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Health, Healing, and the Nursing Process 2 Part A: Revised Case Scenario Group members: Kelly Savage, Rosemary Orumwense, Twinkle Twinkle, Jasmeen Jasmeen, Bhumika Katuwal Assigned chronic health condition: Grave’s Disease Client Narrative/Story: Helen Hill, a 35-year-old graphic designer of Irish Canadian heritage, has navigated the challenges of Graves’ Disease for one year. During her last visit, which was 6 weeks ago, Helen weighed approximately 58 kg. Despite maintaining a stable diet, she has experienced unintentional weight loss, a common symptom of her condition, bringing her current weight down to 48 kg. Standing at 1.68 meters tall, her Body Mass Index (BMI) has shifted from a healthier range to a lower one, indicating this significant weight loss. Helen is a graphic designer and her career as a graphic designer demands precision and creativity. Yet her hand tremors and fluctuating vision have introduced barriers she continuously strives to overcome. Recently, high blood pressure has emerged as another significant concern, further complicating her condition. This addition underscores the necessity of a comprehensive approach to her healthcare, integrating cardiovascular management with her ongoing thyroid disorder treatment. Socially, Helen has felt isolated due to her condition. The physical changes, particularly the noticeable swelling in her neck and the protrusion of her eyes have led to self-consciousness and withdrawal from social gatherings. Additionally, the unpredictable nature of her symptoms, including severe fatigue and night sweats, has strained her relationships and ability to engage in activities she once loved. Helen has a history of smoking, and does not drink or use recreational drugs, Helen has also recently taken pregnancy tests due to irregular menstrual cycle, which were negative. Despite these challenges, Helen is determined to remain independent and continue her career. She has sought support through online communities, finding solace and understanding among others with similar experiences. She also plays a significant role in her community, volunteering her graphic design skills to local non-profit organizations, which not only allows her to give back but also provides a sense of purpose and belonging. Her interest in alternative medicine has led her to explore various supplements and dietary changes to complement her conventional treatment, seeking a more holistic approach to manage her symptoms. Helen’s resilience is evident in her commitment to managing her condition, from adhering to a strict medication regimen to experimenting with dietary changes and stress reduction techniques. Issues client is experiencing related to their chronic health condition: ·Significant Weight Loss and Altered BMI: Helen’s unintentional weight/muscle loss from 58 kg to 48 kg, despite a stable diet, significantly affects her physical health and well-being. This change has not only altered her BMI from a healthier range to a lower one but also indicates the severity of her condition. ·High Blood Pressure (152/90 mmHg): Exacerbated by Graves’ Disease, posing additional risks to her cardiovascular health and necessitating careful monitoring and management. ·Dizziness: The dizziness introduced by Graves’ Disease created barriers to her ability to perform better in both her personal and professional life. Chart Data: Biographical Data Name: Helen Hill, Age: 35, Gender: Female, Heritage: Irish Canadian, Marital Status: Single, Occupation: Graphic Designer. Health History Graves’ Disease diagnosed one year ago; Anxiety; hypertension (Health history evidence client’s BP range from 128/90 – 135/95) Family History Mother with hyperthyroidism Allergies NKA Risk factors High-stress career, genetic predisposition to thyroid disorders Physical assessment Objective Data: HR 110 bpm; BP 152/90; Visible goiter; Exophthalmos. ·Height: 5’5” inches (1.68 m) ·Past Weight: 58 kg (Before significant weight loss). ·Current Weight: 48 kg (After weight loss). ·Past BMI: Approx. 21.3 ·Current BMI: Approx 17.6 (Indicative of weight loss). Subjective Data: Client reports hand tremors, increased appetite, heat intolerance, night sweats, excessive sweating, and sleep disturbances Emotional assessment Appears anxious and fatigued; expresses feelings of isolation and frustration. Psychosocial assessment Active community volunteer; challenges in social interactions; strong online support network. Diagnostics and lab values TSH: 0.009 mIU/L; Free T4: 3.4 ng/dL; Free T3: 6.8 pg/mL; TSI: 5.2 IU/L; TPOAb: 277 IU/mL Current medications Methimazole – 20 mg, Propranolol – 80 mg, Lisinopril – 5 mg, SSRI – 2 tabs for anxiety (Tyerman et al., 2022). Current treatment plans ·Medical Intervention: Focuses on managing thyroid hormone production and symptoms through medications, regularly monitoring thyroid function to adjust dosages. ·Nursing Intervention: Emphasizes education, medication adherence, symptom tracking, and lifestyle adjustments for stress and symptoms management. ·Alternative Intervention: Incorporates supplements, dietary changes, and practices like yoga and meditation, guided by consultations with experts in thyroid disorders and alternative medicine. Complications The potential for thyroid storm and other complications such as osteoporosis and atrial fibrillation underscores the critical nature of consistent treatment and monitoring. Cultural considerations Helen’s heritage and holistic health approach could be integrated into her care plan, if requested, which enhances the therapeutic relationship and treatment adherence. Her active community involvement and online support highlight the role of social support in managing chronic conditions, contributing to her psychosocial well-being and resilience References Tyerman, J., Cobbett, S., Harding, M. M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2022). Lewis’s Medical-Surgical Nursing in Canada – E-Book: Assessment and Management of Clinical Problems. Elsevier Health Sciences. Website, N. (2023, September 25). Propranolol. nhs.uk. Website, N. (2022b, February 2). How and when to take lisinopril. nhs.uk. Website, N. (2021, December 17). Dosage – Selective serotonin reuptake inhibitors (SSRIs). nhs.uk. antidepressants/dosage/ antidepressants/dosage/ antidepressants/dosage/

