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The disease process described in the case study is: Peripheral Arterial Disease

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Hello, I am please in need of assistance with a homework assignment. I will attach the case study with information to answer the questions, as well as a sample/example of how the assignment should be
Spring Homework 2 Case study • Olga Brenheim is a 65-year old female presenting with “heaviness” and pain in her lower thighs and calves during walking. • She has a history of coronary artery disease, myocardial infarction, heart failure, carotid stenosis , hypertension, hyperlipidemia, type 1 diabetes mellitus, and asthma. Physical examination and diagnostic test results • General , neuromuscular : Obese , alert, oriented, cooperativ e. Pupils equal, round, reactive to light and accommodation. Nasopharyngeal mucous membranes pink and moist. Slow, but steady gait . • Vital signs: Temperature = 98.6 degrees Fahrenheit (oral) ; heart rate = 84 beats/min , sinus rhythm with 1 -2 monomorphic, pre mature ventricular complexes per min ; respiratory rate = 18 breaths/min , slightly labored with exertion ; blood pressure = 1 40 /80 mmHg ; oxygen saturation = 90% on room air; pain = 0/0 when resting, but increases to 4/10 with prolonged walking. • Cardiopulmonary : Bilateral chest expansion symmetrical . Lung sounds clear. S1, S2, and S3 auscultated , but no murmur . Bilateral jugular vein distention noted. • Extremities: Full ROM in all e xtremities . Strength 4/5 in upper extremities and 3/5 in lower ext remities. Lower extremities coo l and pale. Diminished sensation and prolonged c apillary refill in both feet. Bilateral 2+ pedal edema . Doppler pedal pulses difficult to find and weak. • Abdomen: Large, soft, non -tender, and bowel sounds in all quadrants. • Serum test results: Complete blood count results , chemistry panel, and troponin levels within normal ranges . • Other results: Chest x -ray shows clear lungs and cardiomegaly . Electrocardiogram shows no acute ischemic changes. Echocardiogram with decreased left ventricle motion and decreased ejection fraction consistent with her baseline; no new changes . Abdominal aortogram with arteriogram of the lower extremities showed aortoiliac disease with multiple stenoses of varying degr ees and affecting both legs . The r esting ankle -brachial index was 0.50 and 0.70 at the right and left dorsalis pedis, respectively (normal = 0.90 -1.30). Spring To answer questions 1 -3, use the scenario above 1. Identify the likely disorder, the underlying pathophysiology (i.e., cellular and tissue changes), and relate the changes to abnormal findings to support your interpretation. (20 points) Hint: We are in the cardiovascular system ☺ ! 2. Identify all nursing d iagnoses labels (just the label!) that apply to this patient (e.g., impaired swallowing). Identify the priority (#1) nursing diagnosis label; and for the (#1) nursing diagnosis label, explain the nursing interventions to address the identified problem. Pro vide evidence -based rationale to explain the need and/or benefit of each intervention. For interventions, include what the nurse should “monitor/assess”, “do”, and “teach” to the client. (20 points) 3. Describe 2 medical therapies used to treat the disorder and explain their specific mechanism of action and intended impact at the cellular and/or tissue level. (15 points) To answer questions 4 -5, choose ONE disorder from this week’s reading 4. For the chosen disorder, identify the disorder and describe the impa ct on the population in the United States including incidence, prevalence, costs, morbidity, mortality, and/or other appropriate issues. Be sure to identify the disorder, the population associated with the data, and the year(s) of data. (15 points) 5. For t he chosen disorder, locate recommendations in a nursing journal article or professional nursing organization . Provide a brief summary of the information and specific recommendation s for nursing actions to improve care for patients. (15 points) Hint: To increase the likelihood of locating a nursing journal or organization, look for some form of the word “nurse” in the journal or organizational name! Scholarly Writing: Use correct sp elling, grammar, sentence structure, formatting, professional terms, title page, paraphrasing, citations, and references. Sources current (<5 years old) and professional (15 points) Hello, I am please in need of assistance with a homework assignment. I will attach the case study with information to answer the questions, as well as a sample/example of how the