Case Study

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“I can’t seem to control my urine. I feel like I have to urinate all the time. However, when I do go to the bathroom, I often pass only a small amount of urine. Sometimes I wet myself. I was started on a medication for my leaking a few weeks ago, but it doesn’t seem to be working. I also can’t seem to remember anything. It is a wonder that I remembered to come to the clinic today.” Case Study

HPI

Susan Jones is a 65-year-old woman with urinary urgency, frequency, and incontinence. She reports soiling her underwear at least two to three times during the day and night and has resorted to wearing panty liners or changing her underwear several times a day. The patient has curtailed much of her volunteer work and social activities because of this problem. Urinary leakage is not worsened by laughing, coughing, sneezing, carrying heavy objects, or walking up and down stairs. She does not report wetting herself without warning. She has been taking Detrol LA 2 mg PO daily for the past month with no improvement in her voiding symptoms, and she complains of new-onset confusion and difficulty remembering routine tasks. Case Study

PMH

HTN for many years, treated with medications for 10 years. Dyslipidemia for 5 years, controlled with a low-cholesterol diet, weight control, regular exercise, and medication. Menopausal; stopped ovulating at age 52; no longer has hot flashes. Has difficulty falling asleep and often has sleepless nights. She has no history of spinal or pelvic surgery.

FH

Noncontributory

SH

Nonsmoker; social drinker; married Case Study

Meds

Hydrochlorothiazide 25 mg PO once daily with supper

Irbesartan 150 mg PO daily

Pravastatin 40 mg PO at bedtime

Detrol LA 2 mg PO daily

Sominex (diphenhydramine) 15 mg PO at bedtime as needed, usually about five times a week

Amitriptyline 50 mg PO at bedtime as needed Case Study

All

NKDA

ROS

Complains of urinary incontinence that has not responded to Detrol LA. Feels confused and has difficulty remembering routine tasks. Patient states that her ability to remember what she has to do became impaired in the past 3 weeks after Detrol was started.

Physical Examination

Gen

WDWN woman Case Study

VS

BP 135/84 mm Hg, P 90 bpm, RR 16, T 37°C; Wt 65 kg, Ht 5′2″

Skin

No rashes, wounds, or open sores

HEENT

PERRLA; EOMI; no AV nicking or hemorrhages

Neck/Lymph Nodes

No palpable thyroid masses; no lymphadenopathy

Pulm

Clear to A&P Case Study

Breasts

Normal; no lumps

CV

Regular S1, S2; (+) S4; (–) S3, murmurs, or rubs

Abd

Soft, NTND, (+) bowel sounds

Genit/Rect

Genital examination shows atrophic vaginitis consistent with menopausal status. Perineal sensation and anal sphincter tone are normal.

Pelvic examination shows no uterine prolapse and a mild degree of cystocele. Cervix is normal. No pelvic, adnexal, or uterine masses found.

External hemorrhoids; heme (–) stool.

Ext

Normal; equal motor strength in both arms and legs

Neuro

Although alert, the patient is not oriented to correct month, day, or year. CNs II–XII grossly intact; DTRs 3/5 bilaterally; negative Babinski. When asked to recall a series of five objects after 5 minutes, the patient had difficulty and could only recall one object.

Labs

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Na 140 mEq/L

Hgb 12 g/dL

K 4.2 mEq/L

Hct 37%

Cl 105 mEq/L

Plt 400 × 103/mm3 Case Study

CO2 28 mEq/L

WBC 5.0 × 103/mm3

BUN 17 mg/dL

SCr 1.2 mg/dL

Glu 100 mg/dL

UA

No bacteria; no WBC

Other

Using an ultrasonic bladder scan, a residual urine volume was measured after the patient voided. No residual urine was found. The bladder was then filled with 300 mL saline. The patient felt the first desire to void at 100 mL. The catheter was removed. The patient was asked to cough in different positions. No stress urinary incontinence was demonstrated. The patient voided the entire volume of saline that was instilled.

Assessment

Overactive bladder with symptoms of urinary urgency, frequency, and incontinence, which has not responded to Detrol LA 2 mg PO daily for 1 month. Patient is also having new-onset confusion and forgetfulness, which are probably related to Detrol LA and to the total anticholinergic burden. Will evaluate carefully and consider alternative medication options.

QUESTIONS

1-a. Assess the severity of incontinence based on the subjective and objective information available.

Case Study

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Question 1

Review the case study and mark the words that indicate an emotion or a behavior related to an emotion experienced by the woman. Make a note of the line number in which the word occurs. Case Study

Question 2

List probes or statements the interviewer might use to keep the woman talking about being diagnosed. Case Study

Question 3

In the case study, the qualitative approach was identified to be exploratory-descriptive qualitative with the inference that the interview had been done recently. What additional sources of data would you collect if the qualitative approach used in the study had been historical with the aim of describing the oncology nurse’s role in the 1960s? Case Study

case study

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You will complete a comprehensive psychiatric mental health assessment of a child/adolescent.

This should NOT be a patient you have case study  encountered in your work but, instead, should be a family member or friend (who gives consent) or preferably a patient in clinical. You should note that all information will be confidential and that their private information will NOT be shared as part of this assignment.

