Intensive Case Study

Mr. Kennedy arrived at the walk-in clinic with his 2-week-old infant, RK. Mr. Kennedy explained that his wife has been up all night with the baby so she stayed at the shelter to rest. Mr. Kennedy wants the infant to be seen due to concerns of poor feeding, irritability, and fussiness for the past two days. The father states the baby has been sleeping more than usual and refuses to take the breast as consistently as before. He reports a slight cough and noticed the baby is breathing faster than normal. Due to the parents current housing and transportation situation, access to regular prenatal care was limited, and the father is unsure about the mothers Group B Streptococcus (GBS) status. They have been staying in an overcrowded shelter with many other families.

1. What additional information will you need to obtain from Mr. Kennedy for the HPI?
2. What assessments would you need to complete for RK based on the information that you have so far?

Your initial assessment of the infant reveals that RK is lethargic, irritable, and fussy with a bluish tint around the lips. You auscultate bilateral coarse crackles, wheezing, and grunting with decreased breath sounds in the lower lobes. Respiratory rate 70 breaths/minute, heart rate 160, regular rhythm no murmurs, O2 88% RA. You note Tachypnea with nasal flaring and mild intercostal retractions. Rectal temperature 101.4F. Abdomen is soft, non-distended, non-tender to palpation, normal bowel sounds x4 quadrants.

1. As you assess the infant you document normal and abnormal findings.

Based on your primary assessment:

1. What are the abnormal findings?
2. What are the normal findings?
3. Based on the abnormal findings what other assessments would you perform?
4. Would you ask additional HPI questions based on the abnormal findings?
5. What labs would you order for RK? Why?
6. What diagnostic tests would you order for RK? Why?
7. What are 3-5 differential diagnoses you are considering for RK?

Based on your findings you order stat labs CBC, CMP, CXR.

1. What are the normal ranges for this 2-week-old patient for Pathogen Swabs, CBC, CMP, CRP, and CXR?

• CBC:
• CMP:
• CXR:
• CRP:
• Swabs:

1. A Respiratory diagnosis is a concern for this patient. What order(s) would you prioritize to plan to manage the patient as you await the test results?
2. What are some family / socioeconomic concerns that you may have in regard to RKs medical care, recovery, parental education, referrals, and overall health?
3. Based on all of the data that you collected, what are your top 3 differential diagnoses and what is your final diagnosis?

*** Remember to include in-text citations for any references, along with a title page and reference page. The question-and-answer format is acceptable, however, APA is still expected.

Rubric

Intensive Case Study

Intensive Case Study

CriteriaRatingsPtsThis criterion is linked to a Learning Outcome

Accuracy of facts and evidence of critical thinking

Accuracy of facts and evidence of critical thinking

All supportive facts are reported accurately. The response demonstrates mastery of content and significant critical thinking related to the questions in the case study.

30 pts

Exceeds Expectations

All supportive facts are reported accurately. The response demonstrates mastery of content and significant critical thinking related to the questions in the case study.

20 pts

Average

Most supportive facts are reported accurately. The response shows knowledge of the content but limited critical thinking to the question.

10 pts

NEEDS IMPROVEMENT

Very little supportive facts are reported accurately. The response demonstrates limited knowledge of the content and no critical thinking related to the question

0 pts

Does not meet Expectations

No facts are reported OR are inaccurately reported. The response contains misinformation and/or inaccurate thinking related to the question.

30 pts

This criterion is linked to a Learning Outcome

Questions addressed for each section of the Case

All questions are supported by eveidence- based practicce resources . Questions were addressed to their full extent.

10 pts

Exceeds expectations

All twelve questions answered correctly and/or literature cited to support the results where applicable

5 pts

Partially Met Criteria

1-2 questions were not answered/ answered incorrectly and/or no lack of resources to support the answers is missing.

3 pts

Barely Meets expectations

3-4 questions were not answered/ answered incorrectly and/or no lack of resources to support the answers is missing.

0 pts

Does not meet Expectations

Four or more questions were not answered/ answered incorrectly and lack of resources to support the answers is missing.

10 pts

This criterion is linked to a Learning Outcome

Writing Skills

Submission demonstartes professional writing skills

The posts are professionally written with no errors in spelling, word usage, sentence structure, grammar, or punctuation

5 pts

Exceeds Expectations

The posts are professionally written with no errors in spelling, word usage, sentence structure, grammar, or punctuatio

3 pts

Meets most expectations

The post has 1-2 errors in spelling, word usage, sentence structure, grammar, or punctuation

2 pts

NEEDS IMPROVEMENT

The post has 3-4 errors in spelling, word usage, sentence structure, grammar, or punctuation

0 pts

Does Not Meet Expectations

The post has 5 or greater errors or no submission.

5 pts

This criterion is linked to a Learning Outcome

APA format

APA format is without error and aligns fully with current APA guidelines

5 pts

Exceeds Expectations

APA format is without error and aligns fully with current APA guidelines

3 pts

Meets most expectations

APA format has 1-2 errors with formatting and/or citations. Reference page formatted APA with no errors

0 pts

Does not meet Expectations

APA Format has greater than 3 errors; no citations used or citeed properly in text.

5 pts

Total Points: 50