Case Study: Mrs. J.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mrs. J., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.
- Is very anxious and asks whether she is going to die.
- Denies pain but says she feels like she cannot get enough air.
- Says her heart feels like it is “running away.”
- Reports that she is exhausted and cannot eat or drink by herself.
- Height 175 cm; Weight 95.5kg.
- Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
- Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
- Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
- Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
The following medications administered through drug therapy control her symptoms:
- IV furosemide (Lasix)
- Enalapril (Vasotec)
- Metoprolol (Lopressor)
- IV morphine sulphate (Morphine)
- Inhaled short-acting bronchodilator (ProAir HFA)
- Inhaled corticosteroid (Flovent HFA)
- Oxygen delivered at 2L/ NC
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:
- Describe the clinical manifestations present in Mrs. J.
- Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
- Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
- Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
- Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
- Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
- Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Critical criminology has gained traction in recent years, with its devotion to questioning the definitions of crime and measurements of official statistics, its critical view of agents, systems, and institutions of social control, and the connections with social justice and policy change (Carrington & Hogg, 2002). Theories of critical criminology are rooted in the structure of society, focusing on power systems and inequality. This paper will focus on labeling theory and crimes of the powerful, as they have a certain dichotomy regarding public vs. private criminality. With labeling theory, those in power have the authority to decide what is the “norm” and what is the “other,” ostracizing the “other” from the rest of society. The stigmatization of public shaming for the common citizen is carried out in all aspects of public life – the labeled individual is looked down on by family, peers, community, and employers, and it is very hard for them to shake the label (Denver et al., 2017; Kroska et al., 2016). Regarding crimes of the powerful, those in power have the privilege to escape stigmatization and consequences of illegal actions. Those in power protect their own through deciding what is illegal or not, and deciding the consequences for illegal actions. These crimes occur in private and are often underreported and under prosecuted, allowing the powerful to escape consequences. Critical analysis will address these dichotomies, challenging theoretical assumptions and criminal justice practices to advocate for structural change. Labeling Theory Background Labeling theory discusses the structural inequalities within society that explain criminality. It can be traced back to Mead’s theory of symbolic interactionism in 1934, which discusses the importance of language regarding informing social action through processes of constructing, interpreting, and transmitting meaning (Denver et al., 2017, p. 666). From there, labeling theory was further developed with Lemert’s distinction between primary and secondary deviance in 1951, which explained how deviance of an individual begins and continues (Thompson, 2014). Finally, and perhaps most influentially, we have Becker’s labeling theory of deviance in 1963, which is the version of the theory that will be guiding this discussion in the essay (Paternoster & Bachman, 2017). In Becker’s labeling theory, he describes crime as a social construct:>GET ANSWER