Your assessment should be comprehensive, and you should refer to course texts to inform items for inclusion in your assessment. Keep in mind that you will be case study  responsible for covering those areas addressed in the reading assignments up to this point. The documentation should remain HIPAA-compliant even though this is not a real patient. DO NOT USE REAL PATIENT IDENTIFIERS. Be sure to include birth and developmental information as well as school and behavior information for the child. Consider cultural, gender, ethnicity, spiritual, and social competencies needed to formulate the best care case study  plan for the patient.

The patient will be referred to as Jane Doe or Jack Doe.  case study

 

Case Study

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Orientations. Case Study Part 1.

My question

PICOT (PICO) Question Case Study
In elderly patients suffering from osteoarthritis, how does water exercise compared to land exercise influence pain alleviation after two months ?

• 1. Introduction. Describe the health problem. Don’t type “Introduction”. (1 paragraph).
Using data and statistics, support your claim that the issue you selected is a problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measurable.
2. Describe the vulnerable population. (1-2 paragraph). Case Study
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
3. Provide a review of literature from scholarly journals (at least 2, one of those two should be systematic review supporting what you wish to accomplish) of evidence-based interventions that address the problem. (2 paragraph, one for each article).
After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found and how this evidence supports your ideas.
4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal. (1-2 paragraph).
For this assignment a conclusion paragraph is not required. Case Study
Paper Requirements
Three to five pages in length (excluding title page, references, and appendices)
Follow APA format
Cite a minimum of five research articles, including the two sources you will use as body of evidence in the literature search, in point 3.
To view the Grading Rubric for this Assignment, please visit the Case StudyGrading Rubrics section of the Course Home.

Assignment rubric
Case Study Part II

[100 Points Total]

A. Project Content

90 points possible
0 1 2 3 4 Score Case Study

1. Describe the health problem.
Using data and statistics, support your claim that the issue you selected is a
problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measureable Did not identified the problem Poorly identified the problem and aspect to address
Vaguely identified and discussed the problem and aspect to address
Briefly identified and discussed the problem and aspect to address
Case Study

Thoroughly identified and discussed the problem and aspect to address

2. Describe the vulnerable population.
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
Did not identified or described population supported by evidence. Poorly identified or described population supported by evidence.
Vaguely identified or described population supported by evidence. Briefly identified or described population supported by evidence. Thoroughly identified or described population supported by evidence.
3. Provide a review of literature from scholarly journals of evidence-based interventions
that address the problem.
After completing a library search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and
weaknesses of all the sources you have found.
You might consult research texts for information on how to write a review of the
literature found in your search.
Did not provide a review of literature from scholarly journals of evidence-based interventions
that address the problem.
Poorly provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

Vaguely provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

Briefly provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

Thoroughly provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

4. Select and present an appropriate health promotion/
disease prevention theoretical
or conceptual model that best serves as the guiding framework for the proposal.
Did not select and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Poorly selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Vaguely selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Briefly selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Thoroughly selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model
5. Provide an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
Did not . provide an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
Poorly provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
Vaguely provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline. Briefly provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline. Thoroughly provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
6.Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach.
Did not describe the intended outcomes. Poorly described the intended outcomes. Vaguely described the intended outcomes. Briefly described the intended outcomes. Thoroughly described the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach.
7. Provide a detailed plan for evaluation for each outcome.
Did not. provide a detailed plan for evaluation for each outcome.
Poorly provided a plan for evaluation for each outcome.
Vaguely provided a plan for evaluation for each outcome.
Briefly provided a plan for evaluation for each outcome.
Provided a detailed plan for evaluation for each outcome.

8. Thoroughly describe possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.
Did not describe possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Poorly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Vaguely described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Briefly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Thoroughly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.
Total Points ___/32
Percent Accomplished ___%
A. Project Content Points
(___% x 90 pts) ___ pts
B. Organization and Formatting

10 points possible 0 1 2 3 4 Score

Organization
Organizes project and writes well.
No project or paper submitted. Project was unorganized and poorly written. Project was somewhat organized and overall writing left room for improvement.
Project was well-organized, but overall writing left room for improvement. Project was thoroughly organized and well-written.
States ideas clearly and logically.
No project or paper submitted. Ideas were not stated clearly or logically. Some ideas were stated clearly and logically. Most ideas were stated clearly and logically. All ideas were stated clearly and logically.
Writes relevant content. No project or paper submitted. Project was off topic and not relevant. Some portions of project were on topic and relevant. Project was mostly on topic and relevant. Project was thoroughly on topic and relevant.

Formatting

Uses Course Policies formatting guidelines.
No project or paper submitted. No formatting guidelines were followed. Some guidelines were followed. Most guidelines were followed. All formatting guidelines were followed and the template was used.
Avoids spelling and grammatical errors.
No project or paper submitted. Greater than 6 spelling or grammatical errors. 4 to 6 spelling or grammatical errors. 1 to 3 spelling or grammatical errors. No spelling or grammatical errors.

