Review the assigned case study. Then, using the Case Study Analysis Assignment Outline, write a 4-6-page paper (not including title and reference page) on the assigned topic. Case Study Analysis Assignment Outline: 1. Introduction 2. Brief overview of the disease process. Include: • What lab abnormalities would you look for? • What diagnostics would you expect to see? • What medications would you expect to be prescribed? • What are the priority nursing interventions that should be implemented? • Supportive rationales. 3. Implications of a Nursing Theory or Framework • How does nursing theory or framework impact care related to the disease and patient care? o Application of a nursing theory in relation to the following: 1. disease process 2. patient care 3. safety 4. Patient Education • Include teaching strategies that you would utilize to enhance learning for the patient. Provide 3 examples of education topics and support with rationale. 5. Interdisciplinary Collaboration • What interdisciplinary team members need to be included. Include rationale. • Include at least one of the following topics related to interdisciplinary collaboration: nutrition, support systems, cultural considerations, discharge, transition, and financial implications. 6. Conclusion Case Study Analysis Paper Guidelines for Submission
CASE STUDY: D.V., a 32-year-old man, is being admitted to the medical floor from the neurology clinic with symptoms of multiple sclerosis (MS). D.V. has experienced increasing urinary frequency and urgency over the past 2 months. D.V. recently had two brief episodes of eye “fuzziness” associated with diplopia and flashes of brightness. He has noticed ascending numbness and weakness of the right arm with the inability to hold objects over the past few days. Now he reports rapidly progressing weakness in his legs along with blurred, patchy vision. 1. MS is associated with scattered, patchy demyelination of the sheath around nerves in the brain and spinal cord. What does myelin do? What is demyelination? . 2. MS is characterized by remissions and exacerbations. What happens to the myelin during each of these phases? 3. Is D.V. too young to get MS? What is the cause of MS? 4. Outline the subjective and objective assessment data associated with MS. Place a star next to those D.V. has. 5. The neurologist orders an MRI scan of the brain and spine. What role does this test play in diagnosing MS? 6. How will the neurologist determine whether D.V. has MS? 7. What are the overall goals of collaborative care for a patient with MS? 8. D.V. asks, “If this turns out to be MS, how will I be treated?” How would you respond? 9. D.V. is started on interferon beta-1a (Avonex) 30 mcg intramuscularly each week. What teaching do you need to provide regarding interferon therapy? 10. The neurologist also orders 500 mg methylprednisolone (Solu-Medrol) IV daily. What do you need to do to administer this medication safely? Select all that apply. a. Begin the infusion before 0900 each day b. Reconstitute with 8 mL of benzyl alcohol c. Use the solution within 60 minutes of reconstitution d. Administer a total dose of 8 mL of reconstituted solution e. Deliver the dose over 30 minutes using IV pulse administration 11. Because D.V. is experiencing urinary frequency and urgency, the neurologist orders oxybutynin. In addition to medication teaching, what will you teach him to do to assist in controlling urinary symptoms? 12. When planning D.V.’s care, what goal is the most appropriate goal for the clinical problem of activity intolerance related to muscle weakness? a. “D.V. is free of trauma related to muscle weakness.” b. “D.V. will maintain muscle strength in his arms and legs.” c. “D.V. can identify three factors that aggravate muscle weakness.” d. “D.V. will participate in daily activities as desired without fatigue.” . 13. As part of your teaching plan, you want D.V. to be aware of situations or factors that are known to exacerbate symptoms. List 4. CASE STUDY PROGRESS After testing is complete, D.V. is diagnosed with MS. He confides in you that he has been depressed since his parents’ divorce and the onset of these symptoms. He tells you that he knows his girlfriend has been unfaithful, but he is afraid of being alone. He is afraid if he tells her about his MS diagnosis, she will leave him. 14. What are you going to do with this information? 15. You are concerned with D.V.’s psychological status, particularly the negative feelings he expresses regarding himself and the concerns he has voiced. Write a nursing outcome addressing this issue and identify independent nursing actions you would implement. 16. In view of his personal history and current diagnosis, what 2 critical psychosocial issues require monitoring in his follow-up visits? 17. What community resources might D.V. find helpful?