assignment should be 1 Homework 1 Student Name RN -BSN Program, St . Petersburg College NUR 3125: Pathophysiology: Dr. Jean Lee April 1, 2025 DISCLAIMER: APA Style , 7 th ed. This sample assignment is provided as a courtesy. This is an example of a well - written homework assignment . It is NOT perfect. You are expected to use the scenarios and questions provided in your edition of the homework and APA formatting from the edition of the APA manual stated by the instructor in your syllabus . Do NOT print or distribute copies. Do NOT copy or use this author ’s words in your own paper . Areas have been blacked out because this sample is only intended to give you an idea of the flow of content. 2 Homewor k 1 Question 1 : The likely problem is an allergic reaction associated with type I hypersensitivity , which is categorized as an immediate hypersensitivity reaction (Brashers & McCance, 2020) . An allergic reaction is consistent with the underlying cellular and tissue changes responsible for the abnormal assessment findings. An inhaled allergen triggers a mechanical response and activation of immunoglobulin G (IgG) in the affected tissues, especially the upp er respiratory system. W hen a n allergen (e.g., dust mites, cat dander, or pollen ) enters the body through the nasal tissue , it triggers mechanical responses including sneezing, coughing, and tearing (Brashers & McCance , 20 20 ). The cellular response involves production and activation of immunoglobulin E ( IgE ) which rapidly binds to mast cells. Mast cells release different mediators such as histamine and bradykinin. Histamine causes bronchial smooth muscle constriction (narrows bronchial lumen) , vascul ar permeability (promotes edema ), and vasodilation (increase s blood flow ) (Brashers & Huether , 20 20 ). Bradykinin promotes vasodilation, chemotaxis, and bronch oconstriction . These changes affect the eyes, nose, and respiratory tract causing conjunctivitis, rhinitis , wheezing , mucus production , and edema (Brashers & Huether, 2020 ). The patient complains of right ear pain , and a mild serous otitis is present bilaterally on the tympanic membranes . Pain is associated with inflammation and the ear’s serous fluid is indicative of early or mild inflammation ( Brashers & McCance , 20 20 ). The purulent postnasal drip may be related to bacterial infection. The nasal smear is positive for eosinophils. When mast cells release chemotactic factors during inflamm ation, eosinophils are stimulated at the site of inflammation to fight parasites and regulate local inflammation ( Brashers & McCance , 20 20 ). Complications include s inus and ear infections from blockage of the Eustachian by edema and/or muc us (National Center for Complementary and Integrative Health [NCCIH] , 2016 ). Sinus infection can be ruled out because nasal endoscopy confirms the sinus es drainage to be normal . The reported symptoms, assessment, history, and laboratory, radiology , skin test ing , and laboratory test s are consistent with environmental allergy. 3 Question 2: The applicable NANDA labels include ineffective airway clearance, anxiety, acute pain (in the right ear), and disturbed sleep pattern (Gulanick & Myers, 2019b). The priority diag nosis is ineffective airway clearance because the oxygen saturation is slightly below normal and should be corrected as hypoxia can be quickly fatal (Gulanick & Myers, 2019a). The immediate nursing responses include s ongoing assessment, actions to prevent further deterioration and promote improvement, and patient teaching. For assessment, airway assessment is the priority as well as monitoring for changes that indicate worsening airway obstruction. The airway is asse ssed for patency and the patient’s breathing must be monitored. Specific items to monitor include heart rate, respiratory rate, oxygen saturation, work of breathing, and lung sounds. Signs that indicate hypoxemia include tachycardia, tachypnea, oxygen satu ration <90%, use of accessory muscles of respiration, and wheezing. In addition to wheezing, persistent dry coughing or stridor are indicators of a dangerous le vel of bronchial constriction (De Vries et al., 2018 ). Actions needed to prevent further deteri oration involve improving oxygenation and bronchodilation. It is essential to elevate the head -of-bed (HOB), provide supplemental oxygenation , and administer bronchodilator medications. Elevating the HOB relaxes the diaphragm allowing it and the intercosta l muscles to push air out of the lungs (Durham , 2017 ). Supplemental oxygen can directly increase the concentration of oxygen in the lungs and increase diffusion across the