Class notes
NUR 183 Nursing Care Plan
- Course
- NUR 183-602
- Institution
- Bergen Community College
This is a comprehensive and detailed nursing care plan for Nur 183. *Essential Study Material!!
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DEPARTMENT OF NURSINGNursing Care Plan
Student Name: Charby Albarico Age: 67
Course number: NUR-281-601 Developmental state: Integrity vs Despair
Health care agency: St. Joseph Hospital Instructor: Professor Robelisa Sistoso
Date of Care: 9/23/2023
Patient’s initials: A.K.
Patient’s room: 552-2
Medical diagnosis: EXPLAIN PATHOPHYSIOLOGY AND INCLUDE STRUCTURAL FUNCTIONAL CHANGES THAT THE DISEASE CAUSES:
Patient 67 years old female diagnose with chronic obstructive pulmonary disease (COPD) exacerbation and Congestive Heart Failure (CHF) exacerbation.
Congestive heart failure (CHF) is a complex cardiovascular disorder characterized by the heart's inability to pump blood effectively, leading to insufficient oxygen
and nutrient delivery to vital organs and tissues. This condition often results from underlying cardiac diseases such as hypertension, coronary artery disease, or
cardiomyopathy, which can weaken the heart muscle. As the heart weakens, it struggles to eject blood efficiently, causing blood to back up in the lungs and
peripheral tissues, leading to congestion and edema. To compensate for its diminished pumping capacity, the heart may undergo remodeling, with chambers
enlarging and the heart muscle thickening. However, this adaptive response can become maladaptive over time, exacerbating the condition. Neurohormonal
mechanisms, such as activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, further contribute to CHF by increasing fluid
retention and peripheral vascular resistance. Ultimately, CHF leads to symptoms such as dyspnea, fatigue, and fluid retention, and if left untreated, it can have a
severe impact on a patient's quality of life and prognosis (Papadakis et al., 2022).
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder primarily caused by long-term exposure to irritants, such as cigarette smoke
or occupational pollutants. These irritants lead to chronic inflammation and structural changes in the airways and lung tissue. In response to this inflammation, the
airways narrow and become obstructed due to increased mucus production and smooth muscle contraction. Additionally, the destruction of lung tissue and
alveolar walls, known as emphysema, reduces the surface area for gas exchange and impairs lung elasticity, making it difficult for affected individuals to exhale
effectively. This combination of airway obstruction and lung tissue damage results in characteristic symptoms like chronic cough, excessive sputum production,
shortness of breath, and decreased lung function, all of which progressively worsen over time, contributing to the hallmark clinical presentation of COPD
(Papadakis et al., 2022).
, Explain significance of operative procedure, lab data, and/or special diagnostic test or procedures:
Electrocardiogram
Electrocardiogram (EKG or ECG) is a non-invasive medical test that records the electrical activity of the heart over a period of time. It involves placing electrodes
on specific locations on the skin, typically on the chest, arms, and legs, which detect and measure the electrical impulses generated by the heart's contractions.
These electrical signals are then converted into a graphical representation known as an EKG waveform or tracing, which displays the heart's rhythm, rate, and any
abnormalities. EKGs are valuable diagnostic tools used to assess heart health, detect irregularities such as arrhythmias, identify signs of ischemia or damage from
heart attacks, and monitor overall cardiac function (M. & Bladh, 2019).
Patient’s result is sinus tachycardia.
Chest X-ray
chest X-ray is a common diagnostic imaging procedure that involves the use of low-dose ionizing radiation to capture detailed images of the structures within the
chest, including the heart, lungs, ribs, and surrounding tissues. During the process, the patient stands in front of an X-ray machine, while a radiologic technologist
positions a special film or digital detector behind the patient's chest. The machine emits a controlled burst of X-rays through the chest, which are absorbed
differently by the various tissues, creating a shadowy image on the film or digital sensor. The resulting X-ray image allows healthcare professionals to evaluate the
condition of the lungs, heart, and nearby structures, aiding in the diagnosis of various respiratory conditions, infections, fractures, and other chest-related disorders
(M. & Bladh, 2019).
Patient’s result are the following: enlarge heart, AICD
Glomerular Filtration Rate
Glomerular filtration rate (GFR) is a crucial measure of kidney function and represents the rate at which the kidneys filter waste and excess substances from the
blood. The GFR process involves the passage of blood through tiny filtering units in the kidneys called glomeruli, where waste products and excess substances
are selectively removed and excreted into urine, while vital molecules are retained in the bloodstream. To determine GFR clinically, a blood test is often performed,
where a substance like creatinine or inulin is introduced into the bloodstream, and the rate at which the kidneys clear or filter this substance from the blood is
measured. A lower GFR can indicate impaired kidney function, as the kidneys are less effective at filtering waste, while a higher GFR can suggest increased
filtration capacity. GFR assessment is vital for diagnosing and monitoring kidney diseases and guiding treatment decisions (M. & Bladh, 2019).
Patient’s result is 30.2 mL/min/1.73 m² and it is lower than normal range for her age group.
Hemoglobin and Hematocrit
Hemoglobin (Hgb) is the main protein in red blood cells and carries oxygen to the body while removing carbon dioxide. Hgb is made up of heme and globulin, and
copper is needed for the incorporation of iron into heme. The affinity of Hgb for oxygen is influenced by 2,3-DPG, and a shift to the left or right can occur due to
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