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Grading Criteria for Clinical Case Decisions:

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The highest potential points for each Clinical Case Decision Question are 15-points. Students are required to upload their response as a word document attachment to the assignment drop box.

Each uploaded response is worth a possible 15 points.

  1.       Your comments should be substantiated and substantive. Postings require two citations from 1 scholarly journal and/or 1 outside text book           Text books assigned to this course may be used for an additional citation only.   
  2.       Each of the two references must be from a different reference source.
  3.       To gain full credit for the assignment, the response must be a full page discussion, but no more than three (3) pages in length, which                   includes the reference list.
  4.       Students are required to use APA format, proper citations, and references.  Students using direct quotes from referenced sources in the body       of the paper must include quotations.
  5.       Students will be assigned to a question.

Clinical Cases

You have been assigned two (2) cases to provide analysis.  All cases should include the following:

a. Pathophysiology and pharmacology of the disease

b. Expected signs and symptoms of the disease.

c. Nursing Diagnosis with a plan of care.

d. All questions pertaining to the case are listed under each case. 

Clinical Decision Cases

C1.   Mr. Appel has a severe chronic obstructive pulmonary disease (COPD). He is admitted to the hospital with a respiratory infection and increased dyspnea; yellow, purulent sputum; anxiety; and diaphoresis. He states he feels weak and tired. He routinely takes a diuretic (furosemide) and his pulmonary medications. The following laboratory values are obtained:

Arterial blood gases:

pH 7.25                                         Serum sodium (Na+) 140 mEq/L

PaO2 60 mmHg                             Serum potassium (K+) 2.0 mEq/L

PaCO2 78 mmHg                           Serum chloride (Cl–) 105 mEq/L

HCO3– 34 mEq/l

a. What type of electrolyte imbalance does Mr. Appel have?

b. Interpret his ABGs.

C2.   Mr. Jones is admitted to the hospital with an exacerbation of heart failure. He has +3 peripheral edema of the lower extremities.

a. What are the possible causes of his peripheral edema?