NRS 455 Case Study: Mrs. T.

NRS 455 Case Study: Mrs. T. – Step-by-Step Guide

The first step before starting to write the NRS 455 Case Study: Mrs. T., 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 NRS 455 Case Study: Mrs. T.

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 words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can 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 NRS 455 Case Study: Mrs. T.

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 to read 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 NRS 455 Case Study: Mrs. T.

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 conducted from the research, 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 each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NRS 455 Case Study: Mrs. T.

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 NRS 455 Case Study: Mrs. T.

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 NRS 455 Case Study: Mrs. T.

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, in sentence sentence care. 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.0000000000000456Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NRS 455 Case Study: Mrs. T.

Use the “Case Study: Mrs. T.” template to complete the assignment.

Case Study: Mrs. T. has indirect care experience requirements. The “NRS-455 – Case Studies: Indirect Care Experience Hours” form, found in the Topic 1 Resources, will be used to document the indirect care experience hours completed in the case study. As progress is made on the case study, update this form indicating the date(s) each section is completed. This form will be submitted in Topic 3. Read the next task here NRS 455 Topic 3 DQ 1 Describe in detail the pathophysiological stages of kidney stones in a working 45-year-old adult male.

You are required to cite a minimum of three 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.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

American Association of Colleges of Nursing Core Competencies for Professional Nursing Education

This assignment aligns to AACN Core Competencies 2.3, 2.4, 2.5, and 2.9.

Case Study: Mrs. T.

Directions: Read the case study below. Evaluate the information and formulate a conclusion based on your evaluation. Complete the critical thinking table and submit this completed template to the assignment dropbox.

NRS 455 Case Study: Mrs. T. Example.

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. T., presented below.

Health History and Medical Information

Mrs. T., a 42-year-old female, has been living at home with her two high school age children, husband, and dog. She is a schoolteacher who works full-time teaching at the local grade school. She tries to be active by walking with her husband and dog for 20 minutes on the weekend but is starting to add weight as she gets older. She has no known allergies. She is a pack-a-day smoker and drinks three glasses of wine/per night after work. She tries to eat healthy but likes to eat out at fast food restaurants to avoid having to cook.

Medical history includes atrial fibrillation controlled with beta blocker, hypercholesterolemia, mild anemia related to heavy menses, and migraines. Current medications include:

1. Metoprolol 50mg daily
2. Pravastatin 40 mg at bedtime daily for cholesterol
3. Birth control pill Microgestin Fe in the AM
4. Amitriptyline 20 mg/daily for migraines

Case Scenario

You are the school nurse where Mrs. T. works. While at recess duty, another teacher runs up to you and reports that Mrs. T. is not acting like herself. When you approach, you see her sitting on a bench mumbling something to the kids gathered around her. She has dropped her cell phone on the ground, and her right arm appears limp. You try asking her questions and you notice the right side of her face is slacken, and she does not seem to be making sense when talking. You call an ambulance, and try to walk her back to your office, but she does not move well. You reassure her and try to determine if anything occurred prior to her loss of speech and movement. The other teachers say it came on suddenly, within the last 5 minutes. Mrs. T. shakes her head no to pain.

Objective Data – Completed by Ambulance Personal:

1. Temperature: 36.5 degrees C
2. BP 184/92, HR 101, RR 24, Pox 99%

• Blood Glucose = 107
• Positive FAST & VAN score, NIHSS = 12
• Height: 62 inches; Weight 89 kg

Laboratory/Test Results – On Arrival to the Emergency Department (Initial Results)

1. WBC: 9.4 (1,000/uL)
   1. INR – 0.7
   1. CT Head is normal.
   1. Negative pregnancy test
   1. Cholesterol – 247, Triglycerides – 302

Critical Thinking Table

Clinical Manifestations Describe the clinical manifestations present in Mrs. T., focusing on what is normal and abnormal and how this relates to her current condition.
Subjective
Objective	The right arm appears to be flaccid. The right side of the face is flaccid. Her cell phone was dropped. Lack of agility. The blood pressure is 184/92 mmHg, heart rate is 101 beats per minute, respira breaths per minute, and oxygen saturation is 99%. The blood glucose level is 107. The FAST & VAN score indicates a positive result,
Primary and Secondary Diagnoses Discuss the primary and secondary medical diagnoses that should be considered for Mrs. T., and why you chose this diagnosis.
Primary medical diagnosis and why you chose this diagnosis.	The diagnosis of ischemic stroke that ischemic stroke happens when a clot or fatty plaque blocks a blood artery in the brain, cutting off blood supply to certain regions of the brain, American Stroke Association. (2021). Because of this obstruction, the brain does not receive enough oxygen and nutrients through the bloodstream. Within minutes of a loss of blood flow, brain cells start to die; failure to restore blood flow rapidly enough can cause irreversible brain damage or death.

