Reference no: EM133821349

Case: In this Part 3 of your Threaded Case Study, you will continue to work and develop a care plan for the case study you chose from your practicum experience.

Build on this case study Often, patients with overlapping chronic illnesses and lifestyle-related concerns require a thorough evaluation to identify the underlying causes and contributing factors. A 50-year-old woman, RC, seeks medical treatment at an outpatient primary care facility for acid reflux, bloating, and fullness, which have a significant adverse effect on her quality of life. Considering the combination of obesity, hypertension, type 2 diabetes mellitus, and asthma, these symptoms provide a complex clinical picture that should be addressed through an integrated and patient-centered approach. The dietary and lifestyle choices she makes exacerbate her symptoms even further, emphasizing the need for specialized interventions to manage them effectively. An in-depth analysis of RC's clinical presentation, history, and comorbidities and a diagnosis-driven treatment plan is presented. The purpose of this narrative is to provide a comprehensive overview of the patient's treatment requirements by explaining the pathophysiology of her suspected primary diagnosis, gastroesophageal reflux disease (GERD), and by describing the medications she is currently taking as part of the discussion of pertinent diagnostic tests, short-and long-term nursing goals are set to ensure the most accurate diagnosis and the highest standard of care. Get It Done Now!

A 50-year-old woman named RC presented to an outpatient primary care clinic complaining of bloating, acid reflux, and fullness, which worsened at night. Her medical history reveals numerous chronic conditions, including asthma, type 2 diabetes mellitus (T2DM), and hypertension. These disorders can be treated with several medications, including metformin, albuterol, Pulmicort, cetirizine, and bisoproll. On weekends, RC drinks socially and eats fast food once a day, consumes two cups of coffee daily, and consumes fast food once daily. Nursing care is an essential component of the overall quality of hospital services. Managing the quality of nursing care is integral to nursing management, and assessing the quality of nursing care is the central component of coordinating and managing the quality of nursing care (Ju et al., 2018). The patient reports that her symptoms of reflux have worsened over the past few months. Her symptoms include heartburn, regurgitation, and bloating, especially after eating or while lying down. A significant loss of weight, dysphagia, or odynophagia has not been reported, which could suggest a more serious cause. Despite this, she acknowledges that she has been less than ideal in complying with food guidelines and making lifestyle changes. She had a blood pressure of 142/85 mmg at the time of her visit, which indicates that her hypertension is not adequately controlled. Due to its history and symptoms, gastroesophageal reflux disease (GERD) is the most likely differential diagnosis. Peptic ulcer disease (PUD), particularly if she has a history of NSAID use or Helicobacter pylori infection, and functional dyspepsia may present with similar symptoms but without significant exposure to stomach acid. Despite the overlap between the symptoms of each of these disorders, GERD is most likely to match the patient's clinical presentation, particularly about symptoms that worsen at night and eating habits that promote acid reflux. Prescribed Medications The proton pump inhibitor (PPI) omeprazole is prescribed for the treatment of GERD. This drug permanently blocks the H+/K+ ATPase in the gastric parietal cells, substantially reducing stomach acid production. In addition to relieving symptoms, this decrease promotes the regeneration of mucosal tissue damaged by acid. Achieving the best acid suppression usually takes 30 minutes before the day's first meal. To treat her diabetes, RC takes metformin, the second medication prescribed to her. In addition to improving insulin sensitivity, metformin increases peripheral glucose absorption and reduces hepatic glucose synthesis. Aside from promoting weight management, this drug may also tangentially lessen the symptoms of GERD. Treatment Plan To meet the demands of the 21st century, healthcare provider education must address quality and patient safety language. Universities focus on the quality and safety language outlined in the Quality and Safety Education for Nurses (QSEN). However, hospitals emphasize the competencies and standards outlined in the Joint Commission accreditation standards and the Magnet competencies of the American Nurses Credentialing Center (QSEN Institute, 2020). The treatment for RC involves a combination of lifestyle changes, medication, and careful observation of her coexisting medical conditions. Omeprazole is recommended to be taken before breakfast daily at a dose of 20 mg. RC will also be instructed on how to avoid high-fat foods, caffeine, alcohol, and late-night eating, all of which have been known to aggravate the condition. She will be advised to maintain a healthy weight and raise the head of her bed to alleviate reflux episodes. Due to her diabetes, an ACE inhibitor or an increase in bisoprolol dosage will be considered to achieve a blood pressure target of less than 130/80 mmg. Asthma management will be prioritized by adhering to Pulmicort and using appropriate inhaler techniques. Assignment identify and describe a set of problems common to this specialty ( out patient primary care setting) that are applicable to the patient ( case study above) that can be addressed by a nurse in an advanced care role. ... The response clearly, accurately, and thoroughly explains the knowledge gaps the patient has that a nurse in an advanced care role can address. provide a goal that leads to improved outcomes, and clearly, accurately, and thoroughly explains the solutions for any complex problems through a systematic method of data collection. The response includes a clear and accurate explanation of the methodology.