Our Services

Get 15% Discount on your First Order

[rank_math_breadcrumb]

TBI Case Study

NRS-460 Case Study: John Doe – Emergency Department

Directions: Read the case study below. Evaluate the information and formulate a conclusion based on your evaluation. Complete the critical thinking table and submit this completed template to the assignment dropbox.

The purpose of this assignment is to evaluate and synthesize patient data to propose interventions for an individualized plan of care prioritizing health problems and health concerns.


PART I:
Health History and Medical Information

Evaluate the health history and medical information for John Doe, presented below.

John Doe, a 35-year-old male, was riding his motorcycle under the influence and experienced a motor vehicle accident resulting in multiple fractures and a traumatic brain injury (TBI).

On scene, John Doe was alert but exhibiting restlessness and agitation with hands-on care. En route to the hospital, he displayed changes in level of consciousness (LOC), mood and behavior, nausea and vomiting (N/V), and dilated pupils. Upon arrival to the emergency department, John was unconscious with a Glasgow Coma Scale (GCS) score of 6, indicating a severe TBI. Prior to losing consciousness, he was exhibiting signs of extreme pain on the left side.

Objective Data – completed by ambulance personnel:

1. 84/60 BP, HR 136, RR 28 irregular, SpO2 92%

2. 5′ 11″ height, 180 lbs. weight

3. GCS Score: 6

a. No response in eyes: 1

b. No verbal response: 1

c. Flexion withdrawal from pain: 4

4. Change in LOC

5. Possible fractures to left leg and left ribs

6. Intubated in route to ED

Objective Data and Laboratory/Test Results – on arrival to the emergency department (initial results)

1. Complete blood count (CBC) –

a. White blood cells: 11.3

b. Hemoglobin: 15.6

c. Hematocrit: 41.5

d. Platelets: 316,000

2. Comprehensive Metabolic Panel (CMP) –

a. Alanine Aminotransferase (ALT): 32 U/L

b. Albumin: 4.8 g/dL

c. Alkaline Phosphatase (ALP): 122 U/L

d. Aspartate Aminotransferase (AST): 52 U/L

e. Blood Urea Nitrogen (BUN): 16mg/dL

f. Bilirubin: 1.4mg/dL

g. Calcium: 9.8mg/dL

h. Creatinine: 1.1mg/dL

i. Glucose: 112mg/dL

j. Potassium: 3.9 mEq/L

k. Sodium: 138 mEq/L

3. Prothrombin time (PT) – 12 seconds

4. Partial Thromboplastin time (PTT) – 37 seconds

5. Panscan CT (Polytrauma Whole Body Imaging): Results –

a. Closed left femur fracture

b. Hairline fracture of 3 left ribs

c. TBI consisting of frontal-temporal skull fracture

6. Urinalysis (UA) – positive for red blood cells in urine

7. Drug panel – positive for cannabinoids

8. Consent to treat options


PART II: Critical Thinking Activity

Use the findings from your evaluation to complete the following:

Assessment Findings

Evaluate Mr. Doe’s health history and other pertinent medical information presented above to answer the questions that follow.

Based on your evaluation, synthesize normal and abnormal findings. Create a list prioritizing three to five problems and health concerns present for the patient. Your response should be a minimum of 300 words.

Provide rationale justifying your proposed list. Use at least one evidence-based resource to support your rationale. Your response should be a minimum of 200 words.

Discuss how each team member can contribute to the formation and improvement of diagnosis for this patient. Your response should be a minimum of 200 words.

Interventions

Mr. Doe requires numerous interventions upon arrival to the hospital.

Based on your assessment, describe the interventions that are required upon Mr. Doe’s arrival to the hospital to mitigate the risk of further complications. Your response should be a minimum of 300 words.

Diagnostic Tests

Review the diagnostic tests that were ordered.

Choose two diagnostic tests and explain how these tests relate to the patient’s condition. Your response should be a minimum of 200 words.

Surgical Intervention

Review your assessment of Mr. Doe’s physical injuries to answer the questions below.

Discuss the possible surgical interventions necessary to address Mr. Doe’s multiple fractures. Your response should be a minimum of 200 words.

If surgery is not necessary, what steps are needed to ensure proper healing of the bones? Your response should be a minimum of 200 words.

Panscan Results

The panscan results indicate a positive TBI.

Based on these results, what interventions do you foresee as necessary when treating the patient? Your response should be a minimum of 300 words.

Psychosocial and Spiritual Considerations

Providing holistic nursing care for patients with complex conditions requires that the nurse takes into account the patient’s psychosocial and spiritual needs.

Given the patient’s current situation, discuss ways in which the nurse can take into account and address the patient’s psychosocial and spiritual needs. Your response should be a minimum of 150 words.

