Nurs Topic Cystic Explained for Students (Easy Guide)

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NURS 711 TOPIC: CYSTIC FIBROSIS Patient’s Chief Complaints Provided by patient’s mother: “I noticed a let-down in T’s exercise tolerance level a week ago, and the last couple of days his cough and sputum production have gotten much worse. When he started having breathing problems, I brought him in immediately. T is normally a bubbly and lively little boy and it is obvious when he isn’t feeling well. I think that he has another infection.” T.B. is a 6 yo Caucasian male with a history of CF. He was diagnosed with CF at 8 months of age. He had been doing well until five days ago, when his mother noticed that he became tired very easily while playing. She also reported an increasing cough productive of very dark-colored sputum but that he had no fever. The patient also has not had much of an appetite during the past week and has lost 2½ pounds. His oxygen saturation is currently 87% and he was immediately placed on oxygen via nasal cannula. PMH T.B. was born (74 months ago) a 6 lb-7 oz white male to a 23 yo mother. A normal vaginal delivery followed an uncomplicated pregnancy. The infant had Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. The initial physical examination was unremarkable, but at 30 hours following delivery, the infant developed abdominal distension and began vomiting bile. No bowel movements had occurred since birth. A second physical exam disclosed an afebrile, well-developed infant with a tense abdomen from which only occasional faint bowel sounds were heard. The anus was patent, lungs were clear to auscultation, and the cardiac exam was unremarkable. There were no neurologic abnormalities. Radiography of the abdomen revealed distended loops of bowel without air. Both the CBC and serum chemistry panel were normal. Exploratory laparotomy disclosed meconium ileus and atresia of the distal ileum. The narrowed segment of ileum was successfully resected and the infant recovered without complications. An attempt to collect a sweat sample for chloride analysis was unsuccessful. After discharge, the infant was lost to follow-up. At 8 months of age, the child presented with failure to thrive characterized by poor weight gain. His appetite had been good, but for several months he had been having up to 6 pale and foul-smelling bowel movements daily. During that time, he had also experienced several episodes of bronchitis. Physical examination revealed a small, frail-looking, pale child who appeared malnourished with little subcutaneous fat and a protuberant abdomen. There was a scattering of crackles in both lungs consistent with pulmonary edema or pneumonia. The cardiac exam was normal. Chest x-rays showed markings in all lung fields. The patient’s WBC was 8.3 × l03/mm3, serum albumin was 1.9 g/dL, sweat chloride was 99 meq/L, and a stool smear was positive for fat. The child was hospitalized and 24 hours later became febrile with tachypnea and increasing signs of respiratory distress. Auscultation revealed poor breath sounds in the right lung. Radiographs of the chest revealed consolidation of the right lung consistent with pneumonia. The WBC had increased to 19.3 × l03/mm3 with an increase in band forms (i.e., immature neutrophils) in the peripheral blood to 16%. Sputum cultures were positive for both Pseudomonas aeruginosa and Staphylococcus aureus. With intensive support and aggressive intravenous antibiotic therapy, the infection resolved and the patient recovered fully. A diagnosis of CF was established and the patient was referred to the regional CF center for follow-up. During the next six years, the patient was hospitalized three times for respiratory infections and one episode of hemoptysis. The infections required hospitalization for up to two weeks at a time and IV antibiotics. He was also diagnosed with bronchiectasis and pancreatic insufficiency. His mother has been administering postural drainage to her son three times daily for approximately 30 minutes each. Some of the positions are obviously uncomfortable, but T never complains. He is being maintained on a high-calorie, high-protein, and fat. The child was hospitalized and 24 hours later became febrile with tachypnea and increasing signs of respiratory distress. Auscultation revealed poor breath sounds in the right lung. Radiographs of the chest revealed consolidation of the right lung consistent with pneumonia. The WBC had increased to 19.3 × l03/mm3 with an increase in band forms (i.e., immature neutrophils) in the peripheral blood to 16%. Sputum cultures were positive for both Pseudomonas aeruginosa and Staphylococcus aureus. With intensive support and aggressive intravenous antibiotic therapy, the infection resolved and the patient recovered fully. A diagnosis of CF was established and the patient was referred to the regional CF center for follow-up. During the next six years, the patient was hospitalized three times for respiratory infections and one episode of hemoptysis. The infections required hospitalization for up to two weeks at a time and IV antibiotics. He was also diagnosed with bronchiectasis and pancreatic insufficiency. His mother has been administering postural drainage to her son three times daily for approximately 30 minutes each. Some of the positions are obviously uncomfortable, but T never complains. He is being maintained on a high-calorie, high-protein, and unrestricted fat diet that is supplemented with fat-soluble vitamins and iron. This assignment provides the opportunity for students to research and present an assigned topic. You will develop understanding of physiology and pathophysiology to make clinical decisions, manage disease, and conditions at the advanced practice nurse level. Using the Patho Essentials Presentations submitted to the Discussion Thread: Patho Essentials Presentation video discussion in each Module: Week, you will provide a peer review to your classmates. Peer- review, as well as exposure to broader concepts within the field of Physiology and Pathophysiology, is crucial to your growth as a scholar. You will engage in constructive criticism to help your peers improve as well as improve from the feedback of others. INSTRUCTIONS TOPIC: CYSTIC FIBROSIS 1. Students will develop an 8-slide narrated PowerPoint to present the assigned topic. 2. Presentation should adhere to professional PowerPoint formatting. 3. Notes for narration may be included in the PowerPoint notes section. 4. Content of the presentation will include a concise description of the following: • Slide 1: Title Slide- Presented case study disorder, student name, date, course (Narration <1 minute) • Slide 2: Patient Case Introduction- chief complaint, history of present illness (HPI). (Narration < 3 minutes) • Slide 3: Disorder description & epidemiology. (Narration <3 minute) • Slide 4: Disorder pathophysiology at the cellular level. (Narration < 3 minutes) • Slide 5: Case Study - Discuss clinical manifestation of the disorder as presented in the assigned Case Study (Narration < 3 minute) â–ª Pertinent subjective data (chief complaint, history of present illness (HPI), past health history, family history, social history, allergies, medications)- presented in assigned Case Study â–ª Pertinent objective data (physical examination and diagnostic tests)- presented in assigned Case Study • Slide 6: Role of the Advanced Practice Nurse underpinned by the Christian worldview. (Narration < 1 minute) • Slide 7: Case Questions- Pose 3 highly relevant Case Study questions that facilitate discussion that encourages thoughtful analysis of the Case Study and underlying pathophysiology concepts. (Narration < 1 minute) • Slide 8: References 5. Narrate the PowerPoint presentation. Limit PowerPoint narration to 15 minutes. 6. Submit the Patho Essentials Presentation to the Discussion Thread: Patho Essentials Presentation by Thursday 11:59 p.m. (ET) of the assigned Module: Week as a video discussion thread for your peers to review. This should be in either a YouTube or Kaltura narrated presentation format. Please follow the instructions How to Submit a Video Discussion (as found under the Discussion: Patho Essentials Presentation Resources within the assignment on Canvas) to submit each Discussion. • Demonstrate thoughtful analysis of points presented. • Encourage and facilitate interaction aimed at increasing understanding of the disorder presented and developing diagnostic reasoning. • Provide examples to support points discussed. • Offer additional questions for thoughtful consideration. 8. Also, the student should support his/her initial narrated PowerPoint presentation post with at least 2 peer-reviewed or evidence-based references (aside from the course textbook).

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