Health, Healing, and the Nursing Process 2

Part A: Revised Case Scenario

Group members: Kelly Savage, Rosemary Orumwense, Twinkle Twinkle, Jasmeen Jasmeen, Bhumika Katuwal

Assigned chronic health condition:

Grave’s Disease

Client Narrative/Story:

Helen Hill, a 35-year-old graphic designer of Irish Canadian heritage, has navigated the challenges of Graves’

Disease for one year. During her last visit, which was 6 weeks ago, Helen weighed approximately 58 kg. Despite

maintaining a stable diet, she has experienced unintentional weight loss, a common symptom of her condition,

bringing her current weight down to 48 kg. Standing at 1.68 meters tall, her Body Mass Index (BMI) has shifted

from a healthier range to a lower one, indicating this significant weight loss.

Helen is a graphic designer and her career as a graphic designer demands precision and creativity. Yet her hand

tremors and fluctuating vision have introduced barriers she continuously strives to overcome.

Recently, high blood pressure has emerged as another significant concern, further complicating her condition.

This addition underscores the necessity of a comprehensive approach to her healthcare, integrating cardiovascular

management with her ongoing thyroid disorder treatment. Socially, Helen has felt isolated due to her condition.

The physical changes, particularly the noticeable swelling in her neck and the protrusion of her eyes have led to

self-consciousness and withdrawal from social gatherings. Additionally, the unpredictable nature of her

symptoms, including severe fatigue and night sweats, has strained her relationships and ability to engage in

activities she once loved. Helen has a history of smoking, and does not drink or use recreational drugs, Helen has

also recently taken pregnancy tests due to irregular menstrual cycle, which were negative.

Despite these challenges, Helen is determined to remain independent and continue her career. She has sought

support through online communities, finding solace and understanding among others with similar experiences.

She also plays a significant role in her community, volunteering her graphic design skills to local non-profit

organizations, which not only allows her to give back but also provides a sense of purpose and belonging. Her

interest in alternative medicine has led her to explore various supplements and dietary changes to complement

her conventional treatment, seeking a more holistic approach to manage her symptoms. Helen’s resilience is

evident in her commitment to managing her condition, from adhering to a strict medication regimen to

experimenting with dietary changes and stress reduction techniques.

Issues client is experiencing related to their chronic health condition:

·Significant Weight Loss and Altered BMI: Helen’s unintentional weight/muscle loss from 58 kg to 48 kg,

despite a stable diet, significantly affects her physical health and well-being. This change has not only altered her

BMI from a healthier range to a lower one but also indicates the severity of her condition.

·High Blood Pressure (152/90 mmHg): Exacerbated by Graves’ Disease, posing additional risks to her

cardiovascular health and necessitating careful monitoring and management.

·Dizziness: The dizziness introduced by Graves’ Disease created barriers to her ability to perform better in both

her personal and professional life.

Chart Data:

Biographical Data Name: Helen Hill, Age: 35, Gender: Female, Heritage: Irish Canadian, Marital Status:

Single, Occupation: Graphic Designer.

Health History Graves’ Disease diagnosed one year ago; Anxiety; hypertension (Health history

evidence client’s BP range from 128/90 – 135/95)

Family History Mother with hyperthyroidism

Allergies NKA

Risk factors High-stress career, genetic predisposition to thyroid disorders

Physical assessment Objective Data: HR 110 bpm; BP 152/90; Visible goiter; Exophthalmos.

