How to Answer Using Case Study Questions (Complete Guide)

This question tests key academic concepts commonly covered in coursework.

What This Question Is About

This question relates to using case study and requires a structured academic response.

How to Approach This Question

Start by identifying the main issue, then apply relevant academic frameworks.

Key Explanation

This topic involves using case study. A strong answer should include explanation, application, and examples.

Original Question

Using the case study data in the article, Appropriately cluster the data into categories and identify your data as normal or abnormal. Develop two appropriate nursing diagnoses from the case study. For each diagnosis statement, include three interventions and three outcomes. Develop two “Risk For” Diagnoses One for physiologic factors One related to psychosocial factors Case study Ms. Z is a 67-year-old retired physical education teacher in a local high school. She is a widow and lives at home with her son and grandson. Ms. Z presented to her primary care practitioner with a chief complaint of chronic lower abdominal pain, lack of energy, abdominal bloating, and constipation alternating with diarrhea. She has had significant changes in her bowel habits, including difficulty moving her bowels, but has bouts of frequent soft stools. She denies nausea and vomiting, but has occasional fevers and believes she may have caught a virus from a student. Ms. Z visited a gastroenterologist for complaints of lower abdominal pain 3 months ago, which seems worse on the lower left side. The gastroenterologist ordered a barium enema, which was negative except for diverticulosis. Her last colonoscopy was 4 years ago. It, too, was negative except for moderate diverticulosis. She is being treated for hypertension and arthritis, which are well managed with medication. Ms. Z visits her primary care practitioner every 4 months for followup of hypertension; otherwise, she is in very good health. She admits to being overweight and plans to manage her diet and nutrition better. Ms. Z has an occasional glass of wine with her meals and perhaps 1- 2 drinks at social events, and does not smoke. She has a surgical history of a knee replacement 2 years ago and is ambulating well now. She travels frequently and has an active social life. Her last trip was to Eastern Europe, where she visited several countries for about a week. She attends a nearby church occasionally and is active in civic groups. Ms. Z works part-time as a basketball coach and substitute teacher which, along with her pension, is more than adequate for her financial support. Both of her parents are deceased, with her father having died of a stroke at the age of 72. Her mother passed away at the age of 56 with a diagnosis of colon cancer. The review of systems is negative for any other complaints except for arthritis of her knees and back. She denies headaches, dizziness, and problems with vision, but has mild hearing loss. No complaints of chest pains, palpitations, shortness of breath on exertion, or cough. She has no problems with urination. She is 16 years postmenopausal and denies any vaginal bleeding. She has no problems with gait or balance and denies frequent falls. She states that she has had several bone density scans and was told she had mild osteopenia in her right hip. Ms. Z has had several colonoscopies; the last was 4 years ago and was negative for cancerous growths or polyps (see Figure 2.5.1). She was told she had diverticulosis throughout her colon. No history of diabetes or other endocrine problems. She denies having emotional or mental problems; she occasionally experiences bouts of anxiety which may interfere with sleeping. Ms. Z has experienced intermittent abdominal cramping, bloating, flatulence, and constipation over the past 4 months. Sometimes she has a constant ache, which is relieved by evacuation. Lately she has experienced increased pain in her lower coach and substitute teacher which, along with her pension, is more than adequate for her financial support. Both of her parents are deceased, with her father having died of a stroke at the age of 72. Her mother passed away at the age of 56 with a diagnosis of colon cancer. The review of systems is negative for any other complaints except for arthritis of her knees and back. She denies headaches, dizziness, and problems with vision, but has mild hearing loss. No complaints of chest pains, palpitations, shortness of breath on exertion, or cough. She has no problems with urination. She is 16 years postmenopausal and denies any