Discuss about Advanced Pathophysiology paper regarding renal and respiratory issues.

Discuss about Advanced Pathophysiology paper regarding renal and respiratory issues. The textbook:
http://31.42.184.140/main/2745000/d6d4fa3570786b8990e2351519ccfe35/Porth%2C%20Carol_Lippincott%20Williams_Wilkins._Grossman%2C%20Sheila%20C%20-%20Porth%27s%20pathophysiology_%20concepts%20of%20altered%20health%20states-Wolters%20Kluwer%20Health_Lippincott%20Williams%20%26%20Wilkins%20%282014%29.pdf

Attached is a past assignment that follows the exact same guidelines, just a different topic

Next pages: The body of your paper. The body of the paper will include the following:
A WELL ORGANIZED, detailed introduction providing all of the facts of the case (Note: There is no unnecessary information in the scenario. The scenario provides clues for your rationale.)
Next to the last page: TEACHING POINTS (Yes, teaching points go on a separate page.): Include ONLY three teaching points. YOU MUST THINK CRITICALLY ABOUT WHAT IS MOST IMPORTANT FOR THIS PATIENT AT THIS TIME. Teaching points DO NOT need references. (Show us that you can follow instructions.) The teaching points are YOUR words.
Last page: The last page is the reference page. All references should be in APA format. This textbook has authored chapters. The appropriate formatting for an authored chapter in a textbook without a DOI is found on p. 326, example 39, in the Publication Manual of the American Psychological Association, 7th ed.
Submit your work as a DOC or DOCX file through the assignment portal in Canvas. ALL assignments (except the very last one) are due at 2300 Central Time.

INSTRUCTIONS:
Below is a clinical situation that an Advanced Practice Nurse might encounter. Although this case MAY APPEAR to be an obstetrical case, this is a case about the pathophysiologic principles that apply to patients who are men or women, young or old. In NO MORE THAN FOUR PARAGRAPHS (not including the introduction), assess the situation and address the questions (logically and in order) that relate to the scenario. Be concise and clear in your presentation.
The first paragraph of the Clinical Application Essay must include a complete introduction that presents the facts of the case so that a reader not familiar with the case will understand what you are writing about. The next paragraphs should explain the pathophysiology that has caused the conditions of the case. Be sure that you answer each of the questions.
Be sure to check your spelling and grammar. Proper use of APA format is required. DO NOT USE REFERENCES OTHER THAN THE REQUIRED TEXTBOOK (Norris (10th ed.). PLEASE NOTE: YOUR ESSAY SHOULD BE CONCISE, WELL ORGANIZED AND NO MORE THAN FOUR PARAGRAPHS IN LENGTH (not including the introduction and teaching points.) Follow instructions. PLEASE SEE THE RUBRIC FOR GRADING PARAMETERS. Use the rubric as a checklist before submission.
In a separate section (but in the same submitted document), list and enumerate using Arabic (1, 2, and 3) numbers (not bullet points) at ONLY THREE teaching points that relate to this scenario.

