CASE STUDY #1 The nurse is caring

CASE STUDY #1 The nurse is caring for a patient with glaucoma? What nursing considerations should you bear in mind? Make a nursing care plan for this patient? RATIONALE: CASE STUDY # 2 – Neurologic Dysfunction (PARKINSON’S DISEASE) A 65 year-old male comes with gradually progressive stiffness, difficulty walking and going down stairs. On examination: expressionless face, staring gaze with limitation of gaze in all directions and bradykinesia. Above symptoms are due to: · 1. Oculomotor palsy. · 2. Pyramidal tract lesion. · 3. Degeneration of extrapyramidal system. · 4. Midbrain lesion. He was then newly diagnosed with Parkinson disease; he asks what type of medication he will be given. What are possible medications regimens that maybe used to treat his disease and the common drug side effects of each? RATIONALE: CASE STUDY # 3 – Neurologic Dysfunction (MENINGITIS) Russell King, 27, from Stevenage, Herts, contracted the B strain of meningitis with septicaemia at 18. He says: A couple of days before Christmas 2013, when I came back from my first term at university, I started to feel cold all the time and my neck ached. The next morning my throat was sore and my neck was worse, so my father took me to the GP and I was given an antibiotic. The next morning, I started being sick every 15 minutes and my head, arms and legs really ached. Then I started to develop sensitivity to light so my parents called out a doctor. Mum suggested meningitis, but the doctor dismissed it, and gave me an antibiotic. The next day, my parents called an ambulance. I’d lost all coordination and was starting to hallucinate. At hospital, red spots appeared all over my body – literally in front of their eyes. That was the septicaemia (blood poisoning). The doctors said if my parents had brought me in any later I’d have been dead. I spent 12 days in hospital and was given penicillin six times a day. I couldn’t return to university for two months and I took a year to recover fully. What are the two assessment parameters that indicate meningitis? RATIONALE: CASE STUDY # 4 – Musculoskeletal Problem (INTRACAPSULAR HIP FRACTURE) The patient is a 71 year old widowed woman who tripped and fell on an icy step when leaving her nieces home. She complained of immediate, severe pain in her left hip and was unable to move her leg. The patient was immediately taken to the ED of the local hospital. Initial assessment revealed that the patient’s left leg was shorter than her right and externally rotated. Her V/S was stable and the neurovascular status of left leg was intact. An x-ray examination revealed an intracapsular femoral neck fracture. IV were initiated. An ECG, urinalysis, CBC and serum electrolytes were obtained. The patient was transferred to the orthopaedic unit with physician’s order for morphine SO4 via (PCA)) pump, bed rest, pneumonic compression devices biletarally and DAT. Five pounds of Buck’s extension was applied to the left leg. Informed consent was obtained for surgical repair of the fracture. The patient will undergo a herniarthrosplasty (prosthetic replacement of the femoral head and neck) in the morning. She states that she is afraid because she has never undergone surgery before. Her niece is present and supportive. How will the nurse help to reduce the patient’s anxiety regarding impending surgery and actively participate in her plan of care? RATIONALE:

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