DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders

DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders – Step-by-Step Guide

The first step before starting to write the DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last few years and review each one for credibility. Ensure that you obtain the references in the required format, for example, in APA, to save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested in reading through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence collected from the research, and ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between paragraphs by using transition words and a flow of ideas.

How to Write the In-text Citations for DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders Instructions

Assessing, Diagnosing, And Treating Cardiovascular And Pulmonary Disorders

Cardiovascular conditions are among the leading causes of hospitalization and death among older adults, even though many of the risk factors that contribute to such conditions are preventable or manageable. In your role as an advanced practice nurse, you must be able to apply sound critical thinking and diagnostic reasoning skills to correctly assess and diagnosis these conditions. You also play an important role in helping patients manage disorders by planning necessary treatments, assessments, and follow-up care. Have a look at DRNP 6540 Midterm Exam Questions and Answers.

To prepare:

• Review the Week 5 Case Assignment document in the Learning Resources.
• Reflect on the patient’s symptoms and aspects of disorders that may be present.
• Consider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the case study.

The Assignment:

After reviewing the case and the accompanying case analysis questions, included in the document, answer the 10 questions directly in the Case Assignment document. When providing evidence to support your answers, be sure they evidenced-based, current (no more than 5 years old), and follow current standards of care. Follow APA 7th edition formatting. 

By Day 7

Submit your Assignment.

NRNP 6540 Week 5 Case Assignment

Case Title: A 68-year-old With Tachycardia and Coughing

Ms. Baker is a 68-year-old female who is brought to your office today by her daughter Rebecca. Ms. Baker lives with her daughter and is able to perform all activities of daily living (ADLs) independently. Her daughter reports that her mother’s heart rate has been quite elevated at home occasionally, sometimes 110 beats per minute. She has also been coughing a lot over the last 2 days.

Ms. Baker has a 30-pack per year history of smoking cigarettes but quit smoking 3 years ago. Other known history includes chronic obstructive pulmonary disease (COPD), hypertension, vitamin D deficiency, and hyperlipidemia. She also reports some complaints of intermittent pain/cramping in her bilateral lower extremities when walking and has to stop walking at times for the pain to subside. She also reports some pain to the left side of her back, and some pain with aspiration.

Ms. Baker reports she has been coughing a lot lately, and notices some thick, brown-tinged sputum. She states she has COPD and has been using her albuterol inhaler more than usual. She says it helps her “get the cold up.” Her legs feel tired but denies any worsening shortness of breath. She admits that she has some weakness and fatigue but is still able to carry out her daily routine.

 Vital Signs: Temp 99.2, BP 126/78, Pulse 90, RR 22, 0₂ Sat 98%

Labs: Complete Metabolic Panel and CBC done and were within normal limits

CMP Component	Value	CBC Component	Value
Glucose, Serum	86 mg/dL	White blood cell count	5.0 x 10E3/uL
BUN	17 mg/dL	RBC	4.71 x10E6/uL
Creatinine, Serum	0.63 mg/dL	Hemoglobin	10.9 g/dL
EGFR	120 mL/min	Hematocrit	36.4%
Sodium, Serum	141 mmol/L	Mean Corpuscular Volume	79 fL
Potassium, Serum	4.0 mmol/L	Mean Corpus HgB	28.9 pg
Chloride, Serum	100 mmol/L	Mean Corpus HgB Conc	32.5 g/dL
Carbon Dioxide	26 mmol/L	RBC Distribution Width	12.3%
Calcium	8.7 mg/dL	Platelet Count	178 x 10E3/uL
Protein, Total, Serum	6.0 g/dL
Albumin	4.8 g/dL
Globulin	2.4 g/dL
Bilirubin	1.0 mg/dL
AST	17 IU/L
ALT	15 IU/L

Allergies: Penicillin

Current Medications:

• Atorvastatin 40mg p.o. daily
• Multivitamin 1 tablet p.o. daily
• Losartan 50mg p.o. daily
• Albuterol inhaled 90mcg 2 puffs q4–6 hrs. prn
• Caltrate 600mg+ D3 1 tablet p.o. daily

Diagnosis: Pneumonia

Directions: Answer the following 10 questions and upload your document to Canvas site by due date.

Question 1: What findings would you expect to be reported or seen on her chest x-ray results, given the diagnosis of pneumonia?

Question 2: Define further what type of pneumonia Ms. Baker has, HAP (hospital-acquired pneumonia) or CAP (community-acquired pneumonia)? What’s the difference/criteria?

Question 3:

• 3A) What assessment tool should be used to determine the severity of pneumonia and treatment options?
• 3B) Based on Ms. Baker’s subjective and objective findings, apply that tool and elaborate on each clinical factor for this patient.

Question 4: Ms. Baker was diagnosed with left lower lobe pneumonia. What would your treatment be for her based on her diagnosis, case scenario, and evidence-based guidelines?

Question 5: Ms. Baker has a known history of COPD. What is the gold standard for measuring airflow limitation?

Question 6: Ms. Baker mentions intermittent pain in her bilateral legs when walking and having to rest to stop the leg pain/cramps. Which choice below would be the best choice for a potential diagnosis for this? Explain your reasoning.

