nursing

nursing
MODULE B CASE STUDY
Instructions
Students are expected to complete the one of the following developmental/cultural case studies by the due date outlined in the course schedule. Students may elect to work as a small group (no more than 4 students) or individually. Students should use the Jarvis (2012) text as well as other scholarly references (pathophysiology textbook, journal articles, reputable medical/government websites) when developing their answers. Students are encouraged to utilize the grading criteria to ensure that all questions are answered completely.
The assignment should be posted to the Module B Forum by the deadline stated in the course schedule. Please include the questions/question numbers with your answers. If students elect to work as a group, one student should submit the assignment and include all members’ names at the beginning of the posting. Ten points per day will be deducted if submitted late; assignment will not be accepted if submitted more than three days late.
Case Study 1 NUTRITIONAL ASSESSMENT; SKIN HAIR & NAILS:
You are working a 12 hour day shift with your coach on the medical-surgical unit. One of the patients is a 74-year old male with a recent diagnosis of bladder cancer. He is admitted for his third dose in the physician’s prescribed Cisplatin regimen. Height: 6’ 0”. Weight: 170 pounds. WBC count is 3000/mm3. Patient has been retired for 4 years. The patient’s wife is currently at bedside, and she reports a decrease in the patient’s appetite. Your nurse coach tells you that on initial assessment, some lesions were noted in the patient’s mouth; your coach sends you to do a thorough assessment of the oral cavity and throat.
SUBJECTIVE/OBJECTIVE DATA
1. What follow-up questions will you ask the patient/family regarding:
a. the patient’s decrease in appetite? (Select 5-7 of the most important questions)
b. the lesions in the patient’s mouth? (Select 5-7 of the most important questions).
2. The lesions the nurse spoke of appear to be white. What additional objective data would you gather regarding these lesions?
3. What equipment will you make sure to have with you when you begin your assessment?
4. What additional information would like from the patient’s chart? Include rationale.
DEVELOPMENTAL & CULTURAL CONSIDERATIONS
5. You find that the patient has his own teeth. What age-related findings would you expect to observe in the oral exam?
6. List possible age-related factors that may contribute to the decrease in your patient’s appetite.
7. List other possible contributing factors to the patient’s decrease in appetite.
PATHOPHYSIOLOGY
8. Based on history, list two possibilities as to what the oral lesions might be. How would you differentiate between these two possibilities?
Module B Health Assessment
Case Study 2 NOSE MOUTH & THROAT; THORAX & LUNGS:
You are working with your coach in the Emergency Department when a 2 year old female patient is brought in by her mother, who speaks little English. The mother is young and appears frightened and anxious. Through a translator, the mother reports the patient has been running fever and coughing for two days. The child is crying, has a runny nose, and audible wheezes. Her cheeks are also flushed.
SUBJECTIVE/OBJECTIVE DATA
1. What additional questions would you like to ask prior to beginning your physical examination of the patient? (Select 5-7 of the most important questions)
2. What components should your physical examination include?
3. What equipment will you make sure to have with you when you begin your assessment?
4. How will you assess the patient’s developmental level?
DEVELOPMENTAL & CULTURAL CONSIDERATIONS
5. Considering the patient’s age/developmental stage:
a. What should you consider when preparing to examine the patient?
b. The nurse practitioner writes an order for lab work, so you need to draw blood. What strategy will you use to successfully draw blood from the patient who is crying and upset?
6. After evaluating ordered lab work, the physician admits the patient to the pediatric unit at the hospital. What is the potential impact of hospitalization on the patient’s growth and development?
7. What are some of the barriers/obstacles you need to consider, recognizing that the patient’s mother does not speak or understand English well?
PATHOPHYSIOLOGY
8. Based on the information provided in the case study, what are two possible diagnoses this patient might be given? How would you differentiate between these two possibilities?