Case analysis

CASE SCENARIO #1

1. Mr. Z. is a 57 year old complaining of dyspnea. The nurse perform an assessment that includes the
following findings:

a. Onset: approximately 1 month ago

b. Duration: daily for 1 month

c. Other symptoms: no complaints of chest pain; patient complains of fatigue

d. Respirations: 28 breaths/min non labored

e. Color: pink

f. Auscultation: diminished breath sounds in the bases bilaterally with wheezing on expiration

Ø Analyze the above data, determine what relevant data are missing, and explain the importance of
collecting the additional data.

Ø Identify possible nursing diagnosis of this client

Ø Make a nursing care plan

CASE SCENARIO #2

2. Mrs. T. is a 65 year old woman admitted with pneumonia. On physical assessment, the nurse
documents the following findings:

a. Medium-pitched breath sounds heard on inspiration and expiration between the scapulae

b. Loud, clear auscultation of whispered “1,2,3”

c. Increased fremitus

d. Dull percussion

e. Bronchial breath sounds heard over left lower lobe

Ø What is the significance of medium-pitched breath sounds heard between the scapulae?

Ø Auscultation of voice sounds can be elicited by what two methods/

Ø How would you interpret the findings of whispered pectoriloquy in this patient?

Ø Identify possible nursing diagnosis for this client and make a nurse care plan

CASE SCENARRIO #3

3. You are the nurse in an outpatient where a 32 year old female client has come for ongoing medical
treatment. She tells you that she has had asthma since she was a young child. While speaking with the
client, you notice that she is exhibiting mild wheezing and a productive cough. She appears slightly pale.

a. What additional assessment questions should be asked of this client?

b. Identify a possible nursing diagnosis for this client

c. What nurse-initiated actions may be taken at this time?

d. Identify general information that should include in client teaching for promoting oxygenation

e. Make a heath teaching program for this client