Reference no: EM133253719

Assignment - Nursing Case Studies

Case Study 1 - The client with diabetes comes to the clinic for a regular checkup. The nurse notes that the client states that they have been struggling with blurred vision recently and are having difficulty working because the blurred vision makes it difficult to see the computer screen. The nurse asks the client if they are seeing any spots or floaters, and the client denies those symptoms. The client has had diabetes for many years. Although the diabetes is generally well-controlled, the client occasionally has periods of less control. The nurse completes a vision assessment using the Snellen chart and documents vision at 20/60. The client does not routinely wear glasses or contacts except reading glasses obtained from the local discount store. The client drives independently, and their license was last renewed two years previously at the local Department of Motor Vehicles. Respond to the following questions and provide an evidence-based rationale. (The related steps of the Nursing Process and Clinical Judgment functions are listed after each question below.)

a. Identify relevant factors related to the individual's condition. (Assessment/ Recognize Cues).

b. What additional information do you need to know at this time? (Analysis/ Analyze Cues)

c. What are the potential consequences of the client's reported condition? (Analysis/Analyze Cues)

d. Identify the client problems based on the information in the scenario. (Analysis/Analyze Cues)

e. Prioritize the client problems previously identified. (Analysis/Prioritize Hypothesis)

f. Identify the desired client outcomes related to the top two client priority problems. (Planning/Generate Solutions)

g. What nursing actions should the nurse take to address the top two client priority problems? (Implementation/Take Action)

h. What client preferences and needs will need to be explored in order to provide optimal care? (Implementation/Take Action)

i. How will the nurse determine if the desired client outcomes have been achieved? (Evaluate/Evaluate Outcomes)

Case Study 2 - The nurse is caring for a client who is 56 years old with a history of diabetes mellitus type II and had abdominal surgery 3 weeks prior. The nurse notes that the client has a large abdominal wound with negative pressure wound therapy applied. The seal around the wound is intact, and a small amount of serosanguineous drainage is noted in the tubing. The client is moderately obese and smokes one pack of cigarettes per day. The client expresses frustration with their current condition and states, "I wish this thing would heal. I don't know how long it will take." The client is receiving antibiotic therapy to treat the infection in the wound bed. The nurse recognizes that there are several fast-food types of sacks in the client's trash can. When asked, the client states that they have their family bring in food that "tastes better" than the hospital food. Respond to the following questions and provide an evidence-based rationale. (The related steps of the Nursing Process and Clinical Judgment functions are listed after each question below.)

a. Identify the individual factors relevant to the client's condition. (Assessment/Recognize Cues).

b. Identify the relevant assessment findings. (Assessment/Recognize Cues)

c. Identify the client's problems based on the assessment and individual factors. (Analysis/Analyze Cues)

d. Explain the potential problem with the client's diet related to the wound. (Analysis/Analyze Cues)

e. Identify the client's priority problem. (Analysis/Prioritize Hypothesis)

f. Identify the interprofessional team members involved in the client's care and describe each member's role. (Planning/Generate Solutions)

g. Summarize the education the client should receive at this time. (Implementation/Take Action)

h. What cultural considerations should the nurse include in the client's plan of care? (Implementation/Take Action)

i. The client's condition improves but they are to be discharged to home with the negative pressure wound therapy. How will the client's plan of care be modified? (Evaluation/Evaluate Outcomes)

Case Study 3 - The 84-year-old client is admitted to the hospital for treatment and evaluation due to pneumonia. The client is generally weak and indicates that they have little appetite. The client is 5 feet, 5 inches tall and weighs 95 lbs. At home, the client states, they cook for themselves and eat two meals each day. The client indicates that they live alone, and their neighbor takes them to the grocery store once per week; the client denies financial concerns related to acquiring food. The client does not have diabetes and does not have any dietary restrictions. The client wears dentures that have become ill-fitting, causing them to move around in their mouth freely. The client is unable to provide a full 24-hour diet recall, but states that they often eat ground beef or canned meat sources such as chicken; softer fruits and vegetables such as those that are canned or cooked until soft; and bread. Breakfast often consists of cereal or toast. Upon assessment, the nurse notes that the client's skin is dry and that their hair is thinning and brittle. The client appears thin and frail and relates that they manage constipation by using stool softeners daily. Respond to the following questions and provide an evidence-based rationale. (The related steps of the Nursing Process and Clinical Judgment functions are listed after each question below.)

a. Identify relevant individual and environmental factors in the scenario that relates to the client's condition. (Assessment/Recognize Cues)

b. What subjective and objective data is relevant to the client's condition? (Assessment/Recognize Cues)

c. Identify the client's problems based on the assessment findings. (Analysis/ Analyze Cues)

d. Prioritize the client's problems based on two different priority-setting frameworks (Lesson 11). (Analysis/Prioritize Hypothesis)

e. Identify one short-term (1 week) and one long-term (4 weeks or greater) optimal client outcome. (Planning/Generate Solutions)

f. What interventions will be used to meet the short-term client outcome? (Take Actions/Implementation)

g. What interventions will be used to meet the long-term client outcome? (Take Actions/Implementation)

h. While in the hospital, the client develops a pressure ulcer. How would this event alter the desired client outcomes? (Evaluate Outcomes/Evaluation)