Download Case Study – How to get an “A”

Case Study – How to get an “A”
Medical- Surgical Assessment tool - A Complete Assessment includes all subjective
and objective information relevant to each pattern/section in your assessment tool. This is
the foundation for your case study! This must be complete and accurate in order for you
to interpret and analyze what you find. Physical assessment data is to be obtained by
you. Information obtained from the chart should be labeled as such.
The Nursing Data Base is a detailed report of the client, including what brought the
client to CHH, medical diagnoses, previous surgeries, therapies receiving at CHH and the
reason for and goals of those therapies.
Interpretation and analysis of assessment findings - The case study paper will reflect
your interpretation and analysis of your assessment finding . Summarize and analyze the
client’s strengths and problems related to EACH pattern/section with appropriate
nursing interventions.
Medications -All of the client’s scheduled medications and the PRN medications the
client has taken in the past three days are included in EACH pattern/section that is
appropriate. There must be at least three PRN medications. For each medication, include
the name (generic and brand), classification, dosage ordered, route, frequency, primary
action, major side effects, nursing implications specific to your client, and why you
think your patient is receiving this medication. The full write-up of each medication is
required for only ONE pattern/section, but should be listed, along with the reason, in
EVERY pattern in which it applies.
Laboratory Data/ Diagnostic tests - These should be listed under the appropriate
pattern/section. Include the name of the test, date of the test, the results compared to
normal, why the test was done on your patient, and your interpretation of the results
(what it means). Use your lab book as a reference. Include all laboratory tests performed
on your patient, even if they have normal values. If the values are normal, explain what
they are looking for with this test.
Nursing Diagnoses - List all nursing diagnoses for each pattern/section, correctly written
in a full diagnostic statement. Subjective and objective data supports the nursing
diagnoses selected. From the list of all nursing diagnoses, select the top 10-12 most
important diagnoses for your individual client. On a separate page, list these top 10-12,
prioritized correctly (A-B-C), in a full diagnostic statement.
The assignment will be written as a formal paper using APA format. We suggest that you
organize your paper by health patterns/sections, which include the subjective and objective data
with appropriate medications and laboratory data relating to that pattern/section. This would be
followed by your prioritized list of nursing diagnoses. The paper will be in APA format with a
running head, title page, correct margins and spacing, citations, and a reference page. Helpful
Hint: If you identify a problem in your data, make sure to include a nursing diagnosis and
nursing interventions that address the problem!