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Medical-Surgical Nursing

What Should the Nurse Do?

Medical-Surgical NursingWhat Should the Nurse Do?

What Should the Nurse Do?

Mrs. Harden, a 72-year-old female, visits the orthopedic clinic complaining of recurrent fractures and worsening back pain. She recently moved to the area to be closer to her family. Mrs. Harden has a medical history significant for osteoporosis, which was diagnosed 5 years ago. Other past medical history includes hypertension, COPD, and a COVID-19 infection 3 weeks ago. Her recent dual-energy X-ray absorptiometry (DEXA) scan indicates a significant decrease in bone density. On examination, her vital signs are stable, with a blood pressure of 130/80 mm Hg, heart rate of 78 beats per minute, and respiratory rate of 18 breaths per minute. Mrs. Harden reports difficulty with daily activities due to pain and concerns about her increased fracture risk.
1 .
What chronic diseases is Mrs. Harden currently diagnosed as having?
2 .
Given Mrs. Harden's history, what demographic factors does the nurse hypothesize are contributing to her current condition?
Mrs. Dickinson, a 55-year-old female, presents to the primary care clinic with complaints of persistent joint pain, stiffness, and difficulty moving. She reports a history of rheumatoid arthritis diagnosed 10 years ago, which has gradually progressed, leading to reduced mobility and increased reliance on assistive devices. Mrs. Dickinson's vital signs include a blood pressure of 130/80 mm Hg, heart rate of 82 beats per minute, respiratory rate of 18 breaths per minute, and oxygen saturation of 98% on room air. She expresses frustration with her declining ability to perform ADLs independently.
3 .
What disease does Mrs. Dickinson have and how does it contribute to disability?
4 .
Considering Mrs. Dickinson's frustration and reduced independence, what interventions or solutions could you propose to enhance her ability to perform ADLs and improve her overall well-being?
Mr. Kumar, a 30-year-old male, visits the primary care clinic with complaints of worsening shortness of breath, coughing, and chest tightness. He reports a medical history of asthma diagnosed in childhood, with occasional symptoms controlled by rescue inhalers. Recently, Mr. Kumar notes increased frequency and severity of symptoms, especially during the night. He denies any recent illnesses or changes in his medication routine. Vital signs reveal a respiratory rate of 24 breaths per minute, heart rate of 90 beats per minute, and oxygen saturation of 94% on room air. Mr. Kumar expresses concern about the impact of his symptoms on his daily activities and overall quality of life.
5 .
How would you analyze Mr. Kumar’s vital signs, especially the respiratory rate and oxygen saturation, in the context of his reported symptoms and history of asthma?
6 .
Considering Mr. Kumar’s vital signs and reported symptoms, what immediate actions would you take to address his asthma exacerbation during the clinic visit?
7 .
The nurse begins to assist with care coordination for this patient and makes a list of interdisciplinary team members who should be on the care team. Whom should the nurse include on this list?
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