick diet without incident. Will progress to soft -diet if swallow evaluation results are consistent with this. He is staying motivated but expresses remorse about not “being able to do what he did before”. He remains in sinus rhythm, HR 80s since cardioversion with Amiodarone one week ago. His BP stays in the 130s systolic and he assured us that he would be “good about taking his new medicines”.
IN REHAB Vitals: HR_ 82 NSR
RR- 18 Reg
Sat 96% on 2 L/min oxygen
Admit s/p stroke.
Vital signs every four hours with O2 saturation.
Diet: Nectar Thick
Swallow evaluation and call with results.
Metformin 1000mg po every 12 hours
Enteric Coated aspirin 81 mg po every day
Persantine 75mg po every day
Losartan 75mg po every day
Amiodarone 200 mg po every day
Discharge goal- two weeks from today with once weekly RN visits and outpatient PT/OT three times a week.
Please follow level 2 header with this paper and set level 2 header according to guideline bellow. Therefore, we should have 6 level 2 header(introduction, the case, interventions and inter-professional involvement, pharmacology interventions, nurse education role and conclusion):
1). Introduction: Introduction to the paper includes a concise and clear overview of the role of the nurse educator in assisting nursing students in understanding clinical vignettes. Includes the importance of the nurse educators’ in-depth understanding of the pathophysiologic mechanisms of disease states, the associated physical assessments and the pharmacologic implications for care. Includes all sections of the paper
2). The Case: Present Charles Gibson’s case. Be sure to include a summation of your findings and the associated pathophysiology and physical assessment findings.
a. How does Mr. Gibson present? Include your complete physical assessment,
b. What risk factors can you identify that has pre-disposed Charles Gibson to his disease state?N
c. Which clinical data is essential to identifying specified pathophysiologic or psychological problems?
In an in-depth manner describe why and how this condition affects him pathophysiologically and psychologically.
3). Interventions and inter-professional involvement: Present an overview of the care that Charles Gibson will need with an emphasis on the interprofessional involvement. Be sure to include your rationale for including the specific professional in his care, and their role and scope. Include a summation of the care they will provide with proposed patient outcome. All of the following are present:
• One strategy for resolving the identified issue is discussed substantively
• Concepts and principles from the selected nursing theory are clearly applied
• Rationale(s) for the strategy are evident
• Evidence from the scholarly literature supports the discussion
At least one ethical and/or legal aspect of the strategy is discussed.
4). Pharmacologic interventions: Present a pharmacologic treatment plan for Charles Gibson. Be sure to include an in-depth view of the presented pharmacologic approach and any modification to that pharmacologic treatment approach based on the most current clinical circumstances. Be sure to integrate advanced pharmakinetics in your pharmacologic treatment plan with your rationale for choosing the medications.
5). Nurse Educator Role: Present a brief overview of the nurse educator’s role in advancing students’ knowledge skills and abilities. Briefly explain the meaning of critical thinking in the clinical nursing realm. Propose two strategies for facilitating innovative communication, critical thought, and clinical judgment as a nurse educator. (You may use the strategies that were applied with the critical thinking assignment and the staff development assignment as examples.) What teaching principles were employed? How do the examples presented facilitate innovative communication, critical thought and clinical judgment?
6). Conclusion: Conclusion- Present a substantive overview of what was gleaned by writing this paper. How do understanding patients on an in-depth level assist the nurse educator in facilitating students’ understanding of pharmacology, pathophysiology and physical assessment? Concluding paragraph(s) clearly and adequately show new knowledge about applying nursing theory gained from writing this paper.