References (Please include working hyperlinks.)

© 2024. Grand Canyon University. All Rights Reserved.

2

image1.png

Share This Post

Email
WhatsApp
Facebook
Twitter
LinkedIn
Pinterest
Reddit

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

Can you help by tonight ?

PHIL347 Course Project: Topic Selection 1. My argument will provide reasons related to the following question: ___________________________  2. ______My argument will support this claim as true; my answer to the question is “yes.”   ______My argument will not support this claim and will oppose this claim as false; my answer to

Qualitative & Quantitative Research Design

Critically appraise a qualitative and quantitative research design – Please select two research articles (qualitative and quantitative) and critically appraise both of them.    Once you chose your research articles, answer the following questions for both studies:  1. Is the evidence from a known, reputable source? 2. Has the evidence

Describing, Diagnosing, & Treatment of Skin, Eye, & Ear Disorders

Describe dermatitis, diagnostic criteria, and treatment modalities Describe the drug therapy for Conjunctivitis and Otitis Media  Discuss Herpes Virus infections, patient presentation, and treatment Describe the most common primary bacterial skin infections and the treatment of choice. 

Nursing

Post a cohesive response to the following: What are the key challenges that healthcare practitioners encounter when balancing patient care with the requirement for stringent data protection? How can healthcare organizations ensure patient confidentiality while effectively leveraging digital tools to enhance care delivery?

help with home work

Nurs 506 unit 2 assignment Canada is the first country to permit nurse practitioners to provide euthanasia. Assisted dying legislation has been introduced in Europe, North America, Australia, and New Zealand health systems. From the perspectives of your nursing practice specialization (nurse executive leader, nurse practitioner, and nurse educator), propose

help with home work

NU507-1: Examine U.S. health care policy structures and the role of the nursing leader as a change agent at the public policy table. Directions You will choose one federal-level healthcare policy issue that interests you. As a change agent, using “X” a microblogging platform, you will write to one of your

Can help by tomorrow night ?

In this creative writing assignment, you will take on the role of an advocate and analyze how federal and state powers interact in addressing public, health, and environmental issues. Utilize the First Amendment, your state constitution, and any other documents needed. Select a topic from the list below and create a

Baby Fae Discussion

  Identify and list two ethical or moral issues you observed in this case. Review the ethical codes/tenants of the stakeholders (see attached documents below). You will be assigned to take the perspective of one stakeholder group (RESEARCHERS) using the belmont report and decide how they would respond to one

Literature Evaluation

In collaboration with the approved clinical preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a

Can you complete this by tomorrow night ?

Week 2 Guided Learning Activity: Inductive and Deductive Reasoning Directions: Type the letter answer into Canvas. You may also include the whole line. The letter comes before the line or sentence Example: [A] Paris is the biggest city in France. [B] It is a major cultural center with many famous

Mental health soap mitz

Mental health soap mitz Initial Psychiatric Interview/SOAP Note Template There are different ways in which to complete a Psychiatric SOAP (Subjective, Objective, Assessment, and Plan) Note. This is a template that is meant to guide you as you continue to develop your style of SOAP in the psychiatric practice setting.

RH soap note

RH soap note Initial Psychiatric Interview/SOAP Note Template There are different ways in which to complete a Psychiatric SOAP (Subjective, Objective, Assessment, and Plan) Note. This is a template that is meant to guide you as you continue to develop your style of SOAP in the psychiatric practice setting. Criteria

Nursing Homework

Week 3 PICOT Worksheet Question Assignment Preparing the Assignment Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions. While many different models for evidence-based practice (EBP) exist, a core methodology is shared within each. Central to EBP models is the review

Controversy Associated With Dissociative Disorders

Controversy Associated With Dissociative Disorders The  DSM-5-TR is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with

Nursing Nursing Homework

Nursing Homework help  MUST BE ORIGINAL WORK ONLY PRIMARY POST: 1. Create a PICO question using proper PICO formatting. i. Formulate an EBP question using the PICO format on your selected practice issue (you can assess any intervention other than CHG bathing). 2. Locate one journal article relevant to your

Home work

Competency Analyze the incidence, distribution, and control of emerging healthcare concerns in global populations. Student Success Criteria View the grading rubric for this deliverable by selecting the “Grading rubric” in the right menu.  Scenario You are preparing to speak at a global health conference about a disease affecting a global

Nursing Wk8 assignment conc

Proposed mechanism of action Baseline assessment, laboratory considerations, and frequency of ongoing labs and assessments Note: Discuss the importance of assessment and labs. Special population considerations (birth assigned gender, age, other medical comorbidity considerations) FDA approval indications Typical dosing with discussion on therapeutic endpoints for psychiatric use Major drug–drug interaction