NUR411 CASE STUDY QUESTIONS

Case Study 1 Fluid & Electrolyte Balance (12marks)

Sam, 50years old was admitted to the Men’s’ Medical ward with a urinary problem. Ha had an
intravenous (IV) line in-situ. He was receiving IV fluid that had more salt content in it. He started
complaining of shortness of breath after half of the In fluid had been infused. A blood sample was then
taken from him for further investigation with part of the results as follows:

 Sodium (Na) level: 157mEq/L

 Potassium (K): 4.7mEq/L
 Chloride (Cl): 101mEq/L

Questions

Dissolved substances in the blood plasma can easily move out of the bloodstream and into the
interstitial fluid surrounding the cells.

1. Will the IV fluid given to Sam increase or decrease the saltiness of the interstitial fluid? Explain
(3marks)After receiving the IV fluid the saltiness of the interstitial fluid will increase due to the
amount of salt in the IV fluid and the permeability of the interstitial fluid
2. With your knowledge of osmosis, will this cause the cells in the body to increase or decrease in
size? Explain your answer. (3marks) Increase because the concentration of the salt from the IV
fluid is high and will try to fill the cells until it has equal concentrations
3. How would the increase in salt load affect Sam’s blood-aldosterone level? (3marks)It will elevate
blood sodium ions and inhibit release of aldosterone. Excessive aldosterone hormone is
released in the urine.
4. For the blood levels listed above state whether the values are normal or abnormal. (3marks)
Sodium-abnormal
Potassium-normal
Chloride-abnormal

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Case Study 2 Infectious Disease (22marks)

Disturbances in one body system can affect the other body systems.

Valerie, 36years old was diagnosed with an infectious disease after being seen by a doctor. During the
past three(3) weeks she had complained of increasing cough from dry to wet, shortness of breath at
times, on and off fever, muscle weakness, feeling cold at times even though the weather if hot,
sleeplessness and not eating well.

Vital Signs taken:

Temp: 98.6˚F

Pulse rate: 11 beats/min

Respiratory rate: 26breaths/min

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BP: 120/70mmHg

Questions

1. Convert 98.6˚F to degree Celsius. 98.6°F minus 32 and divide by 1.8 is equal to 37°C
(2marks)
2. List all the abnormal observations recorded in the case study. (7marks)Not eating well, feeling
cold during hot weather, on and off fever dry to wet cough, weak muscles, insomnia, shortness
of breath, pulse
3. Illustrate the stages of infectious disease outlining the span of days for each stage. (5marks)
4. Briefly describe what happens in each stage of the disease (8marks)

Case Study 3 Infection Control (20marks)

Kerstin, 46years old is admitted to the Isolation Unit of the hospital.

Nursing a patient in the isolation unit requires strict nursing care protocols.

Questions

1. Discuss isolation nursing. Isolation nursing is carried out by placing the patient in a single room o
To reduce the risk of spreading certain infections or antibiotic resistant germs to
other patients and staff.
To protect patients from infection if they have a weak immune system due to
disease or taking certain drugs. (5marks)
2. Using the table below explain what the nurse should do for each of the issues outlined. (8marks)

Issues/Problem Nursing Intervention/Action

i. Handwashing
ii. Prevention of cross infection
iii. Disposal of dirty linen
iv. Disposal of used IV lines & IV cannula
Washing hands with soap and water in an
isolated area sink
Disposing all PPE properly
Have a very own bag for dirty linen and must
be washed without other linens
Once disposed if possible to seal the bin and
empty until collecte

3. To curb the spread of the infectious disease nurses should understand the characteristics of the
causative organism.
In Kerstin’s case the causative organism is a virus.

Describe the characteristics of a virus. Viruses are infectious agents with both living and nonliving
characteristics Living characteristics of viruses include the ability to reproduce – but only in living host
cells – and the ability to mutate.

Nonliving characteristics include the fact that they are not cells, have no cytoplasm or cellular
organelles, and carry out no metabolism on their own and therefore must replicate using the host cell's
metabolic machinery.

Viruses can infect animals, plants, and even other microorganisms.

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Since viruses lack metabolic machinery of their own and are totally dependent on their host cell for
replication, they cannot be grown in synthetic culture media.

(3marks)
i. How can a virus be potent? The virus itself has been evolving in the host to not get
defeated by the immune system (2marks)
ii. Why don’t antibiotics work for Kerstin? The odd makeup of these infectious agents is
part of what makes them difficult to defeat. Compared to other pathogens, such as
bacteria, viruses are minuscule. And because they have none of the hallmarks of living
things — a metabolism or the ability to reproduce on their own, for example — they are
harder to target with drugs. (2marks)

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Taniela Gavidi

210902

NUR411