Case Study Scenario Explained for Students (Easy Guide)
Students often encounter this when studying fundamental concepts.
What This Question Is About
This question relates to case study scenario and requires a structured academic response.
How to Approach This Question
Structure your response with introduction, analysis, and conclusion.
Key Explanation
This topic involves case study scenario. A strong answer should include explanation, application, and examples.
Original Question
Case Study Scenario S.P. is admitted to the orthopedic ward. She fell at home and sustained an intracapsular fracture of the hip at the femoral neck. The following history is obtained from her: She is a 75-year-old widow with three children living nearby. Her father died of cancer at age 62; her mother died of heart failure at age 79. Her height is 5 ft. 3 in; weight is 118 lb. She has a 50-pack-year smoking history and denies alcohol use. She has severe rheumatoid arthritis (RA) and gastroesophageal reflux disease (GERD) and had coronary artery disease with a coronary artery bypass graft 9 months ago. Since then she has engaged in “very mild exercises at home.” Vital signs (VS) are 128/60, 98, 14, 99° F (37.2° C), Spo2 94% on 2 L oxygen by nasal cannula. Her oral medications are rabeprazole (Aciphex) 20 mg/day, prednisone (Deltasone) 5 mg/day, and methotrexate (Rheumatrex) 2.5 mg/wk. 1. List at least four risk factors for hip fractures. 2. Place a star or asterisk next to each of the responses in question 1 that represent S.P.’s risk factors. Case Study Progress Physician’s Orders Cefazolin (Kefzol) 1000 mg IV q8h × 3 doses. Give last dose no later than 24 hours after anesthesia end time. Enoxaparin (Lovenox) 30 mg subcut q12h, begin at 2200. Warfarin (Coumadin) 2.5 mg PO, starting postoperative day 1, then titrated to international normalized ratio (INR) per pharmacy dosing Docusate and Senna (Peri-Colace) 1 capsule PO bid Multivitamin with iron 1 capsule/day PO with meals Complete blood count (CBC) in morning after blood reinfusion Hydromorphone (Dilaudid) by IV patient-controlled analgesia, intermittent with 0.1 mg dosing, lockout 10 minutes Physical therapist (PT) and occupational therapist (OT) to evaluate on postoperative day 1 and start therapy Ketorolac (Toradol) 15 mg IV q6h prn pain × 5 days only Hip precautions per protocol Ondansetron (Zofran) 4 mg IV q6h prn for nausea Toilet seat extension Straight catheterization if no void by 8 hours postoperatively 3. Why is S.P. receiving enoxaparin (Lovenox) and warfarin (Coumadin)? 4. Why is the antibiotic to be stopped before the anesthesia end time? 5. S.P. had an arthroplasty. For each characteristic listed, mark A for arthroplasty or O for open reduction and internal fixation (ORIF) of the hip. ______a. Also known as total hip replacement. ______b. Metal pins, screws, rods, and plates are used to immobilize the fracture. ______c. Replacement of the entire hip joint with a prosthetic (artificial) joint system. 6. S.P. receives reinfused blood as an intraoperative blood salvage. Which statements about this procedure are true? Select all that apply. a. The blood lost from surgery is immediately re-administered to the patient. b. The blood lost from surgery is collected into a cell saver. c. One hundred percent of the red blood cells are saved for reinfusion. d. This procedure has the same risks as blood transfusions from donors. e. The salvaged blood must be reinfused within 6 hours of collection. 7. List four critical potential postoperative problems for S.P. 8. How will you monitor for excessive postoperative blood loss? 9. According to the posterior surgical approach, there are two main goals for maintaining proper alignment of S.P.’s operative leg. What are they, and how are they achieved? 10. Postoperative wound infection is a concern for S.P. Describe what you would do to monitor her for a wound infection.. 11. Taking S.P.’s RA into consideration, what is the reason for the PT and OT consultations? 12. What predisposing factors, identified in S.P.’s medical history, increase her risk for respiratory complications? 13. What predisposing factors, identified in S.P.’s medical history, place her at risk for infection, bleeding, and anemia? 14. Briefly discuss S.P.’s nutritional needs. Why is she receiving an iron supplement? Case Study Progress Discharge planning began when S.P. was admitted. The case manager who has been working with S.P. and her family is initiating S.P.’s placement in a rehabilitation facility after discharge. She would like to be near her children but realizes that they work and cannot be with her 24 hours a day. 15. What factors need to be taken into consideration by the patient, family, and case manager when choosing a rehabilitation facility? Case Study Outcome S.P.’s daughters visit several facilities. S.P. is admitted to the rehabilitation facility close to one daughter’s home. After 2 weeks, she completes rehabilitation and is discharged to home. Her children check on her every day.
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