case study help!!!?

Esme12, ASN, BSN, RN · Mar 25, 2013

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What do you think you are reading into? What do you think it means?

This is a complicated patient. How would you care for a patient with multiple invasive lines/ Does that increase their risk of infection?

What happens with bacterial meningitis? How do you care for a patient having seizures? What would cause these seizures in a patient with meningitis? What does the increase of the ICP mean (increase Inter-cranial pressure)?

What does an increased ICP mean? How does that relate to your diagnosis of Bacterial meningitis?

How is elevated ICP treated? What meds are used to lower the ICP? What complications are caused by these meds?

How does the diabetes affect his healing? What medications might be ordered to decrease the ICP but have a detrimental affect on the glucose?

How does being a kidney transplant recipient complicate the recovery or increase this patients risk of infection?

Is this a real patient? What is your assessment of this patient?

karebear13 · Mar 25, 2013

Unfortunately it is not a real patient to put hands on and a chart in front of you. Our textbook is a newer edition than the book we get our case studies from so the research for answers is relentless and very frustrating.

karebear13 · Mar 26, 2013

I tend to over analyze questions and think them through to much and end up missing the point all together. Thanks for the.pointers

guest042302019, BSN, RN · Mar 26, 2013

I have a case study regarding bacterial meningitis and aspiration pneumonia. Pertinent medical history is patient is insulin dependent type 2, HTN, kidney transplant, peptic ulcers. Currently intubated and aggressive antibiotic therapy.

I am having trouble with a question..... outline the nursing management of current problems related to his risks for infection, seizures, increases ICP, hypovolemia, and acute pain.

I may be reading to much into the question , but if someone can point me in right direction would greatly appreciate

Firstly, don't give yourself toooo hard of a time here. This patient would be in the ICU. Lets face it, you aren't a super dooper expert. And, there would probably be many opinions about how to take care of this patient. When you say looking up answers, I bet there are many acceptable answers here within reason. The point is for you to consider priorities and create a care plan. I used to overthink case studies big time. Way too analytical. That's how my mind works. But, I did get better over time as I settled into the nursing frame of mind. Lets find the "point" and look at your case study. This is how I would approach it. I'm no expert so don't me too hard of a time here. HAHA. :)

Diagnosis: Bacterial Meningitis, Aspiration Pneumonia

PMH: Diabetic Type 2, HTN, Kidney transplant, peptic ulcers

Treatments: intubated, ATB therapy

Nursing Management: Risk for infection, Seizures, Increased ICP, Hypovolemia, Acute Pain

My thinking. First, one must prioritize this mess. In terms of maslow, I would prioritize Increased ICP or Hypovolemia first. It is difficult to determine is MORE important. I would say protect brain structures first then take care of fluid issues.

So, priorities could be:

Increased ICP

Hypovolemia

Seizures

Risk for Infection

Acute Pain

Then, go from there. Firstly, we have no physical assessment information. That's okay. Create your hypothetical care plan without it. Start with your first priority nursing diagnosis, determine interventions, and go from there. As far as goals, you can created hypothetical ones there too. While goals are very specific and objective, you could write almost anything you want as long as they are reasonable and measurable. Don't forget to consider PMH when creating your plan. How does intubation, kidney transplant, and diabetes relate to risk for infection? How does diabetes, HTN, Kidney transplant, and meningitis relate to increased ICP or hypovolemia? Seizures and meningitis? Meningitis and risk for infection? meningitis and pneumonia and acute pain? Almost forgot, how does peptic ulcers relate to hypovolemia or acute pain or potentially risk for infection?

Sometimes, creating a visual map or concept map of a complex problem is useful. Hope this helps.

-Andrew

nurseprnRN, BSN, RN · Mar 26, 2013

The OP asked to be pointed in an effective direction to obtain further information. Andrew has helpfully done most of your work for you.

I was going to suggest seeing what your med/surg textbook has to say about care for the things you describe: infection, seizures, increased ICP, hypovolemia, and acute pain. I am dead certain sure that each of those will have entries in the index and point you to nursing monitoring and interventions.

Your NANDA-I 2012-2014 will also have useful information on these for you, under Safety, Elimination/Exchange, Nutrition (this is where the hydration and fluid balance comes in), Activity / rest (cardiovascular and pulmonary responses). Let us know what you find out there.

Esme12, ASN, BSN, RN · Mar 26, 2013

I agree with GrnTea Andrew has been very helpful in doing most of the work....however that will not help make you the best nurse you can be.......our goal is to mkae you the best nurse you can be....help you develop your critical thinking skills so that when you graduate you will be ready for the nursing world and the NCLEX.

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