Client Case Study Scenario

/ Samples / By

Case Study Analysis 1

Please be sure your assignment submissions meet both criteria:

  1. The TurnitIn score is no higher than 25%; and 
  2. No amount of plagiarism can be present.

If the TurnitIn score for your submitted assignment is greater than 25%, your assignment will automatically undergo an Academic Integrity review.

Please be sure your assignments meet both criteria: TurnitIn score of no higher than 25% and no instances of plagiarism.

As part of APA formatting, this assignment requires Level 1 headings for each of the main sections of the paper. The Introduction section is the only section for which there should be no Level 1 heading. Please use the topic headings as stated in the assignment rubric as the Level 1 headings for the assignment. For more information about section headings, please view the following APA Style resource:

https://apastyle.apa.org/style-grammar-guidelines/paper-format/headings

 

Assignment Instructions:

  • Review the case study scenario below and the client’s family history and medical profile information from unit 1.
  • Next, write a 6-8-page paper analysis of the client (including title and reference page) according to the assignment specifications, outline, and grading rubric.

Case Study 1 Scenario:

Client, Sarah Collins, has chronic kidney disease. She receives dialysis twice a week. Today when Mrs. Collins arrives at the dialysis clinic, the nurse assesses Mrs. Collins and notes her blood pressure is 145/90 mm Hg and she has gained three pounds since her last visit. Mrs. Collins tells the nurse she was trying earlier to walk to her mailbox at the end of the driveway and couldn’t because she was out of breath. Mrs. Collins’ husband and 16-year-old grandson are at the clinic with her.

Case Study Analysis Assignment Outline:

 The case study analysis paper should include the following sections with responses and rationales for all the prompts.

Introduction (3-5 paragraphs)

Provide an overview of the pathophysiology of the disease exhibited by the client. Include:

  • What additional assessment findings would you look for?
  • What lab abnormalities would you expect to see?
  • What diagnostics would you anticipate the healthcare team ordering?
  • Provide a rationale for your answers.

Implications for Self-Care (2 paragraphs)

  • Consider Maslow’s hierarchy of needs and describe where the client falls in that hierarchy and how this will impact care and healing.
  • How does this disease process impact the client’s and/or their care provider’s ability to care for themselves?

Patient Education Strategy (2-3 paragraphs)

  • Identify 3-5 appropriate nursing interventions and teaching points for your client based on the pathophysiology and assessment findings.
  • Describe the educational strategies that should be incorporated when building a plan of care for your client.
  • Support with rationale.

Interdisciplinary Collaboration (2-3 paragraphs)

  • Identify 2-4 interdisciplinary team members who need to be included in the care of the client. Include rationale.
  • Consider the care the client will need while inpatient and upon discharge.
  • Consider nutrition, community services, and financial implications.

Conclusion

  • Summarize the key concepts of this disease process and client case study scenario.

References

  • A minimum of three references should be used in this paper.
  • References should be no more than five years old. Exceptions include seminal works, such as original publications by nurse theorists. 
  • One reference must be your textbook, (Banasik, J. L. (2022). Pathophysiology (7th ed.). Elsevier. ISBN-13: 9780323761550)
  • One reference must be from a peer-reviewed journal,
  • One reference must be from an authoritative website such as the CDC, NIH or Healthy People 2030.

Assignment Specifications:

  • Name the paper with a File Naming Protocol: When you save the paper, name it: Valdes_NSG 3300_CaseStudyAnalysis_1.docx
  • Paper reflects clinical and professional client/cases, and no references to personal or family issues.

APA Formatting

  • All papers should be written in APA formatting. This paper should include:
  • Formal components, such as a title page, and APA formatting with an introductory and conclusion paragraph that summarizes the key concepts
  • APA-formatted levelheadings
  • APA margin, font, and paragraph spacing
  • Include page numbers
  • Appropriate in-text reference citations
  • A reference page, in correct APA format

client case study scenario

Title: Case Study Analysis 1

Introduction

Chronic kidney disease (CKD) is a progressive and irreversible condition characterized by the gradual loss of kidney function over time. In the case of Mrs. Sarah Collins, she is currently undergoing dialysis twice a week due to her advanced CKD. This paper aims to provide an overview of the pathophysiology of CKD in the context of Mrs. Collins and discuss additional assessment findings, lab abnormalities, and diagnostic tests that may be relevant to her case.

Pathophysiology of CKD: CKD is typically categorized into five stages, with Stage 1 being the mildest and Stage 5 representing end-stage renal disease (ESRD). Mrs. Collins likely falls into Stage 4 or 5 CKD, given her need for dialysis and reported symptoms. The primary pathophysiological changes in CKD involve the gradual loss of nephron function, leading to impaired filtration, electrolyte imbalances, and the accumulation of waste products in the bloodstream. The following are key aspects of CKD pathophysiology relevant to Mrs. Collins:

  1. Glomerular Filtration Rate (GFR): In CKD, the GFR progressively declines, leading to reduced clearance of waste products and excess fluid from the blood.
  2. Electrolyte Imbalances: As kidney function deteriorates, there can be disturbances in electrolyte levels, such as hyperkalemia and hyperphosphatemia.
  3. Fluid Retention: Impaired renal function results in the inability to effectively regulate fluid balance, leading to edema, hypertension, and weight gain.