·Height: 5’5” inches (1.68 m)

·Past Weight: 58 kg (Before significant weight loss).

·Current Weight: 48 kg (After weight loss).

·Past BMI: Approx. 21.3

·Current BMI: Approx 17.6 (Indicative of weight loss).

Subjective Data: Client reports hand tremors, increased appetite, heat intolerance,

night sweats, excessive sweating, and sleep disturbances

Emotional

assessment

Appears anxious and fatigued; expresses feelings of isolation and frustration.

Psychosocial

assessment

Active community volunteer; challenges in social interactions; strong online support

network.

Diagnostics and lab

values

TSH: 0.009 mIU/L; Free T4: 3.4 ng/dL; Free T3: 6.8 pg/mL; TSI: 5.2 IU/L; TPOAb:

277 IU/mL

Current medications Methimazole – 20 mg, Propranolol – 80 mg, Lisinopril – 5 mg, SSRI – 2 tabs for

anxiety (Tyerman et al., 2022).

Current treatment

plans

·Medical Intervention: Focuses on managing thyroid hormone production and

symptoms through medications, regularly monitoring thyroid function to adjust

dosages.

·Nursing Intervention: Emphasizes education, medication adherence, symptom

tracking, and lifestyle adjustments for stress and symptoms management.

·Alternative Intervention: Incorporates supplements, dietary changes, and practices

like yoga and meditation, guided by consultations with experts in thyroid disorders and

alternative medicine.

Complications The potential for thyroid storm and other complications such as osteoporosis and atrial

fibrillation underscores the critical nature of consistent treatment and monitoring.

Cultural

considerations

Helen’s heritage and holistic health approach could be integrated into her care plan, if

requested, which enhances the therapeutic relationship and treatment adherence. Her

active community involvement and online support highlight the role of social support

in managing chronic conditions, contributing to her psychosocial well-being and

resilience

References

Tyerman, J., Cobbett, S., Harding, M. M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2022). Lewis’s

Medical-Surgical Nursing in Canada – E-Book: Assessment and Management of Clinical Problems.

Elsevier Health Sciences.

Website, N. (2023, September 25). Propranolol. nhs.uk.

Website, N. (2022b, February 2). How and when to take lisinopril. nhs.uk.

Website, N. (2021, December 17). Dosage – Selective serotonin reuptake inhibitors (SSRIs). nhs.uk.

antidepressants/dosage/

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The appeal to emotions with if the 30 seconds of no reaction was a lifetime situation and her being sad left an impression on me. I would want my child to feel safe and to trust me and if a game of peek-a-boo could change that, I would do it. Also, she left with an outro that was made to say she answered the questions on how peek-a-boo could change the world. · Presentations Aids: The presentation aids by the speaker include the baby and his father interacting (video aid), bean bags that showed us the different sizes of the brain at each stage (prop), and a colorful PowerPoint with little words (visual aid). Also, the PowerPoints included pictured that aided her words and pulled on my heart strings. All her presentation aids were effective to me because I got to see her main points being put into action. 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please see attachment Health Concepts HLTH185 Chapter 5 Developing Muscular Strength and Endurance and Chapter 6 Flexibility Name ___________________________________ Date _____________________________ For this activity, you will apply concepts from the chapters on “Developing Muscular Strength and Endurance” and “Flexibility”. You will develop a Muscular strength, endurance, and flexibility program for the following patients.  Type entries, be specific, and use your textbook to support your recommendations using specific evidence. Attach additional pages if you need space. I have provided a case example below: Example: 20-Year-old ECSU volleyball student (female) with an old ACL injury needs to prepare for the upcoming season. She weighs 175lbs and is 5’9. She has no pre-existing medical conditions. Complains of pain when she doesn’t warm up. Patient# Description Age Weight Height Type of Strength Training needed Intensity and Time (reps) Equipment Flexibility/Stretching Suggestions Case Example Volleyball student with an old ACL injury. No existing medical conditions. 20 175lbs 5’9 Isometric exercises to warm up old ACL injury. Isotonic exercises to prepare joints for a full range of motion. p. 97 Minimum 5-10 reps for each exercise since she is a seasoned athlete. p.97-98 Free weights to engage muscles in both legs Weight machines, targeting specific muscles around the knees and legs Resistance Bands to work muscles while healing,99-101 Dynamic stretching to move joints through full range of motion to warm up for practice and pre-game Ballistic Stretching at the performance level on game night. (105-106) Case #1:  ECSU Student (age 23) who has a BMI OF 40 (severe obesity), weighing in at 290lbs and 5’2. He would like to lose 50 pounds as quickly as possible. He is suffering from High Blood Pressure and is having digestive issues. Case #2   70- year- old patient with partial amputation of right foot due to a car accident. Weight 140lbs, 5’7. Needs therapy for atrophy and strengthening of muscles. Case #3   ECSU athlete is preparing for the Fall 2022 football team and is trying to increase muscle strength and endurance for the upcoming season. Weight 200lbs, 6’4, 19 years old. Patient# Description Age Weight Height Type of Strength Training needed p.96-97 Intensity and Time (reps) p.97-98 Equipment 99-101 Flexibility/Stretching Suggestions (105-106) Case 1 Case 2 Case 3 Patient# Other comments or additional information (Caution: Do not leave this area blank) Case Example The patient needs to follow the doctor’s recommendations to prevent further ACL injury. It is important to perform stretching before and after every activity. On a weekly basis, she should work on strengthening muscles for optimal muscle movement. 1 2 3 2

