Naïve Patients with Active luminal Crohn Disease Essay

Naïve Patients with Active luminal Crohn Disease Essay

Case study 3

Case study three describes a 27 years old male with Crohn’s disease admitted to the emergency room with an extreme flair up. Crohn’s disease is a chronic inflammatory bowel disease that affects the digestive tract. It may cause abdominal pain at the lower quadrant, diffuse without radiation, sharp on acute superimposed and dull constant aches (Roda, et al 2020). The pain is usually precipitated by meals and relieved by defecation. The abdominal pain is associated with dyspepsia and heartburn, nausea, vomiting, diarrhea, weight loss, anemia, and fatigue. It may also cause flare-ups, leg cramps, and depression. Patients with Crohn’s disease usually complain of altered stool frequency, altered stool form, altered stool passage, leucorrhea, and abdominal bloating. Treatment modalities involve medications such as steroids and anti-inflammatory drugs (Kennedy, et al, 2019). A surgical procedure such as bowel resection, lifestyle modification like taking dietary fiber, and medical procedures like enema help relieve Crohn’s disease. Naïve Patients with Active luminal Crohn Disease Essay

This patient reports not being compliant with medical clinic follow-up and medication because of his financial instabilities. As the nursing officer on duty, I would attend to the patient and offer the best available treatment to the patient despite the financial hardships. All patients have a right to access emergency services at the time of need despite their race, gender, and financial power.  Ethical principles; benefice, autonomy, informed consent, non-maleficence, governs the delivery of healthcare services. Beneficence is the principle that describes the art of doing good to the patient. Non-maleficence protects the patient from harm, autonomy is a shared decision making (Welie, J. V. 2019). Informed consent is the permission granted to the care provider before initiating treatment. for this case, the applicable principles are the provision of emergency services, beneficence, and non-maleficence. Informed consent and autonomy may not apply in this case because the patient feels obese.

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ASSIGNMENT

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

Select one scenario and reflect on the material presented throughout this course.

What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

For this assignment, you should use at least three different references from current evidence-based literature. Naïve Patients with Active luminal Crohn Disease Essay

CASE STUDY 1

The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines.

CASE STUDY 2

A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance.

CASE STUDY 3

A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment.

CASE STUDY 4

A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled.

CASE STUDY 5

A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days.

CASE STUDY 6

A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is deeply religious and believes that the vaccine would encourage premarital sexual activity.

CASE STUDY 7

A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home.

REFERENCES

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 24, “Sports Participation Evaluation”

Chapter 25, “Putting It All Together”

https://ebookcentral.proquest.com/lib/waldenu/detail.action?docID=1407862

https://bmcmedethics.biomedcentral.com/articles/10.1186/1472-6939-15-29

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004129/

RUBRIC

Write a detailed 1-page narrative (not a formal paper) addressing the following: Naïve Patients with Active luminal Crohn Disease Essay

• Explain the health assessment information required for a diagnosis of your selected patient (include the scenario number).–

Excellent 30 (30%) – 35 (35%)

The response clearly, accurately, and thoroughly explains detailed health assessment information required to diagnose the selected patient, with correct scenario number included.

Good 24 (24%) – 29 (29%)

The response accurately explains health assessment information required to diagnose the selected patient, with correct scenario number included.

Fair 18 (18%) – 23 (23%)

The response vaguely explains health assessment information required to diagnose the selected patient, with scenario number, correct or inaccurate, included.

Poor 0 (0%) – 17 (17%)

The response lacks and/or inaccurately explains assessment information required to diagnose the selected patient, with scenario number inaccurate or missing.

• Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.–

Excellent 45 (45%) – 50 (50%)

The response clearly, accurately, and thoroughly explains detailed evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with clear, accurate, and thorough justification using three or more different references from current evidence-based literature.

Good 39 (39%) – 44 (44%)

The response accurately explains evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with accurate justification using at least three different references from current evidence-based literature.

Fair 33 (33%) – 38 (38%)

The response vaguely explains evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with vague and/or inaccurate justification using two to three different references from current evidence-based literature. Naïve Patients with Active luminal Crohn Disease Essay

Poor 0 (0%) – 32 (32%)

The response inaccurately explains or lacks evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with inaccurate or missing justification using two or fewer references from current evidence-based literature.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.–

Excellent 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

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Good 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

Fair 3 (3%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

Poor 0 (0%) – 2 (2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation–

Excellent 5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

Good 4 (4%) – 4 (4%)

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

Fair 3 (3%) – 3 (3%)

Contains several (3 or 4) grammar, spelling, and punctuation errors.

Poor 0 (0%) – 2 (2%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.–

Excellent 5 (5%) – 5 (5%)

Uses correct APA format with no errors.

Good 4 (4%) – 4 (4%)

Contains a few (1 or 2) APA format errors.

Fair 3 (3%) – 3 (3%)

Contains several (3 or 4) APA format errors.

Poor 0 (0%) – 2 (2%)

Contains many (≥ 5) APA format errors.

References

Kennedy, N. A., Heap, G. A., Green, H. D., Hamilton, B., Bewshea, C., Walker, G. J., … & Bell, A. (2019). Predictors of anti-TNF treatment failure in anti-TNF-naive patients with active luminal Crohn’s disease: a prospective, multicentre, cohort study. The lancet Gastroenterology & hepatology, 4(5), 341-353.

Roda, G., Ng, S. C., Kotze, P. G., Argollo, M., Panaccione, R., Spinelli, A., … & Danese, S. (2020). Crohn’s disease. Nature Reviews Disease Primers, 6(1), 1-19.

Welie, J. V. (2019). Patient autonomy as a necessary but limited ethical principle in shaping the dentist-patient relationship. The Journal of forensic odonto-stomatology, 37(3), 34. Naïve Patients with Active luminal Crohn Disease Essay