	This disease process is determined by the rapid onset of symptoms, a positive FAST score, and an NIHSS score of 12, indicating substantial neurological impairment.
Secondary medical diagnosis and why you chose this diagnosis.	The medical background of Mrs. T. suggests that atrial fibrillation may have had a role in causing the stroke, Jauch, E. C., et al. (2019). Atrial fibrillation, or A-fib for short, is an irregular heartbeat that happens when the electrical signals sent by the heart’s upper chambers (the atria) are fast and not in sync with one another.
Formulate a nursing diagnosis from the medical diagnoses	Speech impairment is evidence of impaired verbal communication due to an ischemic stroke. When blood flow to the brain is interrupted, it causes a condition known as an ischemic stroke, Jauch, E. C., et al. (2019). The inability to produce or comprehend written or spoken words is known as aphasia. Strokes affecting the linguistic regions of the left hemisphere are a common etiology. After a stroke, aphasia can appear quickly or progress subtly. What causes and how much damage to the brain determines the degree of aphasia.
Pathophysiological Changes Explain the pathophysiological changes in Mrs. T.
What pathophysiolo gical changes would you expect to be happening to Mrs. T.?	Two internal carotid arteries control blood flow to the brain from the front, while two vertebral arteries form the circle of Willis from the back. It occurs when brain tissue dies from ischemia or infarction when the amount of blood flowing to the area is insufficient to fulfill the metabolic demands of the cells. An abrupt cessation of blood circulation to the brain leads to cellular death and neurological deficits. Neurological deficits, potential cognitive decline, and alterations in motor abilities are all anticipated.
How will pathophysiolo gical changes	A condition characterized by a rapid reduction in cerebral blood flow, leading to cell death and neurological deficits. Changes in motor function, cognitive impairment, and neurological

transition in the subacute phase after diagnosis and initial treatment?	impairments are all things that people can anticipate. During the acute phase, we talk about neuroplasticity, recovery and rehabilitation processes, and possible residual deficits.
Health Status Effect Describe the effects Mrs. T.’s current health status may have on her.
Describe the physical, psychological, and emotional effects Mrs. T.’s current health status may have on her.	Patients with this condition are often upset when they are getting better As a common response to this tragic event, Mrs. T may encounter increased depression. Symptoms of mental illness may include a lack of stability in mood, hostility, impatience, rage, and an inability to work with others, American Stroke Association. (2021). Impairments in motor skills, which may result in reduced independence, Personality Disorder Lack of self-restraint Delicate emotional state Reduced ability to handle difficult situations, Depressive disorder’ Exclusion from, Antipathy, dread, and fury Dealing with a lifestyle change while fretting over a recurrence might lead to feelings of isolation. Mrs. T. may find it more difficult to fulfill her family role due to her reduced capacity to engage in family activities.
Discuss the impact it can have on her role in the family.	Impaired speech limited physical abilities, weakness or paralysis of one side of the body, trouble grasping or retaining objects, and a slowed capacity to communicate is the most prevalent forms of impairment following a stroke, American Stroke Association. (2021).
Treatments and Support Discuss treatments and support that can be completed for Mrs. T.
Discuss the immediate treatments that can be completed for Mrs. T.	Administration of thrombolytic therapy, if it is accessible. Regulation of blood pressure. Regulation of blood glucose levels. admission to a stroke unit for medical attention and monitoring.

Describe the
long-term	Rehabilitation therapies include speech, occupational, and physical therapy.
support she	Secondary preventative drugs include anticoagulants and antiplatelets.
may need to	Smoking cessation, dietary modifications, and consistent physical activity are
return to	all instances of lifestyle enhancements, American Stroke Association.
baseline	(2021).
activity level.	Neurologists, physical therapists, occupational therapists, speech therapists,
	and social workers collectively form the multidisciplinary team.
Explain how	When dealing with patients who have had an acute ischemic stroke, Powers,
the	W. J., et al (2018), it is essential to employ a multidisciplinary team
interdisciplina	approach. A wide range of healthcare experts, each with their specialization,
ry team is	make up this team. The primary objective is to offer all-encompassing care
utilized to help	that attends to the patient’s and their family’s emotional, psychological, and
her family	physiological requirements, care that addresses all aspects of the patient’s
support and	health and well-being.
cope with her
diagnosis.

References:

1. American Stroke Association. (2021). Guidelines for the Early Management of Patients with Acute Ischemic Stroke. Stroke, 52(12), e364-e467.
2. Jauch, E. C., et al. (2019). Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 44(3), 870-947.
3. Powers, W. J., et al(2018). Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 50(12), e344-e418.