UNIVERSITY OF SANTO TOMASCOLLEGE OF NURSINGCOMPETENCY APPRAISAL 2

MS CASE # 3

FOCUS OF STUDY:

Care of Client with CVA Care of Client with Spinal Cord Injury Care of Client with Autonomic Dysreflexia Care of Client on complications of immobility Care of Client undergoing Spinal SX Care of Client with Spinal Shock Principles of Rehabilitation for CVA clients & SCI Principles of Emergency nursing

PRE-REQUISITE LEARNINGS:

1. Review of anatomy and physiology of organs involved 2. Pathophysiology of CVA3. Pathophysiology of SCI4. Review of modifiable and non-modifiable risk factors (CVA)5. Pre-operative Nursing Management6. Intra-operative Nursing Management7. Post-operative Nursing Management8. Bioethical Principles involved 9. Rehabilitation principles (PT, OT, SLP, Nursing)

INSTRUCTIONS:1. All Class secretaries will provide the facilitator the CLASS LIST for grading purposes.2. The facilitator will provide the class with Case Scenario/ Case Study a week before the discussion with corresponding focus of study and guidelines.3. Each RLE group will submit their written output before the case presentation in class. This will be graded and counted as part of their presentation grade4. Each student must be ready for learning issues and discussion during the class. This will be graded and counted as part of their participation grade.5. There will be a post test after the class discussion.

Learning outcomes:After studying the case scenario, the student should be able to:1. Identify learning issues2. Utilize the Nursing Process in the plan of care for this client3. Integrate bioethical concepts in the care of your client 4. Integrate psychosocial aspects of careCase Scenario #3PART I - A 26 years old male was brought into the ER by EMTs and paramedics via ambulance after being involved in a MVA 2hours ago. EMTs stated that patient was noted to be intoxicated at the scene of the accident and with DUI. The patient was noted to be lethargic, knows own name only, does not know where he is and does not know the current date and not able to able to follow simple commands. VS 100/60, PR 90/min, RR 22/min, temperature 37 degrees Centigrade axillary, complained of throbbing generalized pain with numerical scale 7/10. Further assessment yielded rib fractures of right ribs 3rd to 5th and open fracture at right tibia and comminuted fractures at right hip ; burned areas all described as white dry leathery areas at right side of the face, right shoulder, front abdomen and right lateral thigh. Pulse oximetry reads at 91%. The patient also has multiple lacerations on his arms and legs namely: left forearm measuring 7cm X 4cm X less than 0.1cm; left upper arm measuring 3cm X 3cm X 5cm; left shin measuring 5cm X 2cm X 1cm ; right medial thigh measuring 8cm X 1cm X 0.5cm. All the lacerated areas described as with red wound bed 100% with sanguinous drainage, non-foul. Additionally, the patient also sustained a SCI T6 to T8 Fracture ASIA C . The patient is 56 with ABW of 165 lbs. The patient is directly admitted to the ICU.

PART II- CASE SCENARIO ON CVA WILL BE GIVEN IN THE CLASSROOM CA-2 2015