NR 536 Developing an Evolving Case Study Template

11 August 2024

NR 536: Developing an Evolving Case Study Template

Course: NR 536 - Advanced Pathophysiology, Health Assessment, and Pharmacology for Nurse Educators Assignment: Development of an Evolving Case Study for Clinical or Classroom Setting

Overview of Evolving Case Study

Learning Objectives:

  1. Develop critical thinking skills through simulation-based learning.
  2. Apply knowledge of advanced pathophysiology, health assessment, and pharmacology in a clinical setting.
  3. Enhance decision-making abilities in acute care scenarios.
  4. Integrate theoretical knowledge with practical skills in a simulated emergency room setting.

Description of the Evolving Case Study

Purpose: The purpose of this case study is to create a simulation learning activity that enhances critical thinking and clinical decision-making skills in nursing students. The case study is designed to mimic real-life clinical scenarios that students may encounter in an emergency room, helping them to bridge the gap between theoretical knowledge and practical application.

Type of Learner: This case study is designed for visual learners who benefit from observing demonstrations and engaging in hands-on activities. Visual learners will gain from the scenario’s immersive environment, where they can observe patient symptoms, clinical interventions, and outcomes.

Concept to be Presented: The primary concept to be presented is the assessment and management of acute confusion and abdominal pain in an emergency room setting. The case study will emphasize the importance of thorough assessment, differential diagnosis, and the application of pharmacological and non-pharmacological interventions.

Description of the Setting

Setting: The scenario is set in a busy emergency room (ER) where the patient presents with acute symptoms requiring immediate attention. The ER environment is chosen to simulate the high-pressure, fast-paced decision-making processes that are critical in such settings.

Description of the Patient

Name: Joseph Jacks

Gender/Age/Weight/Height: Caucasian male, age 50, weight 201 pounds, height 5'11"

Allergies: Penicillin

Past Medical History: None known to the patient.

History of Present Illness: The patient presents with acute confusion and abdominal pain. These symptoms have developed suddenly over the past 24 hours. The patient reports no significant past medical history and is unsure what might have triggered these symptoms.

Social History: Joseph Jacks is a 50-year-old male who works as a construction manager. He is a non-smoker and occasionally consumes alcohol. He is married with two children and lives an active lifestyle. There is no reported use of recreational drugs, and he denies recent travel or exposure to any known illnesses.

Case Progression

Initial Presentation:

  • Vital Signs: BP 145/90 mmHg, HR 110 bpm, RR 22 breaths/min, Temp 100.4°F, SpO2 95% on room air.
  • Chief Complaint: The patient is disoriented, repeatedly stating that he has severe abdominal pain but is unable to provide a clear history.
  • Initial Assessment: On examination, the patient is confused, unable to recall recent events, and appears in distress due to abdominal pain. The abdomen is tender upon palpation, especially in the right lower quadrant. Bowel sounds are hypoactive.

Clinical Progression:

  • Diagnostic Tests: Orders include a complete blood count (CBC), comprehensive metabolic panel (CMP), liver function tests (LFTs), abdominal ultrasound, and a CT scan of the abdomen.
  • Differential Diagnosis: The differential diagnosis includes acute appendicitis, bowel obstruction, pancreatitis, and an abdominal aortic aneurysm (AAA).

Intervention:

  • Immediate Care: IV access is established, and the patient is administered fluids and pain relief (avoidance of morphine due to the unclear cause of abdominal pain). Antibiotics are withheld due to the penicillin allergy and until a clear source of infection is identified.
  • Pharmacological Treatment: An antiemetic is administered to control nausea. Depending on the imaging results, the patient may require surgery or specific medical management for the identified condition.

Outcome and Reflection:

  • Resolution: The case study will conclude with the patient either being stabilized with medical management or being prepared for surgery, depending on the findings of the diagnostic tests.
  • Discussion: Students will discuss the importance of timely diagnosis, the role of differential diagnosis in acute settings, and the management of complex cases involving multiple potential diagnoses.

Debriefing:

  • Reflection Questions: What were the key assessments that led to the diagnosis? How did the patient’s history and presentation guide your decision-making? What are the implications of the chosen interventions?

Conclusion

This evolving case study is designed to provide nursing students with a realistic and immersive learning experience. By simulating a complex clinical scenario in an emergency room setting, students are encouraged to develop their critical thinking, assessment, and decision-making skills. The focus on visual learning and hands-on application ensures that students can connect theoretical knowledge with practical skills, preparing them for real-world clinical practice.