Many nursing assignments help task require for the close review and analyses of nursing case studies. In this situation, the nurses will have to read a case study and correlate it to their learning and experiences. This is imperative towards any nurse’s career growth as it exposes them to important learning and findings identified by previous researchers thus helping build their knowledge. For this example, we shall review hoe a case study on Mr. Rogers needs to be prepared and important questions which need to be answered.
The nurse would prepare Mr. Rogers for the Doppler ultrasound through several ways; describe the process, its purpose and requirements, duration, and what happens before, during and after the procedure.As such the nurse would start by explaining that Doppler ultrasound uses an organ reflection of waves from the sound produced by the machine to detect the movement of blood in arteries and veins; thus, helping to identify clots in conditions like Deep Vein Thrombosis (DVT). The nurse would then ask Mr. Rogers to avoid nicotine substances, remove jewelry and remain still during the procedure which would last for thirty minutes to one hour. These interventions are vital in allaying his anxiety and promoting adherence to the procedure.
Cellulitis refers to a connective or soft tissue inflammation that is diffuse and it is in most circumstances caused by Streptococcus pyogenes and Staphylococcus Aureus; where any skin breakage can be an entry point, for example, abrasions, eczema, burns, insect bites among others. However, the skin usually looks intact. Its common manifestations include pain, warmth, swelling, and erythema. The inflammatory response of the immune system causes pain in the affected anatomical site. Warmth and erythema as a result of the increased supply of blood to the area in a bid to deliver immune chemicals and mediators, white blood cells and increase its temperature to inactivate the microbes. Moreover, inflammation causes swelling.
Always look for important and unique nursing terms used by the expert offering nursing assignment help as it demonstrates their command over the subject. Avoid nursing assignment helps services which offer generic information and lack subject-specific terms.
Gout is a joint inflammation that results from the presence of the crystals of monosodium urate monohydrate (MSU)around or in the tissues of the joint. These crystals are formed due to the increased serum levels of uric acid. Primary gout is mainly due to high levels of blood uric acid because the body is unable to excrete it effectively, consumption of high purine-content foods, grain alcohol consumption among others. On the other hand, secondary gout results from complications caused by other factors such as metabolic syndrome, leukemia, the deficiency of Hypoxanthine-guanine phosphoribosyltransferase, and Fructose 1-phosphate aldolase, von Gierke disease among others. These etiological aspects lead to hyperuricemia which then causes gout.
The main gout stages include; asymptomatic hyperuricemia, an acute attack of gout, inter-critical and finally chronic tophaceous gout. The first stage is characterized by more than 6mg/dL of blood uric acid but the symptoms of gout are not present. This stage takes years and can be corrected by dietary changes, exercising, lifestyle modification among others. The acute gout attack is the second stage which manifests with joint swelling and acute pain episodes. The pain may subside with no treatment and the intervals may be long. In the inter-critical stage, the individual is sandwiched in flares of gout. Pain may be absent but the intensity of uric acid accumulation is high in joints. Lastly, chronic tophaceous gout is now severe with the destruction of cartilage and bones. Moreover, there may be deformity; where the inflammation is active and can lead to renal damage.
The definitive diagnosis will be facilitated by determining the blood levels of uric acid, doing a blood culture of the ankle tissues and the determination of creatinine levels in the blood. Hyperuricemia is a cardinal indicator of gout. On the other hand, a blood culture will isolate the causative agent of cellulitis. Furthermore, the levels of creatinine reveal the involvement of the kidney hence helping the determination of treatment intensity in case of double infection or severe gout.
The nursing assignment help service must deliver specific details linked to the case study to demonstrate their in-depth research and understanding. Specific numeric information and measurement must be used in the assignment and findings reported on how treatment was performed as well as a reaction which was registered.
If Mr. Rogers is found to have cellulitis, the health care provider will prescribe intravenous oxacillin or nafcillin 1.5 grams after every four hours. Moreover, intravenous cefazolin 2 grams after every 8 hours and 900 milligrams of intravenous clindamycin after every 8 hours can be prescribed. These parenteral antibiotics are given for 1 to 3 days and a switch to orals is initiated. In this case, 300milligrams of oral clindamycin is given after every 6 hours. Additionally, 1 gram of oral acetaminophen every 8 hours can be prescribed to manage the pain. As such, Mr. Rogers can swiftly recuperate from the cellulitis following the above prescriptions.
The short-term treatment of recurrent gout involves the use of nonsteroidal anti-inflammatory drugs, colchicine, and corticosteroids. 1.2 milligrams of oral colchicine is given immediately administered followed by 0.6 milligrams after every hour. Afterward, it is given once daily as a continuous prophylaxis not exceeding a daily dose of 1.2 milligrams. Non-pharmacologic therapy is also effective; including massage and destructive measures from concentrating on the pain. 1mg of acetaminophen is also prescribed. Oral prednisolone, 5mg per day is considered to manage the inflammatory effects. The long-term use of allopurinol helps break down blood uric acid to levels below 6mg/dL. Again, non-pharmacologic treatment with regular exercises and dietary adjustments can be prescribed by a nutritionist.
Foods with high purines include meats such as the liver and vegetables like asparagus. The most appropriate fluid intake that helps in the secretion of the uric acid includes water during all major meals with a half or a full cup of strawberries that are fresh. Moreover, milk or yogurt with low fats is consumed during dinner or lunchtime. The fluids above do not produce uric acid instead they facilitate its elimination. An individual should avoid strong alcohols such as beer, whiskey, brandy among others. Instead, wine can be substituted once in a week and a total avoidance during or between gout attacks should be maintained.
The most notable nursing diagnosis after establishing that Mr. Rogers has gout is; acute pain related to the presence of a joint inflammatory process as evidenced by the patient voicing pain in the right foot.
Lastly, ensure the nursing assignment help service provides relevant resources and reference used to produce the review. While the main review article must be delivered, the author must be able to a provide additional reference source related to the different themes and information used to prepare the review. This help demonstrates the researchers analytical reviewing skills which helps them present a more professional nursing assignment review.