1. DVT (Deep Vein Thrombosis)
2. Intermittent Claudication
3. Cellulitis
4. Electrolyte Imbalance

Question 7: Ms. Baker mentions intermittent pain in her bilateral legs when walking and having to rest to stop the leg pain. What test could be ordered to further evaluate this?

Question 8: Name three (3) differentials for Ms. Baker’s initial presentation.

Question 9: What patient education would you give Ms. Baker and her daughter? What would be your follow-up instructions?

Question 10: Would amoxicillin/clavulanate plus a macrolide have been an option to treat Ms. Baker’s Pneumonia? Explain why or why not.

DRNP 6540 Week 5 Assignment – Assessing Diagnosing and Treating Cardiovascular and Pulmonary Disorders Example

Case Assignment

A patient’s health history, physical examination, and laboratory testing/ imaging study results help diagnose and treat patients. Common practice guidelines are crucial to determining appropriate treatment interventions, while specific patient characteristics shape the specific care interventions. This paper reviews the case study of Ms. Baker and discusses vital data, including diagnosis, treatment, and patient education.

Question 1: What findings would you expect to be reported or seen on her chest x-ray results, given the diagnosis of pneumonia?

The patient’s diagnosis, coupled with the health history, raises expectations regarding the possible findings of the chest X-ray. The expected findings include infiltrates or consolidation in the left lung with increased opacity, a common finding in pneumonia (Yee & Raymond, 2020). If the infection is severe, pleural effusion is also expected. These findings are consistent with a diagnosis of pneumonia.

Question 2: Define further what type of pneumonia Ms. Baker has, HAP (hospital-acquired pneumonia) or CAP (community-acquired pneumonia)? What’s the difference/criteria?

Ms. Baker has community-acquired pneumonia (CAP). CAP is diagnosed in individuals who have not been hospitalized or in a healthcare facility within the last 14 days, while hospital-acquired pneumonia is diagnosed after 48+ hours of hospitalization (Aliberti et al., 2021). Ms. Baker lives at home and has not been recently hospitalized, meeting the CAP diagnostic criteria.

Question 3:

• 3A) What assessment tool should be used to determine the severity of pneumonia and treatment options?

Assessment tools are standard, allowing usable information and acceptable inferences to be collected. One tool that can be used to assess the severity of pneumonia is CURB-65. The tool is approved for assessing pneumonia severity and determining whether the patient needs inpatient or outpatient care.

• 3B) Based on Ms. Baker’s subjective and objective findings, apply that tool and elaborate on each clinical factor for this patient.

The tool uses five major parameters, each assigned a point for a total of five points. The five parameters are confusion, uremia (BUN > 19mg/dl or >mml/L), respiratory rate 30bpm and above, and low blood pressure (systolic BP below 90mmHg or Diastolic BP 60mmHg and below), and age above 65 years (Kurt et al., 2021). For this patient, she is not confused; BUN is normal, respiratory rate is 22, BP is 126/78, and is above 65 years, hence a total score of 1, thus low severity, and the patient is suitable for outpatient treatment with close monitoring.

Question 4: Ms. Baker was diagnosed with left lower lobe pneumonia. What would your treatment be for her based on her diagnosis, case scenario, and evidence-based guidelines?

The recommended first-line medications for CAP without comorbidities are amoxicillin, doxycycline, and macrolides. The treatment selected for this patient is Azithromycin 500mg STAT, then 250 OD for 4 days, and levofloxacin 750mg PO OD for 5 days (Aliberti et al., 2021). The patient is allergic to penicillin, hence the avoidance of amoxicillin, which is often a first-line treatment option. An antipyretic such as acetaminophen 500mg PO BID is also necessary for the patient. Other interventions necessary are continued albuterol inhaler for her COPD and encouraging hydration to thin secretions and enhance expectoration.

Question 5: Ms. Baker has a known history of COPD. What is the gold standard for measuring airflow limitation?

The gold standard for measuring airflow limitation is spirometry. Spirometry helps understand the various lung volumes and ratios, which are crucial to determining lung limitations/lung health. Neder et al. (2020) state that the forced expiratory volume and forced vital capacity are the gold standard, and a ratio of <0.70 confirms persistent airflow limitations. Other tests are crucial to determining lung function.

Question 6: Ms. Baker mentions intermittent pain in her bilateral legs when walking and having to rest to stop the leg pain/cramps. Which choice below would be the best choice for a potential diagnosis for this? Explain your reasoning.

The best choice for a potential diagnosis for the patient is Intermittent Claudication. The patient presents with several risks for peripheral artery disease such as symptoms of cramping when walking relieved by rest, pain in the calves, and pain subsiding a few minutes after rest (Waddell et al., 2022). These signs and symptoms are consistent with an intermittent claudication diagnosis.

Question 7: Ms. Baker mentions intermittent pain in her bilateral legs when walking and having to rest to stop the leg pain. What test could be ordered to further evaluate this?

