Professional Development Case Study ALL SOLUTION LATEST EDITION 2023/24 GUARANTEED GRADE A+

1. How did Gary's lifestyle changes slow the progression of symptoms? Select all that apply. 1. Healthier eating allows for better absorption of medications. Although the absorption of some medicines can be impacted by food, healthier eating is not a concern. 2. Physical activity builds muscle strength and coordination. This is a correct statement. 3. Socialization improves depression. It has been shown that socialization will decrease depression in most individuals. 4. The reduction of stress decreases the need for dopamine. Stress increases the need for neurotransmitters, and therefore more dopamine is needed. 5. Retiring provides for financial security. For many people Answer: 2,3,4 Rationale:Nursing Process — It is essential to identify assessment findings that are a priority when caring for clients and determining how their care should proceed. Being able to prioritize ensures the client's most significant issue is addressed first. Assessment. NCLEX®: Physiological Adaptation QSEN: Patient-centered Care The nurse completes an assessment, which finding is most concerning? 1. Large hematoma on the right hip. A large hematoma is a sign of injury, and there could be an untreated fracture of the bone. 2. Tremors of the fingers and hands, right worse than left. This is common with Parkinson's Disease. 3. Hunched stature. Normal finding with Parkinson's Disease and in an older adult. 4. Shuffling gait. Normal finding with Parkinson's Disease. Answer: 1 Rationale:Nursing Process — It is essential to identify assessment findings that are a priority when caring for clients and determining how their care should proceed. Being able to prioritize ensures the client's most significant issue is addressed first. Assessment. NCLEX®: Physiological Adaptation QSEN: Patient-centered Care. Mark in the boxes whether the findings are related or not related to Gary's current situation and disease. Hypotension constipation hypoproteinemia irregular pulse anemia weakened grips and pushes hematoma cataracts hypokalemia dry mouth related: hypotension, constipation, hypoproteinemia, anemia, weakened grips and pushes, hematoma, dry mouth Not related: irregular pulse, cataracts, hypokalemia rationale : Nursing Process — Clients, must be assessed for factors in their history that place them at risk for compromise in health. Except for hypokalemia, cataracts, and an irregular pulse, the factors identified have either a direct or indirect impact on Gary's current health situation. For example, hypotension is a significant factor in falls and Gary is beginning to fall often. Assessment. NCLEX®: Reduction of Risk Potential. QSEN: Patient-centered Care. NurseThink® Prioritization Power! Evaluate the information in the case above and pick the Top 3 Priority concerns or cues. 1. hypotension/falling several times weekly. 2. hematoma to the clients right hip 3. medication regimen: levodopa/carbidopa taken with Selegiline, can result in hypotension, which predisposes the client to fall. Benztropine is predisposing gary to constipation Rationale: The client is falling several times weekly, and that is a priority concern, coupled with hypotension. The side effects of the combined medications as well as the hematoma to the client's hip add additional concerns What should the nurse include in the discharge teaching? Select all that apply. 1. Rest the hip. Stress to the hip can make the hematoma worse. 2. Apply an ice pack to the hematoma. For the first 48 hours. It reduces bleeding in early injury stage. 3. Exercise the affected extremity. The extremity should be rested until the hematoma resolves. 4. Elevate the right lower extremity. Helps to decrease blood pooling in the area. 5. Apply heat to the hematoma. After the first 48 hours. It reduces swelling and promotes comfort. It fosters the flow of blood to and from the area. THIN Thinking: Nursing Process — Clients must be given proper instruction for self-care of a condition at home. Before they leave the facility, the nurse must ensure they understand the teaching and can implement the follow-up interventions at home. Implementation. NCLEX®: Health Promotion and Maintenance QSEN: Patient-centered Care Answer: 1,2,3,4,5, Rationale: Nursing Process — Clients must be given proper instruction for self-care of a condition at home. Before they leave the facility, the nurse must ensure they understand the teaching and can implement the follow-up interventions at home. Implementation. NCLEX®: Health Promotion and Maintenance QSEN: Patient-centered Care Judy is concerned about Gary falling and asks the nurse about some strategies that can be used to minimize Gary's risk of having more falls. What strategies does the nurse suggest? Select all that apply. 