The effect of hypertension and aging

A 75yr old African American male patient with acute cerebrovascular accident, was admitted to the hospital on 11/12/2014. His medical history is significant to atrial fibrillation , chronic kidney disease, hypertension, CVA, peripheral vascular disease and diastolic dysfunction. Initially patient was admitted at Kaiser CDU, with history of vomiting , weakness and mild confusion, according to the history patient had 8 episodes of of vomiting clear liquid the previous day and was mildly confuse but denies any headaches, chest pain, or abdominal pain. Patient had not dysuria, urgency or frequency urination, denies diarrhea, loss of appetite or constipation. CT scan was done, patient was noted with left cerebral hemisphere CVA and was then transferred here in Holy Cross hospital. Patient is alert and oriented to self, sleepy and mildly confuses, but denies any nausea, or vomiting at this time. Vital signs are as follows, 98.0, 155/87, 73, 20, 98%

The effect of hypertension and aging

lung  sound clear on auscultation, abdomen round soft and non distended with active bowel sounds, skin intact and warm to touch, no edema noted in all extremities, but has a left sided weakness. Patient is on Norvasc 5mg, terazosin 2mg, hydralazine, 25mg, Keppra 500mg , hydrochlorothiazide 25mg lisinopril 40mg, Allopurinol 100mg, Lipitor 40mg and aspirin 81mg. He has no known allergies. Lab WBC 10.4,RBC 3.77, Hgb 10.4, HCT 31.5, Platelet 350, sodium 141, potassium 3.7, creatinin 1.30, BUN 33.0 glucose level of 111.0, and calcium 8.5 albumin 2.0.

Through a synthesis of prior knowledge, clinical experiences and skills, evidence based best practices, and care of patients during the capstone experience, you will develop a comprehensive care and teaching plan for a patient for whom you have provided care during this clinical rotation. The paper will be framed within the four components of NCLEX-RN test plan. Multiple concepts contained within each component provide the content guide for your investigation. The NCLEX-RN test plan can be found on the National Council of State Boards of Nursing (NCSBON) website. It would be wise to read this document before you proceed with the project to identify the concepts within each of the four components.
A MINIMUM of five (5) scholarly sources from peer reviewed journals is required for this project. While textbooks are good resources for providing guidance regarding pathophysiology, manifestations, standard assessments and interventions, the majority of supporting evidence driving the care you provide for your patient must come from other scholarly sources. Online sources should be considered additional and will not be accepted as a scholarly source unless it is a peer reviewed online journal. Wikipedia is not a source monitored for accuracy and should not be used. Be very thorough in your research and writing. You will be using the information to create a teaching plan.

Each section of the paper will culminate in a nursing diagnosis, actual or potential related to the patient for whom you have provided care. For the final section of the paper, you will create a teaching plan based on the nursing diagnosis of highest priority you identified from the assessment and care of your patient. The teaching plan should be related to your diagnosis and should reflect patient teaching principles learned previously. You will need to refer to prior resources for a review of teaching learning principles.
Chamberlain College of Nursing NR 452 Capstone
NR452 Evidence-Based Clinical Project Guidelines.docx Revised 5/22/13 nhs 2
PREPARING THE PAPER
• The outline/rubric that follows is to be used as the format for the paper. Each component of the outline should be used as heading in your paper.
• Correct usage of grammar, spelling, and APA format is expected.

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