MR COOPER ALS CASE STUDY ESSAY
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
Mr. Cooper
GENDER Male
AGE 73
SETTING Home
ETHNICITY
SPIRITUAL/RELIGIOUS
PHARMACOLOGIC
Ibuprofen (Motrin); riluzole (Rilutek)
LEGAL Advance directive
ETHICAL White American
CULTURAL CONSIDERATIONS
PREEXISTING CONDITION
COEXISTING CONDITION
COMMUNICATION
No answering machine; slurred speech
DISABILITY Progressive, degenerative disease
SOCIOECONOMIC Lives alone; non-smoker
ALTERNATIVE THERAPY Palliative care
PRIORITIZATION End-of-life planning
DELEGATION Collaboration between health care provider, home care nurse, home care physical therapist (PT), home care occupational therapist (OT), speech-language pathologist (SLP)
Overview: This case explores the onset and diagnosis of ALS. Management of ALS with regard to medication and an interdisciplinary team approach is discussed. The nurse must consider how the prognosis of ALS will affect the client and his family. End-of-life issues are addressed.
Client Profile
Mr. Cooper is a 73-year-old man with no significant past medical history. He livesalone and is very independent in function and spirit. He was seen in the emergency department six weeks ago for complaints of “arthritis in his right knee.” He was examined, given a prescription for ibuprofen, provided with a cane, and instructed to follow up with his health care provider. When Mr. Cooper sees his health care provider for his follow-up visit, the health care provider notices that as Mr.Cooper enters the examination room, he has right footdrop. When the health care provider asks Mr. Cooper what has brought him in today, Mr. Cooper states “I have arthritis in this right knee.” Mr. Cooper explains that he has had this “arthritis”for three months. However, when asked about pain in the knee, Mr. Cooper denies any pain and states “well, maybe it’s a nerve problem.” On physical exam, his vital signs are within normal limits and consistent with Mr. Cooper’s baseline.The health care provider notes that Mr. Cooper has no strength or power in his right lower extremity from the knee down. There is increased tone in his upper right extremity, indicating that those muscles are tighter than they should be. The health care provider also notices hyperreflexia. The health care provider prescribes a head computed tomography (CT) scan and multiple blood tests. The results of the CT scan and blood tests are all within normal limits. An urgent referral to a neurologist is made, and the health care provider asks the nurse to arrange for Mr. Cooper to have magnetic resonance imagery (MRI) of his head and neck and an electromyelogram (EMG). The nurse plans to arrange dates for these tests and to call Mr. Cooper with instructions. Mr. Cooper is fitted for an ankle-foot orthosis (AFO) brace and home physical therapy is arranged as prescribed by the health care provider.
Case Study
The nurse attempts to notify Mr. Cooper of the dates, times, and instructions regarding his MRI and EMG. However, Mr. Cooper does not have an answering machine. The health care provider is notified and she decides to call Mr. Cooper from home to see if she can reach him at home and give him the information. When the health care provider calls Mr. Cooper, he is speaking with slurred speech. The health care provider asks Mr. Cooper how long he has had difficulty speaking clearly to which Mr. Cooper replies, “I just have a touch of laryngitis is all.” Mr. Cooper denies a cough, runny nose, fever, discomfort in his throat, and dysphagia. Concerned, the health care provider suggests that Mr. Cooper go to the emergency department for an evaluation. Despite the health care provider’s repeated suggestions, Mr. Cooper refuses.
The next day, the health care provider calls Mr. Cooper’s home physical therapist and asks the therapist to call her during the visit and let her know if Mr. Cooper is still exhibiting slurred speech. Later that morning, the physical therapist notifies the health care provider that indeed Mr. Cooper continues to have slurred speech. Per the health care provider’s request, Mr. Cooper is transported to the emergency department. An MRI is unrevealing. However, an EMG is consistent with amyotrophic lateral sclerosis (ALS).
Questions
- What is foot drop and why does it occur in a person with ALS?
- An AFO brace is prescribed for Mr. Cooper. What does this brace do?
- An EMG is prescribed for Mr. Cooper. Does this test require his consent? Explain this test to Mr. Cooper and provide instruction regarding anything he should do to prepare for this test.
- Cooper, who is with his daughter, asks the nurse “What is ALS? Is it a type of arthritis like I thought?” It can be a sad and emotionally difficult explanation to give, but how would you explain the diagnosis to Mr. Cooper? Include in your discussion the symptoms, cause, incidence, and usual age of onset.
- What is the prognosis for Mr. Cooper?
- Riluzole is prescribed for Mr. Cooper. Explain how this medication works. What are the benefits of its use in clients with ALS?
- Cooper is prescribed riluzole 50 mg PO every twelve hours. The nurse is teaching Mr. Cooper about his new medication. What should the nurse tell him about how to take riluzole with regard to timing and missed doses? Offer dietary suggestions to maximize the effects of riluzole.
- Cooper lives alone but his daughter and family live close by. The nurse is pleased to learn that the daughter (and family) will be involved in Mr. Cooper’s care and be a support system for him as he copes with his disease. Discuss the issues and arrangements the nurse should address with Mr. Cooper and his daughter, considering Mr. Cooper’s prognosis.
- Describe the purpose of the following advance directive alternatives: living will, health care proxy or durable power of attorney, and an advance care medical directive.
- Discuss the concerns regarding Mr. Cooper’s slurred speech. With whom should the nurse collaborate to help Mr. Cooper?
- The nurse will collaborate with the home are physical therapist to develop an exercise and mobility program and ensure Mr. Cooper’s safety in his home. Create a list of at least five components of a safe home environment.
- An occupational therapist will work with Mr. Cooper to help him with strategies to main-tain his independence with activities of daily living (ADLs) for as long as possible. Discuss at least five pieces of equipment available to assist Mr. Cooper with his ADLs.
- Identify three nursing diagnoses appropriate for Mr. Cooper’s plan of care following his diagnosis of ALS.
- Identify three nursing diagnoses appropriate for Mr. Cooper’s plan of care as his ALS progresses.
- What is palliative care?
- Why do you think Mr. Cooper self-diagnosed himself with “arthritis” and “laryngitis”?
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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