case study 1-4
Case Study Discussion #1
. His x-ray films revealed a right fractured femur and right wrist fracture. An abdominal computed tomography (CT) scan shows bruising of the liver. Mr. Ramirez has not been hospitalized in the past. When he first meets Carla he is very quiet and asks few questions. What reasons might there be for Mr. Ramirez to be so quiet and ask so few questions? What kinds of responsibilities might Carla have when caring for Mr. Ramirez? Do you think that because Mr. Ramirez is very quiet and asks few questions he will be easy for Carla to care for?
Case Study Discussion #2
Mr. Ramirezs leg is in skeletal traction and his right arm is in a soft cast. Carla decides that she needs to begin her care by assessing Mr.Ramirez and determining his health status.She begins by reviewing his medical history She learns that he has a history of smoking and was diagnosed with type 2 diabetes just 5 years ago
Here we find out a little more about the patient Mr. Ramirez and how Carla will care for him.What are the questions that a nurse should ask when caring for a patient? Lets review them now: What is the patients status now? How might it change and why? Which physiological and emotional responses do I anticipate? What do I know to improve the patients condition? In which way will specific therapies affect the patient? What should be my first action? Note that Carla decides that she will begin caring for Mr. Ramirez by assessing his health status. Do you think Carla is making the right decision? WHY?
Case Study Discussion #3
Carla knows that Mr. Ramirez is likely to be in pain because he is reluctant to move and take part in any activity. Her options include conducting a thorough pain assessment and learning how Mr. Ramirez feels about his pain. She must also be culturally sensitive and consider how Mr. Ramirezs Hispanic heritage may influence response to pain. Carla will then take what she learns and use pain control therapies that Mr. Ramirez will be likely to accept.
We just introduced the nursing process a five-step clinical decision-making approach: assessment diagnosis planning implementation and evaluation Do you think Carla is following this process? Back up your answer based on what you have read
Case Study Discussion #4
When Carla notices that Mr. Ramirez is slow to respond to her questions grimaces when
shifting weight on his back and is reluctant to have a bed bath her critical thinking leads to the
inference that Mr. Ramirez is in pain.Carla decides to assess the situation more thoroughly by asking Mr. Ramirez specific questions about his comfort such as Tell me if you are hurting Show me where the pain is located and Is this pain you have felt before?
What does Carla notice about Mr. Ramirez in this case study? What does Carla infer from Mr. Ramirezs behavior? How does Carlas decision to ask Mr. Ramirez specific questions fit in with your understanding of clinical decision making?Which of the 11 attitudes (found in Potter TABLE 15-3) would you say Carla is exhibiting?