please see attachment Health Concepts HLTH185 Chapter 5 Developing Muscular Strength and Endurance and Chapter 6 Flexibility Name ___________________________________ Date _____________________________ For this activity, you will apply concepts from the chapters on “Developing Muscular Strength and Endurance” and “Flexibility”. You will develop a Muscular strength, endurance, and flexibility program for

see attachment  Module 4:  Discussion Forum: Hypothesis Testing Instructions This space has been created for you to share the link of a newspaper or blog article that discusses the importance for companies of using hypothesis testing with your classmates. 1. Write a summary about the blog or article. 2. Write at least two paragraphs. 3. The paragraph must have at least 3 sentences. 4. Read your classmates blogs and select two of them to discuss. 5. Establish a dialogue with them. General Instructions for the Discussion Forum 1. Post your answer as established by your instructor on the course calendar. Your comments must be written in your own words. You can offer examples and quotes to support your proposals. Citations of other authors must be properly documented (author’s name, title, date, etc.). 2. Post your comments to the response of at least two (2) of your classmates on or before the day set by your instructor on the course calendar. Your reaction may be based on personal experiences, study material, or additional information obtained from the  Online Library  or others, and may include: · Some understanding received from what is published that synthesizes the information and offers new perspectives or suggestions. · The validation or rejection of the idea (supported by your experience or research).  · New information that broadens, adds or contrasts perspectives (based on reading and evidence).  3. Remember that your work must be original and must not contain material copied from books or the internet. You must respect the intellectual property of the authors and not commit plagiarism. 4. Examine the criteria used to evaluate your assignment to find out how to get the highest grade for your work. The assignments are graded or evaluated through rubrics or by the distribution of points. 5. Before submitting your entry, read your message several times. This will ensure that it contains the exact information you want to communicate.   Remember to review the  academic expectations  for your submission. Submission Instructions: · Submit your initial discussion post by 11:59 PM Eastern on Wednesday.   · Contribute a minimum of 350 words for your initial post. It should include at least 2 academic sources, formatted and cited in APA. · Respond to at least two of your classmates’ discussion posts by 11:59 PM Eastern on Sunday. Ask a question, and provide a different viewpoint.  

see attachment  Module 4:  Discussion Forum: Hypothesis Testing Instructions This space has been created for you to share the link of a newspaper or blog article that discusses the importance for companies of using hypothesis testing with your classmates. 1. Write a summary about the blog or article. 2. Write

For this lesson, please submit the first round of your analysis and critique essay: your paper’s introduction and first discussion section. When drafting and organizing your first two pages, consider the model outlined in the previous content pages: Introduction Lead-In Personal Narrative with connection to focus topic Thesis Statement – (Topic + Assertion) Discussions (add 1-2 from your subtopics) Review the following Writing Toolkit sections: Introduction, Titles, Discussion(body) Sections, Directly Quoting, Partially Quoting, Paraphrasing Topic Sentence/Point Explanation or Interpretation Example Significance See Graphic for Writing the Research Essay Steps To read more about this assignment’s requirements, please review this content page: Writing Toolkit: Writing the Analysis and Critique Essay. Would you like to see a model? Here you go! Remember that, as stated in the syllabus, you must show evidence of the writing process, and submitting your rough drafts as assigned fulfills that requirement. I reserve the right to refuse to evaluate any paper that did not show evidence of the writing process.

For this lesson, please submit the first round of your analysis and critique essay: your paper’s introduction and first discussion section. When drafting and organizing your first two pages, consider the model outlined in the previous content pages: Introduction Lead-In Personal Narrative with connection to focus topic Thesis Statement –

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