CASE STUDY
(Grading Criteria)
Students will complete a comprehensive case study on a client in order to pull together material learned during the sophomore year, The case study will include completion of the Medical-Surgical assessment tool found in the supplementary material as a data base. The paper will reflect the students’ ability to interpret and analyze this data with relevant nursing diagnoses, nursing implications (or interventions) and evaluation. The paper should be between 10-15 pages in length. The grade for this case study will account for 15% of each student’s final grade.
POINTS GRADE
Medical/surgical assessment tool completion 10 _______
(Data Base to be turned in with case study)
Nursing Data Base: An overview of the pt. including what 10 _______
brought the pt. to CH, medical diagnoses, surgeries, therapies
being received at CH (PT, OT…) and why.
Strengths and Problems: Interpretation and analysis of 20 ______
assessment findings integrated into paper by systems/pattern
With identification of strengths and problems for this patient
Medications: describe in 2-3 sentences: why the pt. is on the med. 10 ________
& relevant nursing assessment & monitoring required. Medications
should be integrated into the paper by systems/patterns.
laboratory data/diagnostic tests: Interpretation and analysis of 10 ________
findings integrated into paper by systems/patterns. Identify
normal & abnormal findings with appropriate interventions.
Nursing Interventions integrated into the paper by system/patterns 20 ________
Individualized for this patient and based on your assessment findings
Prioritized List of Nursing Diagnoses (NANDA format) 10 ________
APA Format 10 ________ Running Head
Title Page
Margins
References
Grammar, clarity, spelling
Organization and clarity
TOTAL POINTS 100 __________
This page must be included when handing in your paper. Also include your mailbox number.
If the paper is turned in late, there will be an automatic reduction of 10 points (10%). If the paper is more than 24 hours late it will not be accepted.
Updated August 2006
CASE STUDY SAMPLE OUTLINE
Medical-Surgical Assessment Tool – This tool should be filled out completely and turned in with your paper.
Overview of Components of the Paper:
The data base will introduce the reader to the patient with an overview of why they are at Cardinal Hill, what therapies are they receiving and a brief health history.
Each of the following patterns/systems will have a separate paragraph. Respiratory, Circulation, Activity/Rest, Food/Fluid, Elimination, Hygiene, Ego Integrity, Pain/Discomfort/ Safety, Neurosensory, Sexuality, Social Interactions, Teaching Learning.
Under each system/pattern incorporate an interpretation and analysis of assessment data (do not just repeat the assessment you have documented in the assessment tool). From this analysis, determine the problems and/or strengths for each system. Incorporate medications related to this system/pattern with the focus on why this patient is on this medication and nursing implications. Incorporate diagnostic tests related to this system/pattern with a focus on interpretation and nursing implications for this patient. Based on your analysis, identify nursing diagnoses for each system/pattern if applicable (some patterns may not have a diagnosis) Develop individualized nursing interventions for each diagnosis. When writing this paper constantly ask yourself “what does this mean and what am I going to do about it”
Develop a prioritized list of nursing diagnoses written in the correct format (etiology and manifestations when appropriate) on a separate page.
APA format
The guidelines for APA format is linked to the NUR 863 web site. Do not use first person when writing in APA format. Review the grading guidelines before turning in your paper.