Running head: HOME CARE CASE STUDY 1
Jennifer Dolly
Nursing 2571: Home Care Case Study
Rasmussen College
Author Note
This research is being submitted on December 1, 2017, for Christi Desautels’ NUR2571
m
er as
Professional Nursing II Course.
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This study source was downloaded by 100000822479833 from CourseHero.com on 04-01-2021 18:40:11 GMT -05:00
https://www.coursehero.com/file/27094136/Home-Care-Case-Study-002docx/
, HOME CARE CASE STUDY 2
Scenario
You graduated 3 months ago and are working with a home care agency. One patient in your
caseload is J.S., a 60-year-old man with chronic obstructive pulmonary disease (COPD) related
to cigarette smoking. He has been on home oxygen, 2 L oxygen by nasal cannula, for several
years. Approximately 10 months ago, he started on chronic oral steroid therapy. His current
medications include an ipratropium/albuterol (Combivent) inhaler, beclomethasone (Beclovent)
inhaler, dexamethasone (Decadron), digoxin (Lanoxin), and furosemide (Lasix).
Question 1
On the way to J.S.'s home, you make a mental note to check him for signs and symptoms of
Cushing syndrome. Why?
I&O- high potential for causing fluid imbalances, because the patient is on furosemide
m
er as
(Lasix), and also weight. S/S of HF, fever (due to poor wound healing) and a full set of vital
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signs. Assure that the temperature is taken due to the increased risk of infection for this type of
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patient especially since they are on corticosteroids. This type of patient is immunocompromised
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due to the fact that there is an overproduction of cortisol of adrenal glands.
Question 2
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Differentiate between Cushing syndrome and Cushing disease.
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Cushing disease causes large amounts of ACTH that is not regulated by the pituitary for a
vi y re
long period of time. This causes fatty deposits to build up in different systems of the body.
Whereas, Cushing’s syndrome is spontaneous and is indicative of the body’s inability to regulate
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ar stu
cortisol and adrenocorticotropin (ACTH). These both increase the chances of developing tumors
on the pituitary gland, but these are generally benign.
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Question 3
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Your assessment includes the following findings. Determine whether the findings are attributable
to J.S.'s COPD or possible Cushing syndrome. Place an L beside the symptoms consistent with
sh
COPD and a C next to those consistent with Cushing syndrome.
___L__ 1. Barrel chest
__C___ 2. Full-looking face (moon face)
___C__ 3. BP 180/94 mm Hg
__L___ 4. Pursed-lip breathing, especially when patient is stressed
This study source was downloaded by 100000822479833 from CourseHero.com on 04-01-2021 18:40:11 GMT -05:00
https://www.coursehero.com/file/27094136/Home-Care-Case-Study-002docx/
Jennifer Dolly
Nursing 2571: Home Care Case Study
Rasmussen College
Author Note
This research is being submitted on December 1, 2017, for Christi Desautels’ NUR2571
m
er as
Professional Nursing II Course.
co
eH w
o.
rs e
ou urc
o
aC s
vi y re
ed d
ar stu
is
Th
sh
This study source was downloaded by 100000822479833 from CourseHero.com on 04-01-2021 18:40:11 GMT -05:00
https://www.coursehero.com/file/27094136/Home-Care-Case-Study-002docx/
, HOME CARE CASE STUDY 2
Scenario
You graduated 3 months ago and are working with a home care agency. One patient in your
caseload is J.S., a 60-year-old man with chronic obstructive pulmonary disease (COPD) related
to cigarette smoking. He has been on home oxygen, 2 L oxygen by nasal cannula, for several
years. Approximately 10 months ago, he started on chronic oral steroid therapy. His current
medications include an ipratropium/albuterol (Combivent) inhaler, beclomethasone (Beclovent)
inhaler, dexamethasone (Decadron), digoxin (Lanoxin), and furosemide (Lasix).
Question 1
On the way to J.S.'s home, you make a mental note to check him for signs and symptoms of
Cushing syndrome. Why?
I&O- high potential for causing fluid imbalances, because the patient is on furosemide
m
er as
(Lasix), and also weight. S/S of HF, fever (due to poor wound healing) and a full set of vital
co
eH w
signs. Assure that the temperature is taken due to the increased risk of infection for this type of
o.
rs e
patient especially since they are on corticosteroids. This type of patient is immunocompromised
ou urc
due to the fact that there is an overproduction of cortisol of adrenal glands.
Question 2
o
Differentiate between Cushing syndrome and Cushing disease.
aC s
Cushing disease causes large amounts of ACTH that is not regulated by the pituitary for a
vi y re
long period of time. This causes fatty deposits to build up in different systems of the body.
Whereas, Cushing’s syndrome is spontaneous and is indicative of the body’s inability to regulate
ed d
ar stu
cortisol and adrenocorticotropin (ACTH). These both increase the chances of developing tumors
on the pituitary gland, but these are generally benign.
is
Question 3
Th
Your assessment includes the following findings. Determine whether the findings are attributable
to J.S.'s COPD or possible Cushing syndrome. Place an L beside the symptoms consistent with
sh
COPD and a C next to those consistent with Cushing syndrome.
___L__ 1. Barrel chest
__C___ 2. Full-looking face (moon face)
___C__ 3. BP 180/94 mm Hg
__L___ 4. Pursed-lip breathing, especially when patient is stressed
This study source was downloaded by 100000822479833 from CourseHero.com on 04-01-2021 18:40:11 GMT -05:00
https://www.coursehero.com/file/27094136/Home-Care-Case-Study-002docx/
