Chat with us, powered by LiveChat NRS-410V-0L191 Pathophisiology and Nursing Management of Client Health. - School Writers

NRS-410V-0L191 Pathophisiology and Nursing Management of Client Health.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

  1. Temperature: 37.1 degrees C
  2. BP 123/78 HR 93 RR 22 Pox 99%
  3. Denies pain
  4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

  1. WBC: 19.2 (1,000/uL)
  2. Lymphocytes 6700 (cells/uL)
  3. CT Head shows no changes since previous scan
  4. Urinalysis positive for moderate amount of leukocytes and cloudy
  5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.'s situation. Include the following:

  1. Describe the clinical manifestations present in Mr. M.
  2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
  3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
  4. Describe the physical, psychological, and emotional effects Mr. M.'s current health status may have on him. Discuss the impact it can have on his family.
  5. Discuss what interventions can be put into place to support Mr. M. and his family.
  6. Given Mr. M.'s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

Submission Ide: 4e2ac7f7-196a-4dcd-9012-bcbe6b9ad88a

33% SIMILARITY SCORE 11   CITATION ITEMS 19   GRAMMAR ISSUES 0   FEEDBACK COMMENT Internet Source   0% Institution   33%

Gillo Gombeh

Case Study Pathophysiology 10-11-2020.docx


 1081 Words  

Running head: MR. M. CASE STUDY 1


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Mr. M. Case Study

Institutional: GCU

Student’s name: Gillo Gombeh

Course: NRS-410V

Date: 10/11/2020

Mr. M. Case Study

The case study is about Mr. M. who is a seventy-year-old male. Mr. M. resides in an

assisted living facility. He has a history of hypercholesterolemia and high blood pressure. His

hypertension is controlled using ACE inhibitors. On the other hand, his hypercholesterolemia is


sedentary lifestyle, and being hypertensive (Ulep, Saraon, & McLea, 2017). A secondary

diagnosis for Mr. M could be delirium. This is as a result of a possible urinary tract infection.

Despite Mr. M. not showing any signs of a fever, he presents with a urinalysis that is cloudy with

moderate leukocytes, elevated lymphocytes, and an elevated white blood cell count. All these are

signs are indicative of an infection.

Expected abnormalities when performing a nursing assessment

When performing my nursing assessment, some of the abnormalities I would expect to

find include Mr. M. being fearful, struggling with speech, difficulty performing ADL, being

confused, displaying delusional, repetitive, or compulsive behaviors, and might have difficulty

controlling his bladder function and bowel. Neurological testing might reveal weak muscle tone

and coordination, and reduced grip strength. Symptoms previously reported would confirm

unsteady gait and difficulty with ambulation.

The physical, psychological, and emotional effects

There are various physical, psychological, and emotional effects the current health status

of Mr. M. could have on him and his family. As indicated above, the primary diagnosis of Mr. M

is dementia. This disease is likely to physically affect Mr. M. The most notable physical changes

that are expected when a patient suffers from dementia include a reduction in the mobility and

balance, ability to swallow, bowel and bladder control diminishes, reduction in fine motor skills,

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controlled using Lisinopril. Mr. M. does not smoke nor drinks alcohol. This paper seeks to

critically evaluate the situation of Mr. M.

Clinical Manifestations

Mr. M. is a resident of an assisted living (AL) facility. In the past two months, the mental

health of Mr. M has been deteriorating. This is evident by him having challenges recalling the

names of his family members and his room number at the AL facility. Mr. M. is also currently

unable to perform daily living activities. The weight of Mr. M. is 87 Kg (191lbs) while his height

is 6 feet 7 inches. Mr. M. is, therefore, overweight. The vital signs of Mr. M. are temperature

37.1 Degrees Celsius, BP 123/78 with HR 93, RR 22, and Pox 99%. Laboratory results indicate a

WBC of 19.2, Lymphocytes of 6700 (cells/uL), Urinalysis is positive for leukocytes, and cloudy

presence of urine. This is indicative of a UTI. Protein is 7.1g/dL, AST is 32 U/L, and ALT is 29

U/L. The Head CT scan indicates no changes from the previous scan.

Primary and Secondary Medical Conditions that should be taken into consideration

The primary diagnosis for Mr. M. would be memory loss (dementia). The most common

form of dementia is Alzheimer’s disease (AD). AD is most common in individuals aged 65 and

above. Dementia is characterized by a decline in memory, changes in reasoning and thinking

skills, poor judgment, changes in language skills, and a decline in focus and attention span. AD

often progresses in 4 phases that include preclinical, mild, moderate, and severe (National

Institute on Aging, 2017). Some of the risk factors of AD include advanced age, overweight,

sleep disturbances, and poor grooming habits (Falkner & Green, 2018). The physical deficits in

functioning abilities could affect the independence of Mr. M. He would have to be dependent

since he will be unable to perform ADL. Dementia is also likely to psychologically and

emotionally affect Mr. M. This is because dementia can result in anxiety and depression. Anxiety


and depression are likely to negatively affect Mr. M. The family of Mr. M. could also be

psychologically and emotionally affected by his current health status. Some of the emotions the

family members might experience include grief, loss, anger, disbelief, and fear. The family might

struggle in dealing with emotions resulting in depression.

Interventions that can be put into place to support Mr. M. and his family

One intervention that can be put in place to support Mr. M. and his family is medications.

Medications can help improve cognition for a short-term duration. This is despite dementia being

incurable. Medications will help manage the negative emotional impacts and depression that

often accompany dementia. Medications will also help in controlling AD risk factors that include

high blood pressure and hyperlipidemia. Another intervention is to provide support for the

patient and family (caregiver) by obtaining social services support. This can be in the form of

home health to assess living conditions. Other interventions include developing a plan of care for

the patient and providing a continual assessment of the patient and family (caregiver). The final

intention is to educate the family (caregiver) regarding proper approaches to a patient suffering

from dementia.

Actual or Potential Problems Mr. M. faces

The actual problem Mr. M. is likely to face is cognition that will become worse. This is

evidenced by his inability to remember the names of family members and simple activities. Mr.

M. also has the potential for injury related to falling. This is attributed to his difficulty with

ambulation and unsteady gait. Another potential problem is infection. This is due to poor

hygiene, and potential loss of bowel and bladder function. Finally, there is a potential for

pneumonia. This is due to the possibility of the disease progressing, hence causing dysphagia.



After analyzing the subjective and objective data, and laboratory results, it is clear that

the primary diagnosis of Mr. M. is dementia. This particular condition has negatively affected

the physical, psychological, and emotional health of Mr. M. Interventions, therefore, need to be

put in place to support Mr. M. and his family. This will help improve the health of Mr. M. and

prevent further negative psychological and emotional effects, the condition (dementia) might

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have on the family of Mr. M.



Alzheimer’s Society. (2020). Psychological and emotional effects of dementia. Retrieved from


Falkner, A., & Green, S. Z. (2018). Neurological, perceptual, and cognitive complexities. In

Grand Canyon University (Ed.), Pathophysiology Clinical Applications for Client Health

(1 ed.).

National Institute on Aging (2017). What are the signs of Alzheimer’s disease? Retrieved from

National Institute on Aging (2018). Biomarkers for dementia detection and research. Retrieved


Ulep, M. G., Saraon, S. K., & McLea, S. (2017). Alzheimer’s disease. Journal for Nurse

Practitioners, 14, 129-135.

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