NUR445 Week 8 Assignment 2: Case Study Part II

This is a 2 part assignment: the worksheet and assignment. I have included both with examples as guidlines with rubrics.

Review the follow information in

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Download and complete

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Submit your completed Case Study Part II worksheet and its attachments into the drop box as one attachment.

For grading details, review the Case Study Rubric below.

Rubric

NUR445 Case Study Assignment Grading Rubric

NUR445 Case Study Assignment Grading Rubric

CriteriaRatingsPtsThis criterion is linked to a Learning Outcome

Case Study Assignments

20 to >18.0 pts

Excellent

Meets all criteria given for the assignment. Adds insight to the subject not provided in lectures, readings, or class discussions. Well-documented, reasoned and thorough analysis of the issues Able to present topic accurately and completely while synthesizing knowledge and relating to material not covered in the course.

18 to >16.0 pts

Satisfactory

Meets most criteria given for the assignment. Does not add much new insight into the subject, can communicate knowledge from class clearly to other. Thorough analysis of most of the issues Mostly accurate and complete there are some unclear components.

16 to >0 pts

Needs Improvement

Does not meet the criteria given for the assignment. Superficial or incomplete analysis of the issues Is vague and incomplete components are missing, inaccurate or unclear.

20 pts

This criterion is linked to a Learning Outcome

Case Study Discussions

15 to >13.0 pts

Excellent

Addresses discussion questions completely Demonstrates understanding of course content and synthesis of concepts Offers clear point of view and detail.

13 to >11.0 pts

Satisfactory

Discussion question is not completely addressed but demonstrates understanding of course content. Point of view is somewhat unclear, or detail is limited.

11 to >0 pts

Needs Improvement

Discussion questions are minimally addressed, does not demonstrate depth of understanding of course content. Point of view is unclear, or detail is under-developed.

15 pts

This criterion is linked to a Learning Outcome

Format

15 to >7.0 pts

Excelllent

Case Study is coherently organized Logic is easy to follow No spelling or grammatical errors Writing is clear and concise

7 to >1.0 pts

Satisfactory

Case Study is generally well-organized Logic is somewhat easy to follow <3 minor spelling or grammatical errors Writing is mostly clear

1 to >0 pts

Needs Improvement

Case Study is poorly organized and difficult to read-does not flow logically from one part to another. >3 spelling and/or grammatical errors Writing lacks clarity and conciseness

15 pts

This criterion is linked to a Learning Outcome

APA Citations for resources used

10 to >8.0 pts

Excellent

No APA errors. Scholarly references used from a wide range of sources and are five years old.

8 to >6.0 pts

Satisfactory

Only a few ( 5) APA errors. Scholarly references mostly from course material and most are five years old.

6 to >0 pts

Needs Improvement

Several ( 5) APA errors. Some or all references not cited.

10 pts

Total Points: 60

Directions: Below is an example of the Patent Case Study that should be derived from a patient you have cared for related to your PICO question.

Guideline Categories:

Use the following pattern as your Guideline Categories for your Patient Case Study Exemplar is based on Septic Shock Abbreviated, (Harding et al., 2020):

1. Patient Profile A.M. is an 81-year-old man who was brought to the emergency department (ED) via an ambulance from a local nursing home. He was found by the nurse on their 6:00 AM rounds to be very confused, restless, and hypotensive.
2. Past Medical History A.M. has type 1 diabetes and a history of prostate cancer, myocardial infarction, and heart failure. He has been a resident of the nursing home for 2 years. His wife had to place him because she could no longer take care of him at home. He has had an indwelling urinary catheter in place for 5 days because of difficulty voiding. Until today, A. M. has been well-oriented and cooperative. His current medications include metoprolol (Lopressor) lisinopril (Zestril) hydrochlorothiazide isosorbide (isordil) and insulin.
3. Subjective Data: Denise any pain or discomfort (but patient is confused, and this information may be unreliable)
4. Objective Data:

