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    1. QUESTION

    Advanced practice nurses often treat patients with vein and artery disorders such as chronic venous insufficiency (CVI) and deep venous thrombosis (DVT). While the symptoms of both disorders are noticeable, these symptoms are sometimes mistaken for signs of other conditions, making the disorders difficult to diagnose. Nurses must examine all symptoms and rule out other potential disorders before diagnosing and prescribing treatment for patients. In this Assignment, you explore the epidemiology, pathophysiology, and clinical presentation of CVI and DVT.

    To Prepare

    Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.
    Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
    Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic venous insufficiency and one for venous thrombosis. Consider the epidemiology and clinical presentation of both chronic venous insufficiency and deep venous thrombosis.
    To Complete

    Write a 2- to 3-page paper that addresses the following:

    Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.
    Explain how the patient factor you selected might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
    Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

    Quality of Work Submitted:
    The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.–

    Excellent 27 (27%) – 30 (30%)
    Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.
    Good 24 (24%) – 26 (26%)
    Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.
    Fair 21 (21%) – 23 (23%)
    Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.
    Poor 0 (0%) – 20 (20%)
    Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.
    Quality of Work Submitted:
    The purpose of the paper is clear.–

    Excellent 5 (5%) – 5 (5%)
    A clear and comprehensive purpose statement is provided which delineates all required criteria.
    Good 4 (4%) – 4 (4%)
    Purpose of the assignment is stated, yet is brief and not descriptive.
    Fair 3.5 (3.5%) – 3.5 (3.5%)
    Purpose of the assignment is vague or off topic.
    Poor 0 (0%) – 3 (3%)
    No purpose statement was provided.
    Assimilation and Synthesis of Ideas:
    The extend to which the work reflects the student’s ability to:

    Understand and interpret the assignment’s key concepts.–

    Excellent 9 (9%) – 10 (10%)
    Demonstrates the ability to critically appraise and intellectually explore key concepts.
    Good 8 (8%) – 8 (8%)
    Demonstrates a clear understanding of key concepts.
    Fair 7 (7%) – 7 (7%)
    Shows some degree of understanding of key concepts.
    Poor 0 (0%) – 6 (6%)
    Shows a lack of understanding of key concepts, deviates from topics.
    Assimilation and Synthesis of Ideas:
    The extend to which the work reflects the student’s ability to:

    Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.–

    Excellent 18 (18%) – 20 (20%)
    Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.
    Good 16 (16%) – 17 (17%)
    Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.
    Fair 14 (14%) – 15 (15%)
    Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.
    Poor 0 (0%) – 13 (13%)
    Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.
    Assimilation and Synthesis of Ideas:
    The extend to which the work reflects the student’s ability to:

    Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.–

    Excellent 18 (18%) – 20 (20%)
    Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.
    Good 16 (16%) – 17 (17%)
    Summarizes information gleaned from sources to support major points, but does not synthesize.
    Fair 14 (14%) – 15 (15%)
    Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.
    Poor 0 (0%) – 13 (13%)
    Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.
    Written Expression and Formatting

    Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.–

    Excellent 5 (5%) – 5 (5%)
    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity
    Good 4 (4%) – 4 (4%)
    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.
    Fair 3.5 (3.5%) – 3.5 (3.5%)
    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time.
    Poor 0 (0%) – 3 (3%)
    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time.
    Written Expression and Formatting

    English writing standards: Correct grammar, mechanics, and proper punctuation–

    Excellent 5 (5%) – 5 (5%)
    Uses correct grammar, spelling, and punctuation with no errors.
    Good 4 (4%) – 4 (4%)
    Contains a few (1-2) grammar, spelling, and punctuation errors.
    Fair 3.5 (3.5%) – 3.5 (3.5%)
    Contains several (3-4) grammar, spelling, and punctuation errors.
    Poor 0 (0%) – 3 (3%)
    Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
    Written Expression and Formatting

    The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

    Excellent 5 (5%) – 5 (5%)
    Uses correct APA format with no errors.
    Good 4 (4%) – 4 (4%)
    Contains a few (1-2) APA format errors.
    Fair 3.5 (3.5%) – 3.5 (3.5%)
    Contains several (3-4) APA format errors.
    Poor 0 (0%) – 3 (3%)
    Contains many (≥ 5) APA format errors.