Total Points ___/10
Percent Accomplished ___%
B. Organization and Formatting Points
( ___% 25 pts) ___ pts
Total Points: (A +B) / 100 ___/100

 

 

Case Study

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Orientations. Case Study Case Study Part 1.

My question

PICOT (PICO) Question
PICOT (PICO) Question
For asymptomatic urethral and anorectal Chlamydia trachomatis infection, would periodically screening of sex workers be beneficial to reduce incidence and prevalence rates at community level when compared to communities without intervention in a period of six months.

• 1. Introduction. Describe the health problem. Don’t type “Introduction”. (1 paragraph).
Using data and statistics, Case Studysupport your claim that the issue you selected is a problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measurable.
2. Describe the vulnerable population. (1-2 paragraph).
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
3. Provide a review of literature from scholarly journals (at least 2, one of those two should be systematic review supporting what you wish to accomplish) of evidence-based interventions that address the problem. (2 paragraph, one for each article).
After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found and how this evidence supports your ideas.
4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework Case Study for the proposal. (1-2 paragraph).
For this assignment a conclusion paragraph is not required.
Paper Requirements
Three to five pages in length (excluding title page, references, and appendices)
Follow APA format
Cite a minimum of five research articles,Case Study  including the two sources you will use as body of evidence in the literature search, in point 3.
To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home.

Assignment rubric
Case Study Part II

[100 Points Total]

A. Project Content

90 points possible Case Study
0 1 2 3 4 Score

1. Describe the health problem.
Using data and statistics, support your claim that the issue you selected is a
problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measureable Did not identified the problem Poorly identified the problem and aspect to address
Vaguely identified and discussed the problem and aspect to address
Briefly identified and discussed the problem and aspect to address Case Study

Thoroughly identified and discussed the problem and aspect to address

2. Describe the vulnerable population.
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
Did not identified or described population supported by evidence. Poorly identified or described population supported by evidence.
Vaguely identified or described population supported by evidence. Briefly identified or described population supported by evidence. Thoroughly identified or described population supported by evidence.
3. Provide a review of literature from scholarly journals of evidence-based interventions
that address the problem.
After completing a library search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and
weaknesses of all the sources you have found.
You might consult research texts for information on how to write a review of the
literature found in your search.
Did not provide a review of literature from scholarly journals of evidence-based interventions
that address the problem.
Poorly provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

Vaguely provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

Briefly provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

Thoroughly provided a review of literature from scholarly journals of evidence-based interventions
that address the problem.

4. Select and present an appropriate health promotion/
disease prevention theoretical
or conceptual model that best serves as the guiding framework for the proposal.
Did not select and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Poorly selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Vaguely selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Briefly selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model Thoroughly selected and present an appropriate health promotion/
disease prevention theoretical
or conceptual model
5. Provide an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
Did not . provide an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
Poorly provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
Vaguely provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline. Briefly provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline. Thoroughly provided an overview of your implementation plan complete with a summary of
communication ideas and a timeline.
6.Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach.
Did not describe the intended outcomes. Poorly described the intended outcomes. Vaguely described the intended outcomes. Briefly described the intended outcomes. Thoroughly described the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach.
7. Provide a detailed plan for evaluation for each outcome.
Did not. provide a detailed plan for evaluation for each outcome.
Poorly provided a plan for evaluation for each outcome.
Vaguely provided a plan for evaluation for each outcome.
Briefly provided a plan for evaluation for each outcome.
Provided a detailed plan for evaluation for each outcome.

8. Thoroughly describe possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.
Did not describe possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Poorly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Vaguely described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Briefly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges. Thoroughly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.
Total Points ___/32
Percent Accomplished ___%
A. Project Content Points
(___% x 90 pts) ___ pts
B. Organization and Formatting

10 points possible 0 1 2 3 4 Score

Organization
Organizes project and writes well.
No project or paper submitted. Project was unorganized and poorly written. Project was somewhat organized and overall writing left room for improvement.
Project was well-organized, but overall writing left room for improvement. Project was thoroughly organized and well-written.
States ideas clearly and logically.
No project or paper submitted. Ideas were not stated clearly or logically. Some ideas were stated clearly and logically. Most ideas were stated clearly and logically. All ideas were stated clearly and logically.
Writes relevant content. No project or paper submitted. Project was off topic and not relevant. Some portions of project were on topic and relevant. Project was mostly on topic and relevant. Project was thoroughly on topic and relevant.

Formatting

Uses Course Policies formatting guidelines.
No project or paper submitted. No formatting guidelines were followed. Some guidelines were followed. Most guidelines were followed. All formatting guidelines were followed and the template was used.
Avoids spelling and grammatical errors.
No project or paper submitted. Greater than 6 spelling or grammatical errors. 4 to 6 spelling or grammatical errors. 1 to 3 spelling or grammatical errors. No spelling or grammatical errors.

Total Points ___/10
Percent Accomplished ___%
B. Organization and Formatting Points
( ___% 25 pts) ___ pts
Total Points: (A +B) / 100 ___/100