Understanding Gastroenteritis, Gastritis, Parkinson's Disease, And Other Health Issues

1. Define gastroenteritis.

2. What is Gastritis? 

3. Explain Mr Bate’s poor skin turgor in relation to his gastroenteritis.

4. How does his blood pressure reflect his illness? Why is it low?

5. Provide two (2) signs /symptoms of gastroenteritis.

6. Describe the pathophysiology of multiple sclerosis

7. Provide two (2) signs/symptoms of Multiple Sclerosis.

8. Define Rhabdomyolysis.

9. Name one group of medications that is prescribed to lower cholesterol and has this as a side effect. What education should you give to your patient when commencing this medication

10. What is the medical term for black stools and what could it mean? 

11. What does ‘emesis’ mean? What does hematemesis mean? 

12. Explain the pathophysiology as to what would be happening to an individual that was admitted to your ward with hematemesis and melena? (2marks) 13. What is the term used to describe skin colour and the sclera of the eyes becoming yellow? What organ of the body is usually involved? (2marks) 14. Give an example of a disease process that might cause this and explain why.

Gastroenteritis and Gastritis

Gastroenteritis is the inflammation of the inner layer of the intestines.

Gastritis is erosion in the inner layer of the stomach.

The reduced skin turgor is caused by black colored stools an indication of gastroenteritis infection.

The blood pressure has lowered from 110/66 which indicates illness.

Severe diarrhea causes dehydration which decreases the blood circulation in the body resulting in low blood pressure.

Diarrhea, vomiting

Multiple sclerosis is a chronic disease which attacks central nervous systems thus affecting the brain, optic nerves and spinal cord.

Muscle weakness, visual disturbances

Rhabdomyolysis is the death of muscle fibers and releasing it content in the bloodstream.

Statins especially lovastatin medication. Side effects intestinal problems and muscle inflammation.

Take the full dose as prescribed by the doctor.

The term is "melena" meaning dark stools with peculiar dour consisting of digested food.

Emesis means vomiting contents from the stomach.  

Hematemesis means vomiting of blood.

The patient vomits brownish blood due to digestion by the stomach acids and turned hemoglobin into the brownish color. (Khan, Khan, Tiwari, Moustafa, Taleb & Khateeb, 2018).

The term is Jaundice. The organ is liver.

Hepatitis, it influences skin color and eyes becoming yellowish.

Pruritus is the medical terminology referring to itchy skin.

Hiatus Hernia happens when the upper part of the stomach pushes up through the diaphragm into the chest region.

Symptom; chest pain, trouble in swallowing.

GORD stands for "Gastro Esophageal Reflux Disease".

Nursing care plans

Diarrhea

The identified problem is abdominal pain.

The goal of diarrhea plan is to regain normal functioning of the patient bowel.

Courses

NURSING INTERVENTIONS	RATIONALE
Establish rapport	To achieve patient’s trust
Limit solid food consumption	For bowel to rest

Acute Pain.

The identified problem is sleep disturbances.

The goal of acute pain is to reduce the pain and ensure relaxation skills.

Courses

NURSING INTERVENTIONS	RATIONALE
Ensure adequate rest	For reducing pain and promoting comfort
Guide effectiveness in pain medication	To enhance timely intervention

Deficient fluid volume

The identified problem is abdominal cramping

The goal of deficient fluid volume is to maintain fluid volume.

Courses

NURSING INTERVENTION	RATIONALE
Provision of frequent oral care	For preventing dryness
Limit solid food intake	For ensuring the bowel rest

What factors would have contributed to her developing osteoarthritis?

The old age

Sex. Osteoarthritis develops more in women

What education would you provide to an individual diagnosed with Osteoarthritis?

Exercise to strengthen the muscle and reduce stress on the knees.

Encourage the patient to lose weight to reduce stress on the joints.

Explain the pathophysiology of Parkinson's disease and how it can contribute to falls.

Parkinson's disease results from loss of cells in the substantia nigra in the brain which produces dopamine. Insufficient of dopamine in the striatum results in an individual failure to control the movements.

Old age, postural severity and insufficient dopamine failing to regulate the movements result to fall. (Steger et al. 2016).

What other symptoms might Carol have about Parkinson's disease?

Movement difficulties, sleeping problems, loss of smell and tremor.

