NUR 200 Week 9 Practice Case Study

Mr. Ventura is 83-years-old widowed male with four children and eight grand-children. He enjoys
working in his yard and his garden every day during the spring and summer months, and attending
church on Sundays. His neighbor brought him to the local urgent care center because she found him
sitting on the front steps of his house confused to time and place, shaking, and agitated. She states she
was shocked to find him this way because he is normally outside tending to his vegetable garden.

Upon arrival to the urgent care center, the nurse’s assessment reveals Mr. Ventura has become
increasingly drowsy and complains of the room spinning making him nauseous. He denies pain. Breath
sounds are clear bilaterally. Current vitals: HR 98 bpm, BP 170/90, RR 16 rpm and non-labored, T 98.2F.
The neighbor reports that Mr. Ventura’s wife of 60 years died three months ago and she is concerned
about his health since he now lives alone and his wife managed most of the household activities. Patient
history reveals Mr. Ventura has DM II, HTN, hyperlipidemia and BPH. His medication record shows:
Metformin 500mg bid, Lisinopril 5mg daily, Lipitor 10mg daily, and Flomax 0.4mg daily. Admission lab
tests completed and resulted: HgbA1c - 10%, FSBS serum glucose – 82mg / dL, urinalysis – negative
protein / negative ketones.

After the nurse administered 1mg of glucagon IM, the FSBS showed the serum glucose now 124mg / dL.
Mr. Ventura is alert, oriented and communicating appropriately. He states that he has many hobbies like
gardening, fishing, and painting so sometimes he gets busy with his activities during the day and before
he realizes it he has forgotten to eat. He reports that since his wife died he only eats maybe one meal a
day.

The nurse reinforces diabetic teaching and Mr. Ventura says “I remember most of this. I think I just
needed a little reminder”. The nurse asks Mr. Ventura “would you be willing to meet with our nurse case
manager and our diabetic educator to help you manage your diabetes”. Mr. Ventura says “I think that
would be a great idea to help me.”

Upon discharge, the nurse lets Mr. Ventura know to call his PCP for a follow-up appointment in one
week. Mr. Ventura verbalizes understanding.

Tanner’s Clinical Judgment Step Definition of Thinking Skill Application of Thinking Skill to
Case Study
Identifying signs and symptoms

Gathering Complete and

Accurate Data

Assessing Systematically and

 NUR 200 Week 9 Practice Case Study

Comprehensively

Predicting (and Managing)

Potential Complications

Identifying Assumptions

Comparing and Contrasting Data

Clustering Related Information

Recognizing Inconsistencies

Checking Accuracy and

Reliability

Distinguishing Relevant from 1. Relevant:

Irrelevant Information

2. Irrelevant:

Determining the importance of

information
 NUR 200 Week 9 Practice Case Study

Judging How Much Ambiguity is

Acceptable

(Predicting and) Managing

Potential Complications

Respond

Reflect