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Case Presentation
Chiyo Nakamura is an 87-year-old woman who was admitted 1 day ago to an inpatient rehabilitation hospital following an open reduction, external fixation for a hip fracture at a large medical center. Upon transfer, her condition was described as stable and her appetite and level of mobility since surgery were reported as “limited” citing ongoing postoperative pain as a barrier to ambulation.
Mrs. Nakamura’s current vital signs are as follows: temperature, 99.1°F; blood pressure, 150/78 mm Hg; heart rate, 100 beats/min; and respiratory rate, 24 breaths/min and shallow. Upon auscultation, the nurse hears subtle crackles in the lower lobes of both lungs. The nurse reflects on these findings in the context of risk factors and recognizes that Mrs. Nakamura may have atelectasis as a postoperative complication.
The nurse knows Mrs. Nakamura needs to deep breathe, increase activity as tolerated, and increase fluid intake. The nurse asks her to use the incentive spirometer and notices she is moving only 800 mL of air. The nurse emphasizes the importance of using the incentive spirometer approximately 10 times every hour while awake to help get air into her lungs. Together, they agree on a goal of moving 1500 mL using the spirometer. The nurse also talks with Mrs. Nakamura about giving her pain medication to make movement more tolerable. After receiving pain medication, Mrs. Nakamura is assisted to sit on the side of the bed, then walks a few steps to a wheelchair, and then goes to a community room for breakfast. Later in the morning, Mrs. Nakamura ambulates in the hallway with assistance from a physical therapist. After ambulating, she reports feeling quite short of breath and is anxious to return to her bed.
Concept Mapping Spring 23 edits
Concept Mapping Spring 23 edits
CriteriaRatingsPts
This criterion is linked to a Learning OutcomeDisease Process and Pathophysiology Risk Factors
5 ptsSatisfactory
Learner performs a thorough review of the disease process pathophysiology; identifies risk factors.
3.5 ptsBeginning
There are critical aspects of pathophysiology missing. This entry is incomplete.
0 ptsUnsatisfactory
The pathophysiology information is missing.
5 pts
This criterion is linked to a Learning OutcomeRecognizing CuesWhat matters most?
5 ptsSatisfactory
Based on available patient data, the learner identifies at least four (4) critical cues that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
3.5 ptsBeginning
Based on available patient data, the learner identifies two (2) or three (3) critical cue(s) that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
0 ptsUnsatisfactory
Based on available patient data, the learner identifies zero (0) or one (1) critical cue(s) that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
5 pts
This criterion is linked to a Learning OutcomeAnalyzing CuesWhat could it mean?
5 ptsSatisfactory
Based on the identified cues, the learner is able to create three (3) – four (4) supporting connections between the relevant cues and client conditions/problems.
3.5 ptsBeginning
Based on the identified cues, the learner is able to create two (2) supporting connections between the cues and patient condition/problems.
0 ptsUnsatisfactory
Based on the identified cues, the learner is able to create one (1) or zero (0) supporting connection(s) between the cues and patient condition/problems.
5 pts
This criterion is linked to a Learning OutcomePrioritizing HypothesesWhere do I start?
5 ptsSatisfactory
Based on the identified connections between cues and patient conditions/problems, learner is able to identify and rank three (3) client conditions/problems critical to positive patient outcomes. These should be listed with most urgent problems first.
3.5 ptsBeginning
Based on the identified connections between cues and patient conditions/problems, learner is able to identify and rank two (2) client conditions/problems critical to positive patient outcomes. These should be listed with most urgent problems first. This point value is also chosen if client/problems are not listed with the priority concern(s) first.
0 ptsUnsatisfactory
Based on the identified connections between cues and patient conditions/problems, learner identifies zero (0) or one (1) client conditions/problems critical to positive patient outcomes.
5 pts
This criterion is linked to a Learning OutcomeGenerating SolutionsWhat can I do?
5 ptsSatisfactory
List five (5) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. Outcomes/goals are listed in the SMART format.
3.5 ptsBeginning
List three (3) to four (4) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. Outcomes/goals are listed in the SMART format.
0 ptsUnsatisfactory
List zero (0) to two (2) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. This point value is also chosen if outcomes/goals are not listed in the SMART format.
5 pts
This criterion is linked to a Learning OutcomeTaking ActionsWhat will I do?
5 ptsSatisfactory
Describe how each of the five (5) identified nursing interventions will be performed, implemented, administered, communicated, or taught.
3.5 ptsBeginning
Describe how three (3) to four (4) of the identified nursing interventions will be performed, implemented, administered, communicated, or taught.
0 ptsUnsatisfactory
Describe zero (0) to two (2) of the identified nursing interventions will be performed, implemented, administered, communicated, or taught.
5 pts
This criterion is linked to a Learning OutcomeEvaluating OutcomesDid it help?
2.5 ptsSatisfactory
Describe how you will determine the effectiveness of the five (5) priority nursing interventions you implemented. How will you know if your interventions are effective or not?
1.5 ptsBeginning
Describe how you will determine the effectiveness of three (3) to four (4) priority nursing interventions you implemented. How will you know if your interventions are effective or not?
0 ptsUnsatisfactory
Describe how you will determine the effectiveness of zero (0) to two (2) priority nursing interventions you implemented.
2.5 pts
This criterion is linked to a Learning OutcomeNursing Process template
2.5 ptsSatisfactory
Recognizing the completion of this template will assist the learner with the concept map assignment, all six (6) boxes are thoroughly completed. The SBAR information is thoroughly identified, and the chosen concept for the assignment is clearly identified.
1.5 ptsBeginning
Information is missing from one (1) to three (3) box(es). The SBAR information is thoroughly identified, and the chosen concept for the assignment is clearly identified.
0 ptsUnsatisfactory
Information is missing from four (4) to six (6) boxes. This point value is also chosen if the SBAR information is missing and/or the chosen concept for the assignment is not identified.
2.5 pts
Total Points: 35
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