Assignment Prompt & Instructions
– ## NRS-460-RS-T1-CaseStudy-JohnDoe-EmergencyDepartment.docx
**## NRS-460-RS-T1-CaseStudy-JohnDoe-EmergencyDepartment.docx**
**NRS-460 Case Study: John Doe – Emergency Department**
**Directions: Read the case study below. Evaluate the information and formulate a conclusion based on your evaluation. Complete the critical thinking table and submit this completed template to the assignment dropbox.**
The purpose of this assignment is to evaluate and synthesize patient data to propose interventions for an individualized plan of care prioritizing health problems and health concerns.
**PART I:**
**Health History and Medical Information**
Evaluate the health history and medical information for John Doe, presented below.
John Doe, a 35-year-old male, was riding his motorcycle under the influence and experienced a motor vehicle accident resulting in multiple fractures and a traumatic brain injury (TBI).
On scene, John Doe was alert but exhibiting restlessness and agitation with hands-on care. En route to the hospital, he displayed changes in level of consciousness (LOC), mood and behavior, nausea and vomiting (N/V), and dilated pupils. Upon arrival to the emergency department, John was unconscious with a Glasgow Coma Scale (GCS) score of 6, indicating a severe TBI. Prior to losing consciousness, he was exhibiting signs of extreme pain on the left side.
_Objective Data – completed by ambulance personnel:_
1. 84/60 BP, HR 136, RR 28 irregular, SpO2 92%
2. 5' 11" height, 180 lbs. weight
3. GCS Score: 6
a. No response in eyes: 1
b. No verbal response: 1
c. Flexion withdrawal from pain: 4
4. Change in LOC
5. Possible fractures to left leg and left ribs
6. Intubated in route to ED
_Objective Data and Laboratory/Test Results – on arrival to the emergency department (initial results)_
1. Complete blood count (CBC) –
a. White blood cells: 11.3
b. Hemoglobin: 15.6
c. Hematocrit: 41.5
d. Platelets: 316,000
2. Comprehensive Metabolic Panel (CMP) –
a. Alanine Aminotransferase (ALT): 32 U/L
b. Albumin: 4.8 g/dL
c. Alkaline Phosphatase (ALP): 122 U/L
d. Aspartate Aminotransferase (AST): 52 U/L
e. Blood Urea Nitrogen (BUN): 16mg/dL
f. Bilirubin: 1.4mg/dL
g. Calcium: 9.8mg/dL
h. Creatinine: 1.1mg/dL
i. Glucose: 112mg/dL
j. Potassium: 3.9 mEq/L
k. Sodium: 138 mEq/L
3. Prothrombin time (PT) – 12 seconds
4. Partial Thromboplastin time (PTT) – 37 seconds
5. Panscan CT (Polytrauma Whole Body Imaging): Results –
a. Closed left femur fracture
b. Hairline fracture of 3 left ribs
c. TBI consisting of frontal-temporal skull fracture
6. Urinalysis (UA) – positive for red blood cells in urine
7. Drug panel – positive for cannabinoids
8. Consent to treat options
**PART II: Critical Thinking Activity**
Use the findings from your evaluation to complete the following:
| | |
| — | — |
| **Assessment Findings**<br>_Evaluate Mr. Doe's health history and other pertinent medical information presented above to answer the questions that follow._ |
| _Based on your evaluation, synthesize normal and abnormal findings. Create a list prioritizing three to five problems and health concerns present for the patient. Your response should be a minimum of 300 words._ | |
| _Provide rationale justifying your proposed list. Use at least one evidence-based resource to support your rationale. Your response should be a minimum of 200 words._ | |
| _Discuss how each team member can contribute to the formation and improvement of diagnosis for this patient. Your response should be a minimum of 200 words._ | |
| **Interventions**<br>_Mr. Doe requires numerous interventions upon arrival to the hospital._ |
| _Based on your assessment, describe the interventions that are required upon Mr. Doe's arrival to the hospital to mitigate the risk of further complications. Your response should be a minimum of 300 words._ | |
| **Diagnostic Tests**<br>_Review the diagnostic tests that were ordered._ |
| _Choose two diagnostic tests and explain how these tests relate to the patient's condition. Your response should be a minimum of 200 words._ | |
| **Surgical Intervention**<br>_Review your assessment of Mr. Doe's physical injuries to answer the questions below._ |
| _Discuss the possible surgical interventions necessary to address Mr. Doe's multiple fractures. Your response should be a minimum of 200 words._ | |
| _If surgery is not necessary, what steps are needed to ensure proper healing of the bones? Your response should be a minimum of 200 words._ | |
| **Panscan Results**<br>_The panscan results indicate a positive TBI._ |
| _Based on these results, what interventions do you foresee as necessary when treating the patient? Your response should be a minimum of 300 words._ | |
| **Psychosocial and Spiritual Considerations**<br>_Providing holistic nursing care for patients with complex conditions requires that the nurse takes into account the patient's psychosocial and spiritual needs._ |
| _Given the patient's current situation, discuss ways in which the nurse can take into account and address the patient's psychosocial and spiritual needs. Your response should be a minimum of 150 words._ | |
| **References (Please include working hyperlinks.)** |
© 2024. Grand Canyon University. All Rights Reserved.