A teaching point is something you say directly to a patient, a parent, or other family members that TEACHES about the situation, condition or treatment to reinforce what you say to the patient during the clinic or office visit that should be remembered after the visit. (“You will need a follow-up appointment” is an instruction, not a teaching point.)
Do not use jargon-not everyone you talk with will have the same level of education that you do. (Perhaps have a non-medical 13-year-old read your teaching points to see if they can understand what you are saying.) Teaching points do not need references.
If we were discussing oral health, examples of teaching point would be:
It is important that you brush your teeth after each meal. This helps keep the teeth clean and prevents cavities and bad breath.
Flossing at least once daily is important to assure proper gum health. This also prevents further gum disease and bone loss.
Seeing your dentist twice a year is important for good oral health. Your dentist will not only check your teeth and gums but will also do a comprehensive cancer screening of the tongue, salivary glands, and other tissues in the mouth. By seeing your dentist often, small problems are taken care of before they become big problems.
Notice the teaching in the above points. Also notice that ARABIC (1, 2, and 3) numbers were used. If an instruction is given, then an explanation (teaching) is given about WHY the instruction is important.
NOT
1. I would tell the patient that tooth brushing is important after meals and I would explain flossing.
Tell what you will say not what you will do.
2. It is important to keep your next scheduled visit.
This is an instruction and teaches the patient nothing about the disease process.
3. If you do not take care of your teeth, you may get terrible diseases in your mouth that could cause you to lose your jaw to die.
This is a bit harsh and a bit extreme. There are softer ways to present this same information.
SCENARIO
History of present illness
Anna-Katherine Insbrook (AKI) is a 52-year-old woman who presents to her oncologist’s office five days after her last chemotherapy treatment with cisplatin, a known nephrotoxic chemotherapeutic agent. AKI was diagnosed 1 year ago with lung cancer initially treated with surgical removal of the right lung followed by chemotherapy.
AKI describes progressive swelling of her ankles and decreased urine output over the past 24 hours. She also describes shortness of breath that is worse today than yesterday.
Following evaluation in the clinic and review of her laboratory results, AKI is admitted to the hospital for intensive care.
SOCIAL HISTORY:
Married 28 years
Works for the United States Department of Agriculture
Uses alcohol rarely
Smoked 1 pack of cigarettes per day for 30 years; no smoking for the past year.
Denies use of illicit drugs
No over-the-counter drug use
PAST MEDICAL HISTORY
PULMONARY: Community-acquired pneumonia 10 years ago; Squamous cell carcinoma of the right lung diagnosed 1 year ago
RENAL: No prior renal disease
IMMUNIZATIONS: Pneumovax and Influenza are up to date. She is completely immunized (3 doses) for COVID-19
ALLERGIES: None known
CURRENT MEDICATIONS – Occasional non-steroidal anti-inflammatory medications (NSAIDs)
Maintenance CHEMOTHERAPY for lung cancer
PAST SURGICAL HISTORY
Right pneumonectomy with node dissection 3years ago for 4 cm squamous cell carcinoma of the lung – well-localized; all nodes negative for metastasis.
Appendectomy at age 14
PHYSICAL EXAM:
Vital signs: temperature: 99.2 F (37.3C); blood pressure: 180/120 mmHg; respiratory rate: 28/minute; heart rate: 120 BPM; weight 156 pounds; height: 5 feet 9 inches (69 inches)
Exam reveals a woman who appears slightly older than her stated age.
The HEENT (head, ears, eyes, nose, and throat) reveals slight periorbital edema, normal vision, normal tympanic membranes, normal nares, and a normal throat with slightly enlarged tonsils without exudate. There is no significant pharyngeal redness.
Pulmonary findings include slightly increased work of breathing with rales in the lower lobes of the left lung. The right lung is absent.
Cardiac exam reveals sinus tachycardia with no murmurs, rubs, or gallops; There is no jugular-venous distension (JVD).
The abdomen is soft.
There are no enlarged cervical, axillary, or inguinal lymph nodes.
Neuro: There is decreased sensation in the extremities. The deep tendon reflexes 3+ (normal 1+)
LABS:
COVID-19 NEGATIVE
URINALYSIS: Color: clear; specific gravity 1.005; no glucose, trace ketones; 3+ protein
Blood glucose (random): 114 mg/dL
Blood gas (room air): pH 7.28; pCO2 55; HCO3- 18
CBC: Hct 35%; MCV 72 fL; WBC 3,000
Metabolic Profile: Na+ 148 mEq/L; K+ 6.2 mEq/L; Cl- 105 mEq/L; HCO3- 18 mEq/L
BUN 45 mg/dL; Cr 25.5 mg/dL; albumin 2.0 g/dL (nl – 3.5 to 5.5 g/dL)
Chest X-ray – Diffuse left lower lobe infiltrate consistent with pulmonary edema
QUESTIONS TO ANSWER
Given AKI’s history, physical exam, and laboratory findings, what is the MOST LIKELY etiology of her ACUTE illness?
Considering her metabolic profile, what intervention(s) may be needed acutely?
Describe the stepwise pathophysiology of her current renal condition including the expected progression of events to recovery.
Characterize the blood gas and explain the compensatory changes (renal and pulmonary) needed to correct her acid/base status. Describe possible reasons that compensation may be difficult.
This is primarily a RENAL case study but the RESPIRATORY system is important, too. Remember these two systems work together. You should reference both systems in your discussion.
Include ONLY THREE teaching points that directly relate to the issues within the scenario. YOU MUST THINK CRITICALLY ABOUT WHAT IS MOST IMPORTANT FOR THIS PATIENT AT THIS TIME.
BE SURE TO INCLUDE AN INTRODUCTION THAT PRESENTS DETAILS FROM THE SCENARIO. Every bit of information in the scenario is important in helping determine the complexities of this patient’s illness.
Be sure that anyone reading your essay will have a clear idea of your thinking. Make sure we can understand not only the “WHAT” but the “WHY”. Be complete but not wordy. Also, you may need to reference more than the renal chapters in Norris.

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