vaginal bleeding. She has no problems with gait or balance and denies frequent falls. She states that she has had several bone density scans and was told she had mild osteopenia in her right hip. Ms. Z has had several colonoscopies; the last was 4 years ago and was negative for cancerous growths or polyps (see Figure 2.5.1). She was told she had diverticulosis throughout her colon. No history of diabetes or other endocrine problems. She denies having emotional or mental problems; she occasionally experiences bouts of anxiety which may interfere with sleeping. Ms. Z has experienced intermittent abdominal cramping, bloating, flatulence, and constipation over the past 4 months. Sometimes she has a constant ache, which is relieved by evacuation. Lately she has experienced increased pain in her lower left side. She has frequent constipation alternating with diarrhea. Usually symptoms appear several hours after eating and upon awakening in the morning. She has not observed any blood in her stools and denies any nausea and/or vomiting. Her medications include Norvasc, 5 mg per day; hydrochlorothiazide, 25 mg per day; Celebrex, 200 mg per day; and alendronate, 75 mg 1 tab per week. She has no known allergies (NKA). Ms. Z is conscious, alert, and oriented, but appears listless at times. She responds well to questions. Vitals are temp: 100; heart rate: 92; BP: 132/80. HEENT: Mild hearing loss, otherwise negative. Chest: Heart and lungs are negative. GI: Skin clear with no scars or lesions on observation; umbilicus in midline; abdomen soft, palpable; tenderness on palpation LLQ; no rebound tenderness RLQ; diminished bowel sounds in LLQ; no masses on palpation. GU and GYN: Negative for urinary and gynecologic problems. Diverticulosis: Ms. Z’s abdominal complaints are consistent with her earlier diagnosis of diverticulosis on a previous colonoscopy and barium enema; however, her low-grade fever may be indicative of an infectious process. To avoid complications such as perforated diverticula, the practitioner should avoid a repeat colonoscopy and/or barium enema at this time. Arthritis: Although unrelated to her diverticulosis, any joint pain may indirectly affect her mobility and proper meal preparation. Vital signs, CBC, urinalysis, sedimentation rate, serum electrolytes Stool for occult blood, bacteria, ova, and parasites Contrast enhanced CT scan (CT colonography) Transabdominal ultrasound Usually a colonoscopy and /or a barium enema are recommended for suspected diverticulosis for differentiation from diseases with similar symptoms; however, because diverticulitis is suspected, these tests should be avoided due to the danger of perforation (Interpretations, 2009; Jacobs, 2007). CT scanning with contrast and ultrasound are the recommended diagnostic tests for diverticulitis (Kang, Melville, & Maxwell, 2004; Lameris et al., 2008; Sartelli, 2010). It is important to rule out peritonitis, as this is an acute condition and requires imme­ diate care. If peritonitis is suspected, call a physician immediately. Laboratory tests include a complete blood count to determine a low red cell count and elevated white cell count. In diverticulitis, the white cell count is elevated with a shift to the left. Stool tests for occult blood will help to determine hemorrhaging; however if guaiac is positive, further testing is necessary to determine if cause is perforated diverticula. Since Ms. Z has a history of travel outside of the U.S, stool testing for ova and parasites will determine whether there is a presence of parasites in her intestines. She has a low grade fever (99°F); however, older adults may not present with an elevated temperature in the presence of infection. Urinalysis and culture and sensitivity tests can be ordered to determine the presence of a UTI. A diagnosis of uterine or ovarian tumors or cancer can be verified on ultrasound; however, no masses were detected. Serum electrolytes will determine if the patient is dehydrated. The primary care practitioner obtained a copy of Ms. Z’s last colonoscopy. One can see the areas of diverticula in all 4 segments of the large intestine. CBC revealed an elevated white cell count of 15,000 with a shift to the left; however, sedimentation rate and C-reactive protein were within normal limits. The urinalysis was negative for white cells and bacteria. Stools were negative for blood, ova, and parasites. Ultrasound for abdominal and uterine masses was negative. CT colonography revealed severe diverticulosis throughout the colon with no evidence of perforation.

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."