Additional Assessment Findings: In assessing Mrs. Collins, additional findings to consider include:

  1. Assessment of Cardiovascular Health: Given her high blood pressure (145/90 mm Hg) and symptoms of dyspnea on exertion, a comprehensive cardiovascular assessment should be performed, including ECG, echocardiography, and monitoring for signs of heart failure.
  2. Assessment of Anemia: CKD often leads to anemia due to decreased erythropoietin production. Monitoring her hemoglobin and hematocrit levels is crucial.
  3. Review of Medication Regimen: Evaluate Mrs. Collins’ current medications, including antihypertensives, phosphate binders, and medications for anemia.

Lab Abnormalities: Common lab abnormalities associated with CKD include elevated serum creatinine and blood urea nitrogen (BUN) levels, hyperkalemia, hyperphosphatemia, and anemia. Mrs. Collins may exhibit these abnormalities in her lab results, reflecting her advanced CKD.

Diagnostic Tests: Diagnostics that the healthcare team may order for Mrs. Collins include:

  1. Renal Ultrasound or CT Scan: To assess kidney size, structure, and presence of any obstructions or tumors.
  2. Renal Biopsy: In some cases, a biopsy may be necessary to determine the underlying cause of CKD.
  3. Doppler Ultrasound: To assess blood flow in the renal arteries and veins.
  4. Echocardiography: To evaluate cardiac function and identify any signs of hypertensive heart disease or heart failure.

Implications for Self-Care

Mrs. Collins’ placement in Maslow’s hierarchy of needs is significantly impacted by her advanced CKD. She is likely positioned in the lower levels of the hierarchy, focusing on physiological and safety needs due to her chronic illness and need for dialysis. This has several implications for her self-care and healing:

  1. Physiological Needs: Mrs. Collins must prioritize her physiological needs, including adhering to her dialysis schedule, maintaining a low-sodium diet to manage fluid retention and hypertension, and managing her anemia with prescribed medications.
  2. Safety Needs: Ensuring her safety is crucial, as CKD patients are at risk of complications like electrolyte imbalances, infection, and cardiovascular events. Education on recognizing signs of these complications is essential for her and her caregivers.
  3. Psychological Needs: CKD often takes a toll on a patient’s mental health. Mrs. Collins and her family may benefit from psychological support and counseling to cope with the emotional aspects of her condition.
  4. Social Needs: Mrs. Collins may experience social isolation due to the time-consuming nature of dialysis and her inability to engage in physical activities. Support groups and social networks can help address this need.

Patient Education Strategy

To empower Mrs. Collins and her family in managing her CKD, several nursing interventions and teaching points should be considered:

  1. Medication Management: Educate Mrs. Collins and her family on the importance of adhering to her medication regimen, including phosphate binders, antihypertensives, and erythropoiesis-stimulating agents. Emphasize the need for regular monitoring of medication side effects.
  2. Dietary Restrictions: Provide dietary education, focusing on a low-sodium and low-phosphorus diet. Collaborate with a dietitian to create a personalized meal plan.
  3. Fluid Management: Teach Mrs. Collins about monitoring her fluid intake and recognizing signs of fluid overload, such as sudden weight gain or swelling.
  4. Symptom Recognition: Educate her and her family on recognizing and reporting symptoms of complications, such as shortness of breath, chest pain, and changes in urinary output.
  5. Lifestyle Modifications: Discuss the importance of regular physical activity within her limitations and stress the avoidance of tobacco and alcohol.

Interdisciplinary Collaboration

Mrs. Collins’ complex care requires the involvement of several interdisciplinary team members:

  1. Nephrologist: The primary physician managing her CKD and dialysis treatment.
  2. Cardiologist: To assess and manage her cardiovascular health, given her hypertension and symptoms of dyspnea.
  3. Dietitian: To provide guidance on her dietary restrictions and ensure optimal nutrition.
  4. Social Worker: To address psychosocial needs, provide counseling, and connect her with support groups.
  5. Financial Counselor: To help navigate the financial implications of long-term dialysis treatment and related expenses.

Conclusion

In summary, chronic kidney disease is a progressive condition that poses numerous challenges for patients like Mrs. Sarah Collins. Understanding the pathophysiology, assessing additional findings, and addressing the implications for self-care and interdisciplinary collaboration are essential in providing comprehensive care. By implementing appropriate patient education strategies and involving a multidisciplinary team, healthcare providers can improve Mrs. Collins’ quality of life and manage the complexities of her condition effectively.

References

  1. Banasik, J. L. (2022). Pathophysiology (7th ed.). Elsevier. ISBN-13: 9780323761550.
  2. [Peer-reviewed journal reference]
  3. [CDC/NIH/Healthy People 2030 reference]
Scroll to Top