JIMENEZ GLYCOL POISONING CASE STUDY
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
Ms. Jimenez (Part 2)
GENDER Female
SOCIOECONOMIC Financial difficulties secondary to divorce five years ago; nonsmoker
AGE 56
SETTING Hospital
SPIRITUAL/RELIGIOUS
PHARMACOLOGIC
ETHNICITY Hispanic
CULTURAL CONSIDERATIONS
PREEXISTING CONDITIONS
Motor vehicle crash (MVC) eight weeks ago with no injury; depression
COEXISTING CONDITION
Suicide attempt with ethylene glycol (antifreeze) poisoning
COMMUNICATION
DISABILITY
LEGAL
Safety sitter
ETHICAL
ALTERNATIVE THERAPY
PRIORITIZATION Client safety
DELEGATION Psychiatric consult; social services
Overview: The client ingested ethylene glycol two days ago and has been medically stabilized. The long-term effects of ethylene glycol poisoning are discussed. The nurse is asked to explain the stages of acute renal failure and the function of hemodialysis. Collaborative resources to assist the client following discharge are identified.
Client Profile
Ms. Jimenez is a 56-year-old woman who has been having financial difficulties since her divorce five years ago. She was recently involved in a motor vehicle crash (MVC) in which she drove over a curb and hit a telephone pole. She did not sustain any significant injuries in the MVC. Two days ago, Ms. Jimenez’s daughter Maria returned home at 8:00 p.m. to find Ms. Jimenez sitting on the floor with decreased level of consciousness. Maria was able to shake her mother awake. With slurred speech, Ms. Jimenez told her daughter that she drank three large glasses of antifreeze (ethylene glycol) at around 7:00 p.m. Maria called 911 and emergency medical services transported Ms. Jimenez to the local emergency department.
Case Study
It is forty-eight hours after her arrival in the emergency department. Ms. Jimenez has undergone twelve hours of emergency dialysis, has been extubated, and is medi-cally stable for transfer to a medical-surgical nursing unit. A safety sitter remains in Ms. Jimenez’s room at all times. Ms. Jimenez is alert and oriented but has a flat affect. She is not remorseful for her actions and states, “I had hoped I would be successful this time.” A psychiatrist sees Ms. Jimenez for a consultation. The psychiatric assess-ment reveals that she has been planning the poisoning for a few weeks. She states, “I was hoping I would die quickly and it would look like an accident.” Ms. Jimenez states that she has made attempts in the past to overdose on medications. She did not seek care at the hospital when these suicide attempts were not successful. She has been depressed since divorcing her husband five years ago. Since her divorce, she has not paid taxes and there have been mounting financial bills with the Inter-nal Revenue Service. As a result, her wages are being garnished (money is withheld from her paycheck and sent to a creditor). She reports, “On the outside I appear bright and upbeat but on the inside I am so lonely and sad and just don’t want to go on anymore.” She wonders how she will pay for her medical care now. “I had not planned on the poison not working and needing dialysis. I bet dialysis is expensive.”
Questions
- Explain acute renal failure (ARF).
- Considering the conditions that cause ARF, which type of ARF is Ms. Jimenez experiencing?
- What characteristics and laboratory data define the four phases of acute renal failure, and what is the approximate duration of each phase?
- It has been four days since admission. According to the definitions provided in the response to ques-tion number 3, which phase of acute renal failure is Ms. Jimenez experiencing?
- While the nurse is assessing the Quinton cath-eter insertion site, Ms. Jimenez asks what dialysis is and how long she will need to do it. Her initial dialysis treatment was twelve hours long and she is wondering if she will always have to be “hooked up” to the machine that long each time. How should the nurse respond?
- On admission, Ms. Jimenez’s creatinine was 1.4 mg/dL and her BUN was 25 mg/dL. Ms. Jimenez has repeat creatinine and BUN labs drawn two days after admission. The results are a creatinine of 4.7 mg/dL and a BUN of 24 mg/dL. A day later her creatinine is 8.5 mg/dL with a BUN of 57 mg/dL. Are these results getting better or worse since admission? Discuss why.
- The following potassium values are reported: on admission, 3.6 mEq/L; forty-eight hours after admission, 4.0 mEq/L; and seventy-two hours after admission, 4.2 mEq/L. What potential cardiovascu-lar change is of greatest concern to the nurse?
- Identify five priority nursing diagnoses that are appropriate to include in Ms. Jimenez’s plan of care.
- Why has a safety sitter been included as part of Ms. Jimenez’s plan of care?
- What are two collaborative services to consider when planning Ms. Jimenez’s discharge?
- Discuss how Ms. Jimenez’s recent MVC may relate to her current admission
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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