• Neurologic: Lethargic, confused to place and time, easily aroused, does not follow commands; moves all extremities in response to stimuli
• Cardiovascular: B/P 80/60; HR112 bpm and regular.; Temp 103 F (40 C) axillary; heart sounds normal without murmurs or S3, S4; peripheral pulses weak and thread
• Skin: warm, dry, flushed
• Respiratory: RR 34 and shallow; breath sounds audible in all lobes with crackles bilaterally in the bases
• GI/GU: Abdomen soft with hypoactive bowel sounds; urinary catheter in place draining scant, purulent urine

1. Interprofessional Care

In the ED, 2 16-gauge IVs were inserted, and 700 ml of normal saline was given over the first hour. The patient was placed on 40% oxygen, via face mask. The patient was started on IV antibiotics and transferred to the intensive care unit (ICU) with a diagnosis of septic shock resulting from gram-negative sepsis.

1. Laboratory Data
2. Outcome Status

A.M.s BP continued to drop despite several liters of crystalloids. In addition to more fluid administration, norepinephrine was started and titrated up as needed to try to maintain the patients BP. Despite all efforts including intubation and mechanical ventilation, A.m., Died on the sixth hospital day. Cause of death was MODS caused by gram=negative sepsis.

1. Develop at least 3 critical questions that relate to your patient cases study. Below are some examples of critical thinking questions.
2. What risk factors for septic shock were present in A.M>?
3. What preventive measures could have been taken by the nursing home staff in regard to A.M.?
4. What are the major pathophysiological changes associated with sepsis?
5. Discuss the mechanism for hypotension in the patient with septic shock.
6. Explain the causes for assessment findings in this patient and any nursing interventions that can improve the patients condition.
7. What are the overall goals for this patient on admission?
8. Why was a pulmonary artery catheter indicated for A.M.?
9. Analyze the results of the ABGs.
10. Describe the changes in the hemodynamic pressure that would be expected as A.M.s condition worsened.
11. Explain the reason for fluid therapy and the use of norepinephrine.
12. Priority Decision: …what collaborative problems are present?
13. Write one critical thinking test question related to your patient case study.

References

Harding, M., Kwong, J, Roberts, D., Hagler, D., Reinisch, C. et al (2020). Lewiss Medical-Surgical Nursing:

Assessment and management: Clinical problems (11th ed.). Elsevier.

Rubric

Patient Case Study Rubric

Patient Case Study Rubric

CriteriaRatingsPtsThis criterion is linked to a Learning Outcome

Introduction of Case Study

30 pts

Excellent

Write up related to: Patient Profile, Past Medical History, Subjective Data, Objective Data; Inter-professional Care; Laboratory Data; Outcome Status, 3 open ended Discussion questions; priority Decision; 1 critical thinking test question

28 pts

Good

Write up has contribution to 80% of the areas.

26 pts

Satisfactory

Write-up has contribution at least 50% of the areas.

24 pts

Poor

Initiate 40% o4 less contribution of the areas

30 pts

This criterion is linked to a Learning Outcome

Quality of Case Study write-ups

20 pts

Excellent

All components are addressed in a comprehensive way/key issues are thoroughly identified.

18 pts

Good

All components are addressed in a acceptable way/ key issues are generally identified.(

16 pts

Satisfactory

Most components are sometimes addressed with less relevant information.

14 pts

Poor

Components are lacking in appropriate scholarly information and superficially built on opinion and personal taste.

20 pts

This criterion is linked to a Learning Outcome

Scholarly Understanding

30 pts

Excellent

Provides thorough understanding of the patient case study through use of 5 peer-reviewed articles to support the major categories (under Introduction of Case study.

28 pts

Good

Provides good understanding of the patient case study through use of 4 peer-reviewed articles to support the major categories (under Introduction of Case study)

26 pts

Satisfactory

Content shows lack focus of patient care study with weak articles.

24 pts

Poor

No peer-reviewed articles to support the case study

30 pts

This criterion is linked to a Learning Outcome

Spelling/ Grammar

10 pts

Excellent

No errors

8 pts

Good

2-3 errors

5 pts

Satisfactory

4 or more errors

4 pts

Poor

5 ore more errors

10 pts

This criterion is linked to a Learning Outcome

APA/ Proofreading

10 pts

Excellent

No errors

8 pts

Good

2-3 errors

5 pts

Satisfactory

4 or more errors

4 pts

Poor

Not acceptable

10 pts

Total Points: 100