2
## image1.png
**## NRS-460-RS-T1-CaseStudy-JohnDoe-EmergencyDepartment.docx**
**NRS-460 Case Study: John Doe – Emergency Department**
**Directions: Read the case study below. Evaluate the information and formulate a conclusion based on your evaluation. Complete the critical thinking table and submit this completed template to the assignment dropbox.**
The purpose of this assignment is to evaluate and synthesize patient data to propose interventions for an individualized plan of care prioritizing health problems and health concerns.
**PART I:**
**Health History and Medical Information**
Evaluate the health history and medical information for John Doe, presented below.
John Doe, a 35-year-old male, was riding his motorcycle under the influence and experienced a motor vehicle accident resulting in multiple fractures and a traumatic brain injury (TBI).
On scene, John Doe was alert but exhibiting restlessness and agitation with hands-on care. En route to the hospital, he displayed changes in level of consciousness (LOC), mood and behavior, nausea and vomiting (N/V), and dilated pupils. Upon arrival to the emergency department, John was unconscious with a Glasgow Coma Scale (GCS) score of 6, indicating a severe TBI. Prior to losing consciousness, he was exhibiting signs of extreme pain on the left side.
_Objective Data – completed by ambulance personnel:_
1. 84/60 BP, HR 136, RR 28 irregular, SpO2 92%
2. 5' 11" height, 180 lbs. weight
3. GCS Score: 6
a. No response in eyes: 1
b. No verbal response: 1
c. Flexion withdrawal from pain: 4
4. Change in LOC
5. Possible fractures to left leg and left ribs
6. Intubated in route to ED
_Objective Data and Laboratory/Test Results – on arrival to the emergency department (initial results)_
1. Complete blood count (CBC) –
a. White blood cells: 11.3
b. Hemoglobin: 15.6
c. Hematocrit: 41.5
d. Platelets: 316,000
2. Comprehensive Metabolic Panel (CMP) –
a. Alanine Aminotransferase (ALT): 32 U/L
b. Albumin: 4.8 g/dL
c. Alkaline Phosphatase (ALP): 122 U/L
d. Aspartate Aminotransferase (AST): 52 U/L
e. Blood Urea Nitrogen (BUN): 16mg/dL
f. Bilirubin: 1.4mg/dL
g. Calcium: 9.8mg/dL
h. Creatinine: 1.1mg/dL
i. Glucose: 112mg/dL
j. Potassium: 3.9 mEq/L
k. Sodium: 138 mEq/L
3. Prothrombin time (PT) – 12 seconds
4. Partial Thromboplastin time (PTT) – 37 seconds
5. Panscan CT (Polytrauma Whole Body Imaging): Results –
a. Closed left femur fracture
b. Hairline fracture of 3 left ribs
c. TBI consisting of frontal-temporal skull fracture
6. Urinalysis (UA) – positive for red blood cells in urine
7. Drug panel – positive for cannabinoids
8. Consent to treat options
**PART II: Critical Thinking Activity**
Use the findings from your evaluation to complete the following:
| | |
| — | — |
| **Assessment Findings**<br>_Evaluate Mr. Doe's health history and other pertinent medical information presented above to answer the questions that follow._ |
| _Based on your evaluation, synthesize normal and abnormal findings. Create a list prioritizing three to five problems and health concerns present for the patient. Your response should be a minimum of 300 words._ | |
| _Provide rationale justifying your proposed list. Use at least one evidence-based resource to support your rationale. Your response should be a minimum of 200 words._ | |
| _Discuss how each team member can contribute to the formation and improvement of diagnosis for this patient. Your response should be a minimum of 200 words._ | |
| **Interventions**<br>_Mr. Doe requires numerous interventions upon arrival to the hospital._ |
| _Based on your assessment, describe the interventions that are required upon Mr. Doe's arrival to the hospital to mitigate the risk of further complications. Your response should be a minimum of 300 words._ | |
| **Diagnostic Tests**<br>_Review the diagnostic tests that were ordered._ |
| _Choose two diagnostic tests and explain how these tests relate to the patient's condition. Your response should be a minimum of 200 words._ | |
| **Surgical Intervention**<br>_Review your assessment of Mr. Doe's physical injuries to answer the questions below._ |
| _Discuss the possible surgical interventions necessary to address Mr. Doe's multiple fractures. Your response should be a minimum of 200 words._ | |
| _If surgery is not necessary, what steps are needed to ensure proper healing of the bones? Your response should be a minimum of 200 words._ | |
| **Panscan Results**<br>_The panscan results indicate a positive TBI._ |
| _Based on these results, what interventions do you foresee as necessary when treating the patient? Your response should be a minimum of 300 words._ | |
| **Psychosocial and Spiritual Considerations**<br>_Providing holistic nursing care for patients with complex conditions requires that the nurse takes into account the patient's psychosocial and spiritual needs._ |
| _Given the patient's current situation, discuss ways in which the nurse can take into account and address the patient's psychosocial and spiritual needs. Your response should be a minimum of 150 words._ | |
| **References (Please include working hyperlinks.)** |
© 2024. Grand Canyon University. All Rights Reserved.
2
## image1.png