Clinical Case Study - Nurses' Notes on Skin Integrity, Nutrition and Metabolism, Elimination, Mobility, Grief & Loss
Read the N11 Clinical Case Study: The Journey of Nurse Manus and Juan Dela Cruz
Familiarize yourself with the narratives of the clinical case of Patient Mr. Juan Dela Cruz and the care provided by Nurse Manus. The case provides details of the daily progress of Mr. Dela Cruz during his hospital stay, including the medical treatment he received, the nursing management and interaction with the relatives.
As you go through the basic nursing procedures and interventions in this course, questions related to the topics will be posted for you to reflect and answer based on Mr. Dela Cruz's health condition and care management.
Post/Upload your answers in PDF format in the designated Submission Bin. If/when you receive comments on your posts/upload, please incorporate these in the final submission bin to be posted later on. The compilation of all your submitted answers (PDF) will be the basis for the final grading of your Clinical Case Study in N11.
If you have concerns or questions, please contact the faculty in charge of your group.
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Discuss the following:
Skin integrity
Will it be safe to move a patient who just recently had surgery? How would Nurse Manus protect Mr. Dela Cruz’s surgical site? How should he care for the patient’s surgical site? What are the ethical and legal standards that the nurse must observe in the care of a postoperative patient? What will be your priority nursing diagnosis and intervention in relation to this?
Nutrition and metabolism
After days of hospitalization, Nurse Manus and Mike noticed that Mr. Dela Cruz’s weight decreased. Is this a normal loss of weight? Whom should they consult about this problem? Will oral feeding be enough to support the patient’s nutritional needs? How will you demonstrate the values of leadership, excellence, and love of learning in the use of a multidisciplinary approach to resolve the nutritional needs of Mr. Dela Cruz?
Fecal elimination
Based on the situation on day eleven, is Mr. Dela Cruz having diarrhea? What do Nurse Manus and Mike need to do? Do they need to stop Lactulose? Explain. Create a nursing care plan to address issues on fecal elimination.
Urinary elimination
What are the parameters to remove an indwelling Foley catheter? How will you instruct a patient during removal of Foley catheter? How do you interpret Mr. Dela Cruz’s urinalysis? Create nursing documentation using the D-A-R format in addressing the skin alteration?
Skin Integrity/ Mobility and restorative care
What could have been the cause of alteration in skin integrity on day eleven? Does the nurse have any ethical and legal liability when a patient develops pressure ulcer?
What is the impact of surgery and weight loss on Mr. Dela Cruz’s mobility? Will he be able to participate effectively in his physical rehabilitation? What are the safety considerations that you need to identify in attending to the mobility and restorative needs of Mr. Dela Cruz? How important is collaboration in resolving mobility issues of Mr. Dela Cruz?
Grief and Loss
You heard from the Rehab nurse that Mr. Dela Cruz is thinking of not following through his rehab schedule because he misses his wife and feels guilty that she didn't want to be hospitalized because of his previous experience. What advise or help can you offer the Rehab nurse to assist Mr Dela Cruz to reconsider his decision to quit his rehab sessions? Is this a normal stage Mr Dela Cruz is going through? Explain your answer. When would you consider grief and loss reactions (bereavement) to be abnormal?