Nursing Care Case Studies: Pressure Ulcers, Nutrition, and Respiratory Health
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Q1) Amal has been assigned to care for Mr. Ayman, a 74-year-old client being treated for a urinary tract disorder. Mr. Ayman suffered a cerebro vascular accident (stroke) 6 months ago and has had difficulty ambulating and attending to his own needs because of right-sided weakness. While assessing Mr. Ayman you note that he is thin for his height, is incontinent of foul-smelling urine, and has deeply reddened areas on his right hip, coccyx, and entire peritoneal area. Mr. Ayman is alert and oriented to person, place, and time, but he has decreased sensation on his entire right side. He spends most of his time in bed or sitting at his bedside in a chair due to his difficulty with ambulation.
a. What independent measures can Amal take to protect Mr. Ayman's skin from further breakdown?
b. Considering that Mr. Ayman does not have any areas of skin breakdown, why is it important to institute treatment for pressure ulcers at this time?
Q2) Mrs. Rania, a 59-year-old homemaker, attends a community hospital-sponsored health fair. She approaches the nutrition information booth, and the clinical specialist in nutritional support gathers a nutritional history. Mrs. Rania is very upset about her 9-kg (20-lb) weight gain. She relates to the nurse clinician that since the death of her husband 1 month ago she has lost interest in many of her usual physical and social activities. She no longer attends YMCA exercise and swimming sessions and has lost contact with her couple's bridge group. Mrs. Rania states she is bored, depressed, and very unhappy about her appearance. She has a small frame and has always prided herself on her petite figure. She says her eating habits have changed considerably. She snacks while watching TV and rarely prepares a complete meal.
a. How do Mrs. Rania's personal characteristics influence her nutritional needs?
b. What further information do you need regarding Mrs. Rania's present diet?
Q3) Dania is a 39-year-old secretary who was admitted to the hospital with an elevated temperature, fatigue, rapid, labored respirations; and mild dehydration. The nursing history reveals that Ms. Dania has had a "bad cold" for several weeks that just wouldn't go away. She has been dieting for several months and skipping meals. Ms. Dania mentions that in addition to her full-time job as a secretary she is attending college classes two evenings a week. She has smoked one package of cigarettes per day since she was 18 years old. Chest x-ray confirms pneumonia.
a. What factors may have led the medical staff to suspect that Ms. Diana had more than a very bad cold? Would you have come to the same conclusion?
b. The care plan appropriately focuses on the acute care of this client. Once she is significantly improved, the nurse will perform discharge teaching. What areas should be included?
c. Mention 3 nursing diagnosis related to dania's condition
This question includes visual content: The image is a printed exam paper from Hebron University, College of Nursing. It contains a header table with fields for Course Name (Fundamental of Adult Nursing 2), Course No. (71212), Instructor Name (Miss Suhair Issa), and Exam Date (14-4-2026). Below the header, there are three numbered case study questions (Q1, Q2, Q3) with sub-questions (a, b, c). The text is black on a white background, and the university logo is at the top center.
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Hi مهند, let's analyze these clinical nursing case studies one by one, focusing on evidence-based practice and patient care.
Nursing Case Analysis
In question one, we have Mr. Ayman, a seventy-four year old stroke patient with right-sided weakness, incontinence, and skin redness. Part A asks for independent measures to prevent skin breakdown.
Question 1: Mr. Ayman
Independent Nursing Measures for Skin Integrity:
- Frequent Repositioning: Turn every two hours.
- Skin Hygiene: Clean and dry immediately after incontinence.
- Support Surfaces: Use pressure-relieving cushions/mattresses.
- Moisture Barriers: Apply barrier creams to the peritoneal area.
- Nutrition/Hydration: Ensure adequate fluid and protein intake.
In part B, we explain why treatment is necessary even without current breakdown. It is because he has multiple high-risk factors: immobility, incontinence, advanced age, and decreased sensation. Prevention is the standard of care to avoid debilitating pressure ulcers.
Now let's look at question two. Mrs. Rania is a fifty-nine year old experiencing grief and lifestyle changes. Part A asks how her characteristics influence her nutritional needs.
Question 2: Mrs. Rania
Influences on Nutritional Needs:
- Psychosocial Factors: Depression and bereavement often lead to emotional eating or loss of appetite.
- Activity Level: Decreased exercise reduces her caloric requirement, contributing to weight gain.
- Habits: Snacking while watching TV leads to 'mindless eating' of low-nutrient foods.
For part B, to get a full picture of her diet, we need a 24-hour food recall, a list of what she snacks on, her fluid intake, and her specific food preferences or allergies.
Necessary Further Information:
1. 24-hour dietary recall.
2. Nutrient density of snacks.
3. Fluid intake levels.
4. Presence of emotional triggers for eating.
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