The Ankle Brachial Index (ABI) test compares blood pressure between the upper and lower periphery (precisely at the ankle and arm) to evaluate arterial perfusion. The test is presented as a ration and an ABI above 0.90 indicates peripheral artery disease, a common cause of intermittent claudication (Herraiz-Adillo et al., 2020). The test can thus facilitate the diagnosis of underlying conditions and their management.

Question 8: Name three (3) differentials for Ms. Baker’s initial presentation.

1. Acute COPD exacerbation. The patient has a history of COPD, reports increased albuterol use for adequate symptomatic relief, and reports sputum production. The patient also has a history of COPD which she manages using an albuterol inhaler, increasing the likelihood of an exacerbation.
2. Bronchiectasis- The patient reports persistent cough with brown-tinged sputum production, repeated colds (which she increases albuterol inhaler intake),
3. Pneumonia. The patient presented with symptoms of cough, fatigue, fever, and left-sided chest pain consistent with pneumonia diagnosis.
4. Congestive cardiac failure. The patient is a known hypertensive patient who manages it with Losartan 50mg OD and presents with symptoms such as persistent cough, chest pain, fever, and fatigue, which can be symptoms of heart failure (Pirotta et al., 2021).

Question 9: What patient education would you give Ms. Baker and her daughter? What would be your follow-up instructions?

There are various education points for this patient. Mohamed et al. (2024) note that care providers should prioritize patient education on CAP to ensure good prognosis and better clinical outcomes. Patient education on medication administration as prescribed and taking a full medication course, using albuterol only as needed cautiously, not to exceed dosage recommendations (Mohamed et al., 2024). Another education point is recognizing symptoms of worsening health situations such as shortness of breath, fever, and chest pain. In addition, smoking cessation counseling is necessary to prevent COPD and cardiovascular issues exacerbation.

Re-evaluation after 48-72 hours is vital to monitor clinical response to the management interventions is crucial. Patient education on the need for hydration is necessary to promote better healing. Instructing the patient to come to the clinic immediately if symptoms worsen even after medication administration and after 3 days to check her response to treatment is crucial. Scheduling for an ABI test for PAD evaluation for this patient is necessary for a more definitive management of intermittent claudication.

Question 10: Would amoxicillin/clavulanate plus a macrolide have been an option to treat Ms. Baker’s Pneumonia? Explain why or why not.

Amoxicillin/clavulanate plus a macrolide are first-line treatment interventions for the management of community-acquired pneumonia. However, all penicillin medications are contraindicated in patients with a penicillin allergy. Ms. Baker’s health history shows that she is allergic to penicillin; hence, the medication would not have been an option to treat Ms. Baker’s pneumonia. 

References

Aliberti, S., Cruz, C. S. D., Amati, F., Sotgiu, G., & Restrepo, M. I. (2021). Community-acquired pneumonia. The Lancet, 398(10303), 906-919. https://doi.org/10.1016/S0140-6736(21)00630-9

Kurt, E., Ak, R., Kurt, Ş. E., Bahadirli, S., Nakiş, B., Cimilli, Ö. T., & Akoğlu, E. Ü. (2021). Prognostic utility of CURB-65 and E-CURB-65 scoring systems in healthcare-associated pneumonia patients: Short-and long-term mortality. Nigerian Journal of Clinical Practice, 24(11), 1706-1711. https://doi.org/10.4103/njcp.njcp_433_18

Neder, J. A., de-Torres, J. P., Milne, K. M., & O’Donnell, D. E. (2020). Lung function testing in chronic obstructive pulmonary disease. Clinics in Chest Medicine, 41(3), 347–366. https://doi.org/10.1016/j.ccm.2020.06.004

Waddell, A., Seed, S., Broom, D. R., McGregor, G., Birkett, S. T., & Harwood, A. E. (2022). Safety of home-based exercise for people with intermittent claudication: A systematic review. Vascular Medicine, 27(2), 186–192. https://doi.org/10.1177/1358863X211060388

Herraiz-Adillo, A., Cavero-Redondo, I., Alvarez-Bueno, C., Pozuelo-Carrascosa, D. P., & Solera-Martinez, M. (2020). The accuracy of toe brachial index and ankle brachial index in the diagnosis of lower limb peripheral arterial disease: A systematic review and meta-analysis. Atherosclerosis, 315, 81-92. https://doi.org/10.1016/j.atherosclerosis.2020.09.026

Pirrotta, F., Mazza, B., Gennari, L., & Palazzuoli, A. (2021). Pulmonary congestion assessment in heart failure: Traditional and new tools. Diagnostics, 11(8), 1306. https://doi.org/10.3390/diagnostics11081306

Mohamed, A. F., Abozead, S. E., Shaaban, L. H., & Hussein, A. H. (2024). Patient information regarding pneumonia: Providing comprehensive nursing intervention. Assiut Scientific Nursing Journal, 12(46), 359–366. https://dx.doi.org/10.21608/asnj.2024.309293.1880

Yee, S. L. K., & Raymond, W. J. K. (2020, September). Pneumonia diagnosis using chest X-ray images and machine learning. In Proceedings of the 2020 10^th International Conference on Biomedical Engineering and Technology (pp. 101–105). https://doi.org/10.1145/3397391.3397412