 

Subject Nursing Pages 9 Style APA

Answer

Disorders of Veins and Arteries: Chronic Venous Insufficiency and Deep Venous Thrombosis

            Chronic venous insufficiency (CVI) and deep venous thrombosis (DVT) may have shared symptoms or perceived as signs of other conditions, hence they must be diagnosed accurately and treated appropriately. The scope of this paper includes CVI and DVT pathophysiology, impact of genetics on CVI and DVT, and mind maps of the two conditions.

            CVI leads to varicose veins without/with edema, and stasis dermatitis of the lower extremities (Huether & McCance, 2017). Trophic changes are some of the characteristic alterations that may result into leg ulcers (Santler & Goerge, 2017). Pathogenesis outcome may include venous reflux and/or obstruction. Factors influencing development or exacerbation of this CVI include venous hypertension, inflammatory alterations, especially on the vessel wall, valve incontinence, and other hemodynamic factors. Symptoms and signs of CVI feelings of ‘heavy legs’, evening edema, pruritus, nocturnal leg cramps as well as pain (Huether & McCance, 2017).  In addition, lipodermatosclerosis is an indication of potential occurrence of leg ulceration in the future (Santler & Goerge, 2017). Complications include superficial thrombophlebitis and thromboembolic events (Santler & Goerge, 2017).

            DVT can present with either non-occlusive or occlusive fashion. Occlusive DVT presents with a thrombus in deep veins that can lower blood flow through the affected vein. Occurrence of a thrombus in small veins leads to complete cutting of blood supply to an affected tissue, thus increasing the risk of tissues necrosis. Complications include venous damage, unceasing edema of the legs, and post-phlebitic syndrome (Hammer & McPhee, 2014). The key difference between venous and arterial thrombosis is that the sense that the venous thrombosis is characterized by occurrence of blood clots while arterial thrombosis is characterized by formation of an emboli that will clog small arteries such as coronary arteries. Signs and symptoms of DVT include pain, swelling, leg tenderness, feeling of warmth on the affected site, reddening of the skin on the affected area, and unceasing throbbing cramp-like feeling on the leg (Huether & McCance, 2017).

Genetics is an important patient factor in both CVI and DVT. Family history of CVI increases the likelihood of occurrence of the disease (Santler & George, 2017). Besides, hemochromatosis C282y gene mutation, certain variants of Factor XIII V34l gene, ferroportin gene, and/or matrix metalloproteinase 12 gene, and/or ferroportin gene may increase the risk of leg ulcers in CVI (Chi & Raffetto, 2015). Similarly, abnormalities of certain the elements of the coagulation pathway including mutation of Factor V or prothrombin and deficiencies of protein-S, protein-C, and anti-thrombin factor can lead to DVT (Chi & Raffetto, 2015). Genetic factors can help in diagnosing both CVI and DVT and for determining risk of leg ulcers and DVT.

 

 

 

 

 

 

 

 

 

 

 

Mind Maps

Figure 1: CVI Mind Map

Figure 2: DVT Mind Map

 

 

References

Chi, Y-W., & Raffetto, J.D. (2015). Venous leg ulceration pathophysiology and evidence based treatment. Vascular Medicine, 20(2), 168-181. https://doi.org/10.1177%2F1358863X14568677

Eberhardt, R.T., & Raffetto, J.D. (2014). Chronic venous insufficiency. Circulation, 130, 333-346.

Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

NIH Medline Plus. (2011). Deep vein thrombosis: Symptoms, diagnosis, treatment and lasts NIH research. Retrieved on Sep 22, 2018 from, https://medlineplus.gov/magazine/issues/spring11/articles/spring11pg20-21.html

Santler, B., & Goerge, T. (2017). Chronic venous insufficiency – a review of pathophysiology, diagnosis, and treatment. JDDG: Journal der Deutschen Dermatologischen Gesellshaft, 15(5), 538-556.

 

 

 

 

 

 

 

Appendix

Appendix A:

Communication Plan for an Inpatient Unit to Evaluate the Impact of Transformational Leadership Style Compared to Other Leader Styles such as Bureaucratic and Laissez-Faire Leadership in Nurse Engagement, Retention, and Team Member Satisfaction Over the Course of One Year

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