alveolocapillary membrane into red blood cells to maintain or improve the level of a rterial oxygen ( Brashers & McCance, 2020 ). Short -acting bronchodilator medications are administer ed via inhaler or nebulizer and improve airflow in and out of the lungs (Durham, 2017 ). Allergic asthma is preventable if triggers are removed. In this case, it is essential that the patient receive teaching regarding removal or reduction of environmental triggers. Ideally, she should not have cats in the house. If she is unwilling to give the cats away, then she should consider not allowing them 4 in her bedroom to reduce the direct exposure to the dander. Frequent dusting and linen changes can also reduce dander levels ( NCCIH, 2016 ) Question 3 : Treatment o f environmental allergies involve s medications and immunotherapy. Corticosteroids may be prescribed for moderate to severe obstruction to interfere and prevent the inflammatory response . Corticosteroids are anti -inflammatory because they antagonizing prostaglandins and bradykinin to preven t vasodilation and stabilizing lysosomal membranes to prevent release of pro -inflammatory enzymes (American College of Allergy, Asthma, and Immunotherapy [ACAAI ], n.d. -b). According to the ACAAI (n.d. -a), immunotherapy is directed at preventing further epi sodes by incremental increasing exposure to the trigger under controlled conditions to desensitize the patient. It is thought that incremental exposure creates a blocking antibody that prevents the allergen from triggering an inflammatory response (ACAAI, n.d. -a). Question 4: In the United States from 2001 -2010 , new cases ( incidence ) of asthma increased by 2.9% each year. During that same period, the total number of persons living with asthma (prevalence ) rose from 20.3 million to 25.7 million persons. Of the total cases , 7 million were children and 18.7 million were adults . Unsurprisingly, asthma was the 6th leading cause of chronic illness (Centers for Disease Control and Prevention [CDC], 201 8a). According to the CDC (201 8b); medical care, lost work and school, and early deaths from asthma in 2007 was approximately $56 billion ( cost ). From 2002 to 2007, medical costs $3,000 per person each year (CDC, 2018 b). In 2007, a total of 185 children and 3,262 adults died ( mortality ) from asthma (CDC, 201 8b). Question 5: Durham (201 7) discussed monitoring medication compliance inhaler performance and adverse reactions. Durham emphasizes the need to maximize the effectiveness of inhalers, proper teaching of inhalation techn ique is necessary to prevent asthma exasperation. Nurses must assess patient’s ability to use the inhaler, especially in children and the elderly. Repeated demonstrations of use must be done prior to patient’s discharge from the hospital. During t eaching , the nurse should emphasize which inhalers are for rescue purposes versus long -term control. 5 References American College of Alle rgy, Asthma, and Immunotherapy. (n.d. -a). Immunotherapy. https://acaai.org/allergies/allergy -treatment/allergy -immunotherapy American College of Allergy, Asthma, and Immunotherapy. (n.d. -b). Medication. https://acaai.org/allergies/treatment/medication Centers for Disease Control and Prevention. ( 201 8a, May 16 ). Asthma statistics. http://www.cdc.gov/vitalsigns/asthma/index.html Centers for Disease Control and Prevention. (201 8b, May 16 ). Asthma costs. https://www.cdc.gov/asthma/most_recent_data.htm De Vries, Jonkman, A., Shi, Z., de Man, A., & Heunks, L. (201 8). Assessing breathing eff ort in mechanical ventilation: P hysiology and clinical implications . Annals of Translational Medicine, 6(19 ), 387. https://dx.doi.org/10.21037/atm.2018.05.53 Gulanick , M. & Myers, J.L. (2019a). Ineffective airway clearance. Nursing care plans (10 th ed., pp. 464 -468). Elsevier. Gulanick, M. & Myers, J.L. (2019b). NANDA diagnoses list. Nursing care plans (10the ed., pp. ii -iii). Elsevier. Brashers, V. & Huether, S.E. (20 20 ). Infection. In S.E. Huether , K.L. McCance , & V. Brashers (Ed s.), Understanding pathophysiology (7th ed., pp. 1 96 -209 ). Elsevier. Brashers, V. & McCance, K.L (20 20 ). Adaptive immunity . In S.E. Huether , K.L. McCance , & V. Brashers (Ed s.), Understanding pathophysiology (7th ed., pp. 156 -173 ). Elsevier. National Center for Complementary and Integrative Health. ( 2016, November ). Flu and colds: In depth. https://www.nccih.nih.gov/health/flu -and -colds -in-depth Durham, C., Fowler, T., Smith, W., & Sterrett, J. (201 7). Adult a sthma diagnosis and treatment . Nurse Practitioner, 42 (11 ), 16 -24 . https://dx.doi.org/10.11788097/01.NPR.72503.45456464654