Test 2.

1. Formulate a plan of care to address the needs/ problems of a client with Ebola, prioritize the
needs/ problems.
Nursing Assessment

 History. In patients who have Ebola virus infection, 2 types of exposure history are recognized:
primary and secondary:
 Primary. A history of primary exposure usually involves travel to or work in an Ebola-
endemic area, such as the Democratic Republic of Congo (DRC; formerly Zaire), Sudan,
Gabon, or Côte d’Ivoire; a history of exposure to tropical African forests is more
common in patients with primary exposure to Ebola than is a history of working within
cities in the same region.
 Secondary. Secondary exposure refers to human-to-human or primate-to-human
exposures; in each major outbreak, medical personnel or family members who cared for
patients or those who prepared deceased patients for burial were at very high risk.
 Physical exam. Physical findings depend on the stage of disease at the time of presentation;
early in the disease, patients may present with fever, pharyngitis, and severe constitutional signs
and symptoms; a maculopapular rash, more easily seen on white skin than on dark skin, may be
present around day 5 of infection and is most evident on the trunk.
Nursing Diagnosis
Based on the assessment data, the major nursing diagnosis for a patient with ebola virus are:
 Risk for bleeding related to impaired clotting factors.
 Risk for electrolyte imbalance related to decreased oral intake, vomiting and diarrhea.
 Risk for shock related to progressive multi-organ failure.
 Pain related to musculoskeletal and abdominal aches.
 Risk for fluid volume deficit related to restricted oral intake, bleeding, vomiting and diarrhea.
Nursing Care Planning and Goals
The major nursing care planning goals for a patient with Ebola virus disease include the
following:
 Prevention of bleeding.
 Restoration of normal fluid and electrolyte balance.
 Prevention of shock.
 Relief from pain.
 Restoration of normal body fluid volume.
Nursing Interventions
Nursing interventions for a patient with ebola virus are:
 Prevent bleeding. Instruct the patient to use a soft-bristled toothbrush and nonabrasive
toothpaste, limit straining with bowel movements, forceful nose blowing, coughing, or sneezing,
and be careful when using sharp objects like scissors and knives; when laboratory values are
abnormal, administer blood products as prescribed.
 Restore normal fluid and electrolyte balance. Administer electrolyte replacements as
prescribed; monitor intake and output; note decreased urinary output and positive fluid
balance on 24-hour calculations; and administer oral fluids with caution.
 Prevent shock. Monitor daily weight for sudden decreases, especially in the presence of
decreasing urine output or active fluid loss; and monitor the patient closely for cardiovascular
overload, signs of difficulty of breathing, pulmonary edema, jugular vein distention, and
laboratory results.
 Relieve pain. Provide rest periods to promote relief, sleep, and relaxation; determine the
appropriate pain relief method; get rid of additional stressors or sources of discomfort
whenever possible; and provide analgesics as ordered, evaluating the effectiveness and
inspecting for any signs and symptoms of adverse effects.
 Restore normal fluid volume. Urge the patient to drink prescribed amount of fluid; if patient
can tolerate oral fluids, give what oral fluids patient prefers; provide fluid and straw at bedside
within easy reach; provide fresh water and a straw; emphasize importance of oral hygiene; and
emphasize the relevance of maintaining proper nutrition and hydration.
 Evaluation
Goals are met for a patient with ebola virus as evidenced by:
 Prevented progression of bleeding.
 Restored normal fluid and electrolyte balance.
 Prevented occurrence of shock.
 Relief from pain.
 Restored normal body fluid volume.

2. Discuss the pathophysiology of a client with cystitis.

 Cystitis occurs when the normally sterile lower urinary tract ( urethra and bladder) is
either infected by bacteria or rarely a fungus, Which leads to irritation and
inflammation. Irritation followed by inflammation can also occur in response to trauma,
chemicals or foreign bodies.
3. Provide health education to clients with Crohn’s disease
 Crohn's disease is a chronic (lasting a long time) inflammatory condition that involves
the intestinal tract. Crohn’s disease can affect any part of the digestive tract starting in
the mouth and ending in the anus. Crohn’s disease most commonly affects the last part
of the small intestine (ileum) and/or the large intestine (colon and rectum). Crohn's
disease is a chronic illness that may come back at different times through one’s life.
Some people go a long time without symptoms (remission).There is no way to predict
when the symptoms will stop or when they will return.

4. Discuss the one “patient’s” bill of rights and obligations” and expound
Patient's Bill of Rights
 The Right to Emergency Treatment
 Healthcare professionals have a responsibility to provide medical treatment to any
person with an emergency medical condition. Patients have the right to emergency
medical treatment regardless of their ability to pay.
 The Right to Respect
 The patient's right to respect, otherwise known as nondiscrimination, is the right to be
treated with dignity and respect and is not to be discriminated against for any reason
regardless of sex, race, age, national origin, ethnicity, religion, sexual orientation, gender
identity or expression, veteran or military status, religion or any other basis prohibited
by federal, state, or local law.
 The Right of Informed Consent
 The most important right that a patient has is the right of informed consent. A patient
should only consent to medical treatment if they have sufficient information about their
diagnosis and all treatment options available in terms he/she can understand
 The Right to Refuse Treatment
 It's a given that patients have certain rights including the right to medical treatment in
emergency situations, but they also have the right to refuse medical treatment. From an
ethical perspective, physicians and other healthcare professionals have the
responsibility or duty to protect the life and health of a patient. However, ultimately,
the patient has the final decision regarding the medical treatment they receive, even
when it means they choose to decline such treatment
 The Right to Choose Providers
 All patients have the right to choose the provider who renders healthcare services to
them. This is typically in reference to patient referrals from physicians and hospitals.
Physicians and hospitals often refer patients to specialists, home health care, long-term
facilities or other healthcare professionals for further care outside of their expertise or
ability to provide continuity of care. 
 The Right to Privacy
 One of the most basic rights that a patient has is the right to privacy. Patients have the
right to decide to whom, when, and to what extent their private individually identifiable
health information is disclosed.4 This information includes but is not limited to medical
 diagnosis, treatment plans, prescriptions, health insurance information, genetic
information, clinical research records, and mental health records.
 The Right to Appeal
 Patients have the right to a fair review or appeal of any complaint against physicians,
hospitals, or any other healthcare provider. The right to appeal includes complaints
regarding:
 the adequacy of treatment
 the actions of healthcare personnel
 wait times
 operating hours
 billing and payment issues
 Patient Responsibilities
 Patients have a number of responsibilities to the medical office including active
participation in their treatment plan, timely resolution of their financial obligation and
respectful interaction with all staff.