1. Shuffle the feet when walking. This is what occurs in Gary's disease that predisposes him to falls. 2. Consider walking over imaginary lines on the floor. This is a recommended strategy to minimize falls in persons with Parkinson's disease. 3. Don't walk without someone's assistance. This is not a good recommendation as it takes away the client's independence. Independence must be maintained for a long as the disease process allows. 4. Take medications as prescribed and on time. This is important as the antiparkinsonian medications are managing Gary's symptoms. 5. Avoid distractions when walking. Distractions while walking may cause the client to fall so, they should be avoided. Answer: 2,4,5 Rationale: : Identify Risk to Safety — Client's with Parkinson's disease are at high risk for falls, and so all viable measures must be taken in the home to minimize their risk of falling. Nurses must be able to make recommendations on safe home care measures. Safe Practice. NCLEX®: Reduction of Risk Potential. QSEN: Safety. NurseThink® Prioritization Power! What is the Top 3 Priority post-procedure discharge teaching that the nurse must reinforce with Judy and Gary? 1. Examine the site daily for excessive redness, swelling, abnormal drainage or foul smell, which might indicate an infection. 2. Assess for pain and take pain medication as prescribed. 3. Observe the site for several days to ensure the hematoma does not return Based on Judy's assessment information what should the nurse recommend as the Top 3 Priority interventions? 1. Place non-skid mat and shower chair in the shower. 2. Replace the straight-edge razor with an electric razor for shaving. 3. Buy shirts with clothing fasteners instead of buttons. Rationale: : Nursing Process — For the client with Parkinson's disease and associated mobility and dexterity issues, modifications must be made to assist the client with continuing to perform self-care to remain independent. Assistive devices are often recommended. Implementation. NCLEX®: Health Promotion and Maintenance QSEN: Patient-centered Care. 10. An x-ray of Gary's left hip shows a fracture, and he is scheduled for an open reduction and internal fixation (ORIF) surgery in 4 hours. As the nurse plans Gary's postoperative care what are the most important intervention(s) to ensure that Gary's hip fracture heals without complications? Select all that apply. 1. Perform neurovascular assessments to the affected extremity. Assessment should include sensation, edema, color, pain, capillary refill pulses, temperature, and function. 2. Encourage early and aggressive ambulation. Although early ambulation should be encouraged, aggressive ambulation may be too exhausting in this situation. 3. Maintain proper alignment of the extremity. Turning the client to the uninjured side, pillows need to be placed between the legs with no hip flexion. 4. Provide nutritional support high in protein. Protein will be helpful for wound healing. 5. Assessment of the incision site. The nurse should assess for bleeding, signs of infection, and poor wound Answer: 1.3.4 Rationale: Nursing Process — A client's postoperative care must be determined preoperatively. It is the nurse's responsibility to ensure that a plan of care is outlining client interventions postoperatively be completed. For the client with a hip fracture, it is crucial to plan for assessment of the surgical site, neurovascular assessment, and maintenance of proper alignment of the injured extremity. Planning. NCLEX®: Physiological Adaptation QSEN: Patient-centered Car 11. The nurse checks on Gary's wife who is sitting in the waiting room, waiting for Gary's surgery to be done. She tells the nurse, "My brother was in the hospital for seven days last year and got a nasty infection in his wound that he got in the hospital. I am worried about Gary getting an infection while he's here." What is the best response by the nurse? Answer Consideration: When the skin is cut open, as in Gary's surgery, there is always the risk of getting an infection. However, we take several precautions to decrease the likelihood of clients getting infections in their surgical wounds. For example, we administer antibiotics just before surgery, we cleanse the CONTINUED..