Besides monitoring the above vital signs what other observations should be conducted? Explain why?

Pain sleeps disorders and cognitive problems.

Observations are nonmotor symptoms not related to movement and are essential when diagnosing Parkinson's disease.

Carol starts to complain of a headache and is feeling nauseated.  What do you think could be happening?

A headache and nausea results from a migraine headache preceded by sensory disturbance.

Parkinson's disease causes loss of sense of smell contributing to a headache and nausea.

Complete three nursing care plans for Carol. Each plan must identify one patient problem/issue, one goal and two courses of action you would take.  The outcome should then be evaluated. Parkinson’s disease

Plan include; impaired swallowing

Ineffective coping

Disturbed thought process

Problem of the patient is ineffective in Airway clearance

Goal to improve functional mobility of the patient.

Courses

Nursing intervention	Rationale
Check respiratory status	For baseline data
Assess patient around the mouth	May show hypoxemia

Osteoarthritis

Nursing plan; Risk injury

Activity intolerance

Chronic pain

Courses

Nursing intervention	Rationale
Ensure adequate rest time	To reduce fatigue
Using adaptive equipment	To reduce joint stress

Nursing care plan for fracture

Acute pain

Trauma risk and Risk of infection

Courses

Nursing interventions	Rationale
Maintain bed rest	It provides security
Maintain position of traction	Facilitates union of fractured bone.

Name an Allied Health Worker that you could include in this individuals care in regard to her allergy and poor appetite. Explain their role.  

Dietitian.

Role. to identify nutrition problems and access the nutrition status of patient.

PART C

1. Briefly explain the pathophysiology of decompression sickness.

Supersaturation of the tissue dissolved with gas and subsequent extraction of gas bubbles during diving causes decompression sickness.

2. What symptoms would you be looking for in an individual admitted to your ward who had been buried diving?

The symptoms are dizziness, fatigue, nausea.

3. List two forms of treatment.

Emergency oxygen first aid

The patient made comfortable in the recovery position.

4. What is the recommended time between a dive and an individual flying?

Four hours

5. Can an individual prepare for flying into high altitudes? List two risk factors.

Yes.

Risk, developing the high altitude related disease and developing life-threatening symptoms

6. What symptoms would you educate Melony to look out for and what advice would you give her when she arrives at the high altitude?

  Symptoms                                                                  Advice

Mild symptoms                                                             have enough rest

Increased breathing rate                                                sleep at the lower altitude   

7. Explain the difference in the signs and symptoms of Heat exhaustion and for Heat Stroke.

Heat exhaustion is characterized by body cooling itself while increase body temperature describes heat stroke due to scorching temperatures (Ferri, 2015).

8. Define Hypothermia. List two signs and symptoms Melony might show if she became freezing in Machu Pichu.  

Hypothermia is fatal condition after body temperatures reduce below a safe level.

 Symptoms are shivering and slow breathing.

9. Why should you never remove a penetrating object?  What action should the guide with her take?

To prevent severe bleeding.

Advice, stabilizing the object by taping it in place up to a lower altitude area.

10. List the most common signs of a Benzodiazepine (sleeping tablet) overdose.  As a first responder what contact number in Australia should you ring for advice if you suspect an overdose or poisoning?  

 Signs; weakness, drowsiness and confusion

The contact is 131126.

11. After watching the video on Concussion, list four (4) of the common symptoms you would need to look out for if Melony was to fall and sustain a head injury.

The symptoms are a headache, Nausea and spinning sensation.

Define Blunt trauma

It is an injury caused by an object after hitting the body.

References

Ferri, F. F. (2015). Heat exhaustion and heat stroke. Ferri's Clinical Advisor.

Steger, M., Tonelli, F., Ito, G., Davies, P., Trost, M., Vetter, M., ... & Baptista, M. A. (2016). Phosphoproteomics reveals that Parkinson's disease kinase LRRK2 regulates a subset of Rab GTPases. Elife, 5.

Khan, M. S., Khan, Z., Tiwari, A., Moustafa, A., Taleb, M., & Khateeb, F. M. (2018). Adult Polycystic Liver Disease: An Unusual Cause of Recurrent Variceal Bleed. In C50. CRITICAL CARE CASE REPORTS: THE LIVER, PANCREAS, AND INTESTINES (pp. A5